Lichen planus

What is lichen planus?

Lichen planus is a rash that can be found in various parts of the body, including the mouth and insides of the arms and legs. The words lichen planus can be translated, with ‘lichen’ meaning small bumps on the skin, and ‘planus’ meaning flat. It’s not infectious and is not usually found in children. 

What are symptoms of lichen planus?

Lichen planus looks like a shiny, flat-topped raised area of skin. The rash is usually a purple-pink colour and sometimes has white lines across the surface. 

The most common areas affected include the insides of your wrists and ankles, also known as the flexor surfaces, as well as the palms and genitalia. 

It sometimes is very itchy. 

It can also affect the mouth, where it’s called oral lichen planus. This can can follow 3 patterns:

• Reticular: white lines in a web-like pattern over the affected area 

• Plaques: large white patches of skin in the mouth

• Erosive lesions: the inside of the mouth is bright red and might feel quite sore and painful 

Oral lichen planus can come with symptoms like burning or stinging when drinking, ulcers forming, or tenderness and bruising of the gums. It’s usually not itchy.

Rarely, lichen planus can appear in areas where you’ve been injured. This is called 

Koebner’s response, and can sometimes leave a scar darker than the rest of your skin. 

What causes lichen planus?

The cause of lichen planus is not completely certain, but it’s thought to involve the body making cells that attack itself, called an autoimmune condition. It may be triggered by infections caused by certain viruses, such as hepatitis C, the herpes simplex virus and the varicella zoster virus (which usually causes chickenpox). It may also be linked to stress or anxiety. 

Who is commonly affected by lichen planus? 

Lichen planus can affect anyone, but it’s more likely to occur if 

• You’re between the ages of 40 and 60

• You’re male

• You’re of Indian ethnicity

How is lichen planus diagnosed?

A GP will examine your skin and address any concerns you have. In some instances, it can be difficult to differentiate between lichen planus and other skin conditions, such as eczema, so your GP might refer you to a dermatologist for testing.

How is lichen planus treated?

Lichen planus usually heals by itself within 18-24 months, but there are treatments to help relieve any symptoms. Some types of lichen planus take a longer while to heal, like when it appears around the nails, the mouth or genitalia. 

If the lichen planus is moderately severe, a GP might prescribe a steroid cream to apply to the affected area. These usually act to reduce any itchiness or redness.

If the lichen planus is more severe or affects a large area of your skin, a GP might prescribe steroid tablets. They may also refer you to a dermatologist for a stronger treatment.

It might be helpful to make changes to your lifestyle, such as stopping or reducing the amount you smoke and your alcohol intake. If you have oral lichen planus, avoid foods that might aggravate it, like anything crispy, spicy, acidic, hot or caffeinated. 

Does lichen planus return once treated?

In some people, lichen planus does not return at all once it has resolved. In others, it might leave areas of darker skin where the rash once was. In some people, it might unfortunately return despite treatment. 

When should I seek help?

If you notice any changes to your skin and have any concerns or worries at all, see a GP.

How can Livi help?

A Livi healthcare professional can examine your skin and may provide advice,  prescribe a treatment or refer you to a specialist if needed. Lichen planus can be diagnosed by looking at the skin. If lichen planus is suspected then your Livi healthcare professional can discuss management with you.