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Lichen planus

Lichen planus is a chronic skin disorder that can affect the skin, oral cavity, genitals, scalp, nails or esophagus. The symptoms vary depending on where on the body it is triggered. The condition most often affects women around menopause.

Lichen planus

Lichen planus is a chronic skin disorder that can affect the skin, oral cavity, genitals, scalp, nails or esophagus. The symptoms vary depending on where on the body it is triggered. The condition most often affects women around menopause.


What is lichen planus?

The condition on the skin is characterized by small, flat skin rashes. These are often red or purple in color and cause severe itching. This can occur on the wrists, arms, thighs, calves and the area around the tailbone. If it is triggered on mucous membranes, the symptoms are different. White spots and streaks will appear in the mucous membranes. In some cases, it can also develop into painful sores. This is common orally, especially on the inside of the cheeks.


The condition can come on acutely with a very itchy rash, but it can also have a slower and less itchy onset. Spread of rash can be between 2 to 16 weeks.


Oral lichen planus

Oral lichen planus affects the mucous membranes in the oral cavity, and is a common form of lichen planus. It is not uncommon to be affected in several places, and around half (30 - 60%) of all people with oral lichen planus also experience symptoms in the skin.


Cause of lichen planus

The cause is unknown, but there is a theory that it is due to an abnormal immune response. This means that the immune system mistakenly attacks cells in the skin or mucous membranes. The disease often has a somewhat uneven and fluctuating course, and both stress and depression can trigger and worsen the skin disorder.


Triggering factors that can increase the incidence are:


  • Hepatitis C infection

  • Ulcerative colitis

  • Vitiligo

  • Dermatomyositis

  • Lichen sclerosis

  • Myasthenia gravis

  • Stress - especially in oral lichen planus

  • Depression - especially pronounced in oral lichen planus


Symptoms lichen planus

The symptoms are different depending on where on the body it is triggered.


The symptoms on the skin are:


  • Itch.

  • Flat rashes up to 1 cm in size.

  • Small areas of rash.

  • Red or purple rash with a smooth, shiny surface. This can occur on the wrists, arms, thighs, calves and the area around the tailbone.


Symptoms of nail are:


  • Nail changes.

  • Longitudinal lines on the nail.


Symptoms of mucous membranes are:


  • White spots and stripes.

  • Redness.

  • Can develop into painful ulcers.

  • Eruptions in the oral cavity (oral) can be completely painless, but they can also be burning and painful.


In mucous membranes, it most often affects the inside of the cheeks, but it can also occur in the abdomen, and then in and around the vagina in women and on the head of the penis in men.


Disease course in lichen planus

Most people experience a good prognosis and the symptoms disappear within 1-2 years. If the condition affects the oral cavity (orally) or mucous membranes, it is more likely that the condition is experienced as chronic and recurrent. Oral lichen planus in particular can be more persistent and resistant to treatment.


Good advice for lichen planus

Do not scratch or scratch the rash as this will increase the chance of infection.

Wash and dry your skin gently.

Have good oral hygiene if you have lichen planus in the oral cavity (orally). Brush your teeth with a soft toothbrush morning and night. Use dental floss/toothpicks or an interspace brush, in addition to fluoride rinse.

Get good advice on mouth care here.


Treatment of lichen planus

The aim is to relieve the symptoms and reduce the inflammation. The treatment is different depending on which part of the body is affected and the extent of the symptoms. Some people need to try different treatments to find out which one works best for them.


You can get prescription treatment from the doctor:


  • In case of severe itching, either local or systemic steroids are used. Your doctor will determine what is best for you.

  • There are also immunosuppressive drugs that suppress or inhibit the immune system.

  • Retinoids may be relevant if you do not get an effect from other medicines.

  • Antihistamines may be considered by your doctor.

  • Other types of treatments such as light treatment, tar baths and PUVA can also be tried.


Sources: UpToDate, Norwegian drug handbook, Norwegian electronic medical handbook, Norwegian Tannlege Tidende

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