Lichen planus is a skin disease and oral lichen planus is a mouth disorder of the mucous membrane. It is not contagious nor generally a major health concern.
On your skin lichen planus often causes purplish, itchy skin bumps. And in your mouth it typically causes red, gray or white lesions.
Commonly, lichen planus strikes during middle age, without a definitive cause. However, it may be associated with hepatitis C and several other disorders.
Certain allergens, chemicals or medications also seem to be correlated to lichen planus development, including
- dyes
- arsenic
- iodides
- diuretics
- antibiotics
- quinidine ~ treat arrhythmia
- antimony ~ treat leishmaniasis
- gold ~ treat rheumatoid arthritis
- phenothiazines ~ treat mental illness
- chloroquine, quinacrine ~ treat malaria
Some evidence suggests lichen planus is an autoimmune condition.
Your skin bump or mouth lesion symptoms may appear different from your fellow sufferer. As lichen planus skin bump symptoms may constitute one or more of the following:
- itchy
- 2-4 cm in size
- single or cluster
- large, flat top lesions
- white scales or flakes
- symmetric appearance
- shiny or scaly appearance
- develop at site of skin trauma
- covered with fine white streaks
- affects previous cut or burn area
- lesions have distinct, sharp borders
- color ~ purple or reddish purple bumps
- possible development of blisters, ulcers
- linear scratch marks called Wickham’s striae
- typical locations ~ inner areas of the wrist, forearms, legs, ankles, torso, genitals
Your oral lichen planus lesion symptoms may entail one or more of the following:
- red, open sores
- lesions rarely on the gums
- gradually increases in size
- looks like lacy white patches
- tender, painful, no discomfort
- shiny, red, slightly raised lesions
- occasionally lesions form painful ulcers
- typical locations ~ tongue, inside cheek
- poorly defined area of blue white spots or pimples
- linear lesions forming a lacy looking network of lesions
- small, pale raised areas or bumps that form a lacy network
Sometimes oral lichen planus causes no symptoms other than the raised areas and patches, or it can involve your throat or esophagus.
Lichen planus lesions inside your mouth may cause painful sores, making eating difficult. Oral cancer is a potential complication as well.
These other symptoms might be experienced with either type of lichen planus:
- hair loss
- dry mouth
- nail ridges
- sore gums
- brittle nails
- metallic taste
- burning mouth
- mouth feels rough
- hot or spicy food sensitivity
- teeth brushing causes burning, swelling, bleeding, irritation
If you have oral lichen planus, you may or may not have the skin form of lichen planus. And visa versa
While it’s not known what causes oral lichen planus nor lichen planus of the skin, factors that may increase your risk include:
- sex ~ women more likely
- psychological issues ~ stress, depression & anxiety
- chewing betel quid ~ a plant and nut combination common in Southeast Asia
- medications ~ those used to treat arthritis, heart disease, high blood pressure & malaria
- allergies ~ can result from allergic reaction to food, food additives, fragrances, dyes, dental metals
- medical conditions ~ liver disease, lupus, cirrhosis, Sjogren’s syndrome, ulcerative colitis, alopecia areata
- dental issues ~sharp teeth edges, dental restorations, ill fitting dental prostheses, lip and cheek chewing
Lichen planus is an incurable, chronic condition. Yet, medicine can help reduce your itching symptoms and speed healing of your skin bumps or mouth lesions.
Lichen planus and oral lichen planus treatments options involve:
- antihistamines ~ for skin bump itching
- ultraviolet light therapy may benefit some
- corticosteroids injected directly into a lesion
- hydrocortisone cream ~ directly on bumps only
- topical retinoic acid cream (form of vitamin A) ~ reduces itching, inflammation & assists healing
- topical corticosteroids or oral prednisone ~ prescribed to reduce inflammation and suppresses immune system response
Corticosteroid use for oral lichen planus can also cause thrush.
It can be difficult to bring lichen planus under control. And because it tends to be chronic, you may need treatment for months, maybe years. If your symptoms are mild, treatment may not be necessary.
A couple of lifestyle adjustments and home remedies to complement your lichen planus medication regime are:
- cut out spicy or acidic foods if they worsen symptoms
- keep your mouth clean to reduce symptoms and help prevent infection
- avoid alcohol & tobacco products because they irritate your mouth and further increase your risk of oral cancer
Your initial attack may last for weeks to months, and come and go for years. After your lichen planus skin bumps heal, they may leave a dark brown spot. They are not scars. Slowly they will fade away.
Also, lichen planus of your scalp must be treated right away or the lost hair might never grow back.
Pay a visit to your health care professional to find out for sure if your skin bumps or mouth lesions are actually lichen planus.
