What is lichen planus?

This common skin condition typically develops on wrists, but may develop on several areas of the body. It can appear inside the mouth, scalp or genitals, and can change the appearance of finger and toenails. Lichen planus is not contagious and isn’t a type of cancer.

What are the symptoms?

The symptoms vary depending on where it is located. On the skin, it causes shiny and firm reddish purple bumps, sometimes with Wicham’s striae (white lines) through them. The wrists, ankles, lower back are all areas you may see them. Bumps are typically darker on the legs. Thick patches of rough, scaly skin can develop with time, especially on the shins. Blisters are rare. When appearing in the mouth, it usually happens on the cheeks, but can occur on the gums and tongue as well. Redness, swelling, ting white dots or lines are typical. Lichen Planus can also appear on finger and toenails. Ridges or grooves, and splitting/thinning nails are typical. It is rare for lichen planus to develop on the scalp, but it does happen and can cause hair loss.

What are the causes?

Common in middle-aged adults, women tend to get it in their mouths more often than men, and it can occur in anyone. The causes are not known, but it is speculated to be an autoimmune disease. Some medications can leave a rash that looks like lichen planus. Be sure to tell your dermatologist at Dermatology of Seattle of any medications you might be taking. Metal fillings can cause lichen planus in the mouth, which is rare, and a non-metallic replacement will fix the problem. A rare type, familial bullous lichen planus, is genetic while other variations do not run in families. People with hepatitis C tend to have lichen planus, so be sure to get examined for this condition.

How is it diagnosed and treated?

Typically a skin biopsy and a blood test (to rule out other diseases) is performed, dentists often find it in the mouth when doing dental work or a routine check up. There is no cure and it often goes away on its own, but treatment can speed healing. Antihistamines can eliminate itching, corticosteroids can reduce the swelling and redness, or light therapy may be used. Most lichen planus cases go away within 2 years. About 20% of people will have a second outbreak. Sometimes it leaves dark brown spots, which can be lightened with various techniques by dermatologists.