Lichen Planus

What is Lichen Planus?

Lichen planus is an inflammatory condition affecting the skin, mouth and occasionally the genital area. Rarely, the nails, hair and scalp may also be affected. If lichen planus affects the skin, it often gradually gets better with treatment. This page deals with lichen planus in the mouth. This is a longstanding condition that is not readily cured.

What are the symptoms?

Lichen planus in the mouth may appear as white or red patches, ulcers, or painful, red gums.

After appearing it is often present for life but only feels sore intermittently.

Spicy, acidic (citrus fruits and vinegar) or highly flavoured foods can make the soreness worse. Hard foods, such as toast and crisps may also irritate the affected lining of the mouth.

What is its cause?

We do not know the precise cause. We do know that it is not an infection, so you cannot pass it on to other people. Likewise there is little evidence that lichen planus is inherited. It appears that the body’s immune system starts to react against the lining of the mouth. Lichen planus-like lesions may also be caused in some people by medicines and occasionally dental fillings.

How is the diagnosis made?

In many cases the diagnosis will be made by looking at your mouth. However a biopsy may be needed and the sample taken is then looked at under a microscope.

What treatment is available?

You may not require any treatment if your lichen planus is not affecting your quality of life. It cannot be cured. If your mouth is sore, you will be given medicines to reduce the symptoms. A repeat prescription of these can be obtained from your own doctor. It is not always possible to make the mouth completely symptom free.

You may be given one or more of the following medicines to use:

• Anti-inflammatory corticosteroid mouth wash, for example Betnesol.
• Anti-inflammatory corticosteroid spray, for example Flixonase. This is usually given to patients to use for hayfever but should be dispensed into the mouth directly on to sore areas.
• Anti-inflammatory corticosteroid cream\ointment for example Dermovate or Elocon. It is important that you use a wet finger or a wet cotton-wool bud to put this on to the sore area. If possible, dry the area with a piece of tissue. It is probably most effective to use this cream last thing at night.
• Tacrolimus ointment. It is important that you use a wet finger or a wet cotton-wool bud to put this on to the sore area. If possible, dry the area with a piece of tissue. It can be used twice a day. It has a peppery taste.
• If your mouth is very sore you may be given tablets to swallow, for example corticosteroids or other immune system suppressing drugs.

Your mouth needs to be reviewed regularly. This will be done either by your dentist or the doctor’s at the Oral Medicine Clinic depending on the severity of your disease.

It is important that you return for your review appointments or earlier if your mouth is causing you more discomfort, so we can change your medicines.

What are the long term complications of lichen planus of the mouth?

There have been suggestions that lichen planus of the mouth may increase the risk of mouth cancer. Studies have suggested that less than 2% of patients with lichen planus may get mouth cancer, although this remains controversial. Nevertheless it is important that all patients with lichen planus of the mouth reduce any possible risk of mouth cancer by ensuring that you:

• Do not use tobacco
• Do not drink excessive amounts of alcohol
• Regularly eat fresh fruit and vegetables
• Attend the dentist regularly for careful clinical examinations
• Attend clinic appointments

Further information

British Association of Dermatologists

The British & Irish Society for Oral Medicine

UCLH cannot accept responsibility for information provided by external organisations.

Patient Advice and Liaison Service (PALS)

PALS is a patient-friendly, easy to access service designed to provide a personal contact point to assist patients, relatives and carers. If you have a problem that you have not been able to sort out we can help you to resolve it.

The PALS office is located in the main atrium of University College Hospital, 235 Euston Road, London, NW1 2BU.

PALS are open: Monday to Friday: 10:00 till 16:00
Telephone: 020 3447 3042
Email: uclh.pals@nhs.net

Contact details

Department of Oral Medicine

Royal National ENT and Eastman Dental Hospitals

Address: 47-49 Huntley Street, London WC1E 6DG

Telephone: 020 3456 1061

How to find us

Huntley Street is close to Euston, Warren Street and Goodge Street Underground Stations and there are bus stops nearby.