Lichen Planus Diagnosis & Management Options

Lichen planus is an inflammatory condition that affects the skin and mucous surfaces, and many notice changes in comfort and appearance as symptoms develop [1,2,3].

In this article, we explore how lichen planus presents, how it is diagnosed, and which management strategies help support long term comfort.

Understanding Lichen Planus

Lichen planus is considered an autoimmune condition where immune activity targets skin and mucous membranes, creating persistent inflammation [1,2,3].

Rates vary worldwide, and oral lichen planus is more common in women over forty, often causing daily sensitivity in the mouth [1,3].

Skin Features & Variants

Cutaneous lichen planus appears as flat topped purple bumps on the skin, often with itching, and these can become darker in skin of colour [1,3].

Oral forms show lacy white patterns or sore areas that become sensitive to spicy or acidic foods and can affect comfort throughout the day [1,3].

Lichen Planus Vs Lichen Sclerosus

Table 1: Distinguishing chronic inflammatory conditions

Diagnosis & Assessment

Diagnosis begins with clinical examination to assess the pattern of symptoms, and biopsy can confirm characteristic lymphocyte patterns beneath the skin [2,3].

Oral forms may require close review, especially when discomfort affects eating, speaking, or daily routines [1,3].

Oral Lichen Planus

Oral lichen planus often affects the inner cheeks and gums, where lacy white lines or sore erosive areas may appear [1,3].

The erosive form is more painful and carries a low but recognised risk of long term changes in persistent sites [1,3].

Oral Lichen Planus Features

Table 2: Oral lichen planus presentations

Management Strategies

Management focuses on reducing inflammation, maintaining comfort, and limiting flare ups, as there is currently no definitive cure [2,3].

Supportive habits such as avoiding irritants or reducing stress may also help limit symptom severity [1,3].

Topical Corticosteroids

Topical corticosteroids are first line therapy and help reduce inflammation and surface discomfort in both skin and oral forms [2,3].

Stronger preparations may be used for short periods, while milder forms offer support for ongoing symptoms [1,3].

Systemic Therapies

Systemic steroids, retinoids, or immunosuppressants may be considered for severe or widespread symptoms, often when topical treatments have limited effect [2,3].

These options require medical supervision because of potential side effects during longer use [2,3].

Phototherapy

Narrowband UVB can help reduce inflammation in skin based lichen planus, especially when symptoms are widespread or persistent [2,3].

This approach is not used for oral forms, which require topical therapies instead [1,3].

Lifestyle Support

Dietary adjustments, gentle oral care, and stress reduction may support comfort, especially for oral symptoms triggered by acidic or spicy foods [1,3].

Good oral hygiene and regular dental review may also ease daily sensitivity.

Lifestyle Approaches

Table 3: Supportive strategies for comfort

Lichen Planus Pigmentosus

Lichen planus pigmentosus affects darker skin and appears as brown or grey patches on sun exposed areas, often requiring careful sun protection [3,4].

Management focuses on reducing inflammation and preventing further pigmentation changes in these areas [3,4].

Conclusion

Lichen planus affects the skin and mucous surfaces in varied ways, and understanding these patterns helps guide effective long term management [1,2,3].

Readers seeking tailored guidance can explore options through our personal skincare review, which offers personalised support for long term skin health.

Content is for informational purposes only. Monderma treatments are prescribed following consultation. Results and timeframes can vary. Use as directed by your prescriber.

References

1. NHS. Lichen Planus
2. Arnold DL, Krishnamurthy K. Lichen Planus StatPearls
3. Gorouhi F, Davari P, Fazel N. Cutaneous And Mucosal Lichen Planus
4. Mendiratta V, Sanke S, Chander R. Lichen Planus Pigmentosus