Lichen planus is a chronic skin condition. It causes itchy, flat, scaly patches on the wrists, legs, trunk, or genitals. It can also affect the inside of the mouth and vagina where it resembles a white spider web. The scalp and fingernails can also be affected. Lichen planus may continue on and off for months or years.
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Not much is known about the cause. It may be due to genetic factors, certain medicine, or diseases.
The condition is more common in those aged 30 to 60 years.
Lichen planus is more likely to occur in the presence of:
- Hepatitis C
- Systemic lupus erythematosus
- Certain prescription medications
- Graft vs. host disease
- Dental materials
Lichen planus may cause:
- Itching, flat-topped purplish bumps or scaly patches—especially on the palm side of the wrists, the top of the foot and shins, the trunk, or the genitals
- Hair loss
- Abnormal appearance to the nails
- Milky-white, spider web-like patches in the mouth or vagina, with or without burning or discomfort
You will be asked about your symptoms ad past health. The doctor will also need to know any medicines you are taking. A physical exam will be done. Lichen planus usually can be diagnosed by the appearance. You may be referred to a skin specialist.
If the diagnosis is unclear, a skin biopsy may be done.
Talk with your doctor about the best plan for you. Treatment options include the following:
Scratching makes this condition worse. This symptom can be eased with:
- Antihistamines creams or lotions or pills
- Other anti-itching lotions, such as menthol or eucalyptus oil
- Soothing oatmeal baths
Steroids creams may be used to help decrease inflammation. Steroids may also be injected by a needle directly into the area. Steroid pills are only used in severe cases.
- Retinoids or immunomodulating medicine may be useful. They are more often used for lesions in the mouth or vagina.
- Ultraviolet light therapy may help if lesions are widespread. It is combined with pills that make it more effective.
There are no current guidelines to prevent lichen planus. Avoid any medications that may have triggered it in the past.
Canadian Dermatology Association
Lichen planus. American Academy of Dermatology website. Available at: https://www.aad.org/dermatology-a-to-z/diseases-and-treatments/i---l/lichen-planus. Accessed October 15, 2018.
Lichen planus. American Academy of Family Physicians website. Available at: https://familydoctor.org/condition/lichen-planus/. Updated: January 24, 2018. Accessed October 15, 2018.
Lichen planus. EBSCO DynaMed website. Available at:https://www.dynamed.com/topics/dmp~AN~T116470/Lichen-planus#Complications-and-Prognosis. Updated April 24, 2018. Accessed October 15, 2018.
Usatine RP, Tinitigan M. Diagnosis and treatment of lichen planus. Am Fam Physician. 2011;84(1):53-60.
Last reviewed February 2019 by EBSCO Medical Review Board Daniel A. Ostrovsky, MD Last Updated: 2/12/2019