Oral Lichen Planus

Overview

What is oral lichen planus?

Lichen planus is a chronic, or long-term, disease affecting the skin and mucous membranes, the thin layers of tissue that line body cavities and secrete mucus. When lichen planus appears in the mouth, it is called oral lichen planus.

How common is oral lichen planus?

The skin and oral types of lichen planus together affect an estimated two percent of the population.

Who is likely to have oral lichen planus?

Anyone can develop oral lichen planus. Women are twice as likely as men to develop the condition. Most cases of oral lichen planus occur in adults age 50 and older.

Is oral lichen planus contagious?

No, oral lichen planus does not spread from person to person.

Symptoms and Causes

What causes oral lichen planus?

The exact cause of oral lichen planus is unknown. Research suggests the condition is related to your genetic makeup and immune system.

Some people develop oral lichen planus after taking certain medications, such as beta-blockers and nonsteroidal anti-inflammatory drugs (NSAIDs). Diseases such as hepatitis B and primary biliary cirrhosis may also cause oral lichen planus.

What are the symptoms of oral lichen planus?

For most people, oral lichen planus (reticular type) appears as white patches or web-like threads on the inside of the cheeks. These patches and threads are raised slightly. This type of lichen planus is usually not painful.

In some cases, oral lichen planus (erosive type) appears as bright red gum tissue. In severe cases, ulcers develop on the gums of mucosal tissues inside the mouth, or on the tongue. Eating and drinking spicy, hot or acidic foods or beverages can be painful for people with oral lichen planus.

Skin lesions are common among people with oral lichen planus. Almost half of people with oral lichen planus also have skin lichen planus, which causes itching.

Diagnosis and Tests

How is oral lichen planus diagnosed?

Your doctor diagnoses oral lichen planus by examining your mouth. In many cases, doctors take a tissue sample (biopsy) to confirm the diagnosis and rule out other diseases.

Management and Treatment

How is oral lichen planus treated?

Mild oral lichen planus may not need any treatment. Instead, your doctor monitors your condition. Doctors recommend specific treatments if symptoms worsen.

Milder forms of the disease usually go away on their own over time, especially if medications triggering the condition are discontinued.

Doctors usually treat more severe cases of oral lichen planus with one or several medications, including:

  • Lidocaine (Lidoderm®, Xylocaine®)
  • Tacrolimus (Prograf®, Protopic®)
  • Corticosteroids
  • Dapsone (Aczone®)
  • Cyclosporine (Neorral®, Gengraf®)

What complications are associated with oral lichen planus?

Oral lichen planus is a chronic, or long-term, condition. Occasional flare-ups are common.

More severe forms of oral lichen planus, called erosive lichen planus, can make it painful to eat, drink or brush your teeth.

Some research indicates a greater likelihood of developing oral cancer if you have erosive oral lichen planus. Approximately 1 to 3 percent of people with oral lichen planus eventually develop oral cancer but the question is still to be resolved due to some cases that may not have been true lichen planus. Regardless, patients with erosive lichen planus should be followed every three months for evaluation.

Prevention

Can oral lichen planus be prevented?

There is no way to prevent oral lichen planus. You can lower your risk for oral lichen planus and other oral conditions by eating a variety of fruits and vegetables, not drinking large amounts of alcohol and quitting smoking.

Outlook / Prognosis

What is the prognosis (outlook) for people with oral lichen planus?

For many people, oral lichen planus eventually disappears. However, the condition can take years to resolve. Flare-ups are common, even with treatment.

Living With

When should I call my doctor?

If you have any of the symptoms of oral lichen planus, your doctor can examine your mouth to determine if this disease is causing your condition.

Last reviewed by a Cleveland Clinic medical professional on 11/06/2018.

References

  • American Academy of Oral Medicine. Oral Lichen Planus. (https://www.aaom.com/oral-lichen-planus) Accessed 11/6/2018.
  • American Skin Association. Lichen Planus. (http://www.americanskin.org/resource/lichen.php) Accessed 11/6/2018.
  • Merck Manual Professional Version. Lichen Planus. (https://www.merckmanuals.com/professional/dermatologic-disorders/psoriasis-and-scaling-diseases/lichen-planus) Accessed 11/6/2018.
  • Oral Health Foundation. Lichen planus. (https://www.dentalhealth.org/lichen-planus) Accessed 11/6/2018.

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