What does lichen planus look like?

On the skin, lichen planus often causes small, flat-topped bumps that may be:

Purple, reddish brown or gray
Shiny
Intensely itchy
Covered by fine white lines
Grouped into patches
Located on the wrists, ankles, lower back or legs

After the bumps clear, they may leave temporary dark marks.

Inside the mouth, lichen planus can cause:

Lacy white patches
Red, swollen tissue
Painful sores
Burning with spicy or acidic food

Genital lichen planus may cause soreness, burning, erosions or scarring.

Can lichen planus affect the hair or nails?

When the scalp is affected, the condition is called lichen planopilaris. It can cause redness, scale, itching, burning and permanent scarring hair loss.

Nail involvement may cause:

Ridges
Thinning
Splitting
Grooves
Nail loss
Scarring around the nail

Early treatment is especially important when the scalp or nails are involved because some damage can become permanent.

What causes lichen planus?

Lichen planus appears to develop when the immune system targets cells in the skin or mucous membranes. The reason this occurs is not always known.

Certain medications, metal dental materials, infections or other triggers may cause lichen planus-like reactions in some patients.

The condition cannot be spread through touching, sharing items or intimate contact.

How is lichen planus diagnosed?

A dermatologist may diagnose lichen planus by examining the affected area. A biopsy is often helpful because the condition can resemble eczema, psoriasis, fungal infection, autoimmune disease or other inflammatory disorders.

Blood testing or additional evaluation may be recommended depending on symptoms and medical history.

How is lichen planus treated?

Treatment depends on the location and severity.

Options may include:

Topical corticosteroids
Corticosteroid injections
Oral corticosteroid medication
Topical calcineurin inhibitors
Phototherapy
Oral immune-modifying medication
Treatments for pain or itching
Specialized mouth or genital care

Scalp lichen planus should be treated promptly to reduce the risk of additional permanent hair loss.

Schedule a lichen planus consultation

Persistent purple bumps, mouth sores, genital irritation or inflammatory scalp hair loss should be evaluated. The Dermatology Clinic can confirm the diagnosis and create a treatment plan based on the areas involved. Contact us today to get scheduled.