Lichen planus
Lichen planus is an inflammatory condition in which the immune system attacks the body's own skin and mucosal cells.
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Medicines commonly prescribed for Lichen planus
For informational purposes only. Always consult a doctor before using any medicine.
Dosage form: OINTMENT, 64 mg betamethasone dipropionate / 100 gActive substance: betamethasoneManufacturer: Organon Salud S.L.Prescription requiredDosage form: OINTMENT, 1 mg/gActive substance: mometasoneManufacturer: Organon Salud S.L.Prescription requiredDosage form: TOPICAL SOLUTION, 1 mg/gActive substance: mometasoneManufacturer: Laboratorios Serra Pamies S.A.Prescription required
Lichen planus is an inflammatory condition in which the immune system attacks the body's own skin and mucosal cells. It is not an infection and is not contagious, despite the name. It appears as characteristic flat, shiny, violet-tinged papules that itch intensely. In most people it settles on its own within one to two years, but it needs treatment to control the itch and prevent complications — particularly where mucous membranes and nails are involved.
How it looks on the skin
- flat, shiny papules with a smooth surface, 2–5 mm across, tending to merge into plaques;
- violet or lilac on light skin; dark brown or greyish-violet on brown and black skin;
- a fine white network is visible on the surface — a characteristic sign;
- marked itching, often distressing;
- typical sites: flexor surfaces of the forearms, wrists, ankles, lower back;
- new lesions appear where the skin has been scratched or rubbed;
- once resolved, persistent dark patches remain for months.
Other sites
This is an important part: the condition often affects more than the skin, and each site is managed differently.
- mouth — a white lacy network on the inner cheeks, sometimes with painful erosions; very common and may be the only manifestation. Requires dental follow-up;
- genitals — burning, soreness, erosions; in women the vaginal opening can narrow, in men the glans is affected;
- nails — thinning, longitudinal ridging, splitting and sometimes complete nail loss. Early treatment matters: the changes can become permanent;
- scalp — redness and scaling around the hair follicles with scarring hair loss. Speed is critical here too: destroyed follicles do not recover.
When to see a doctor
- the rash described above has appeared;
- itching is disturbing your sleep;
- there are white streaks, patches or ulcers in the mouth, particularly painful ones;
- there is burning, soreness or erosion in the genital area;
- your nails have changed;
- areas of hair loss with scalp redness have appeared;
- a non-healing ulcer or a firm area has developed in the mouth — such changes need examination, because long-standing oral disease carries an increased risk of malignancy;
- the rash appeared after starting a new medicine.
Causes
The exact cause is unknown. The mechanism is autoimmune: T lymphocytes attack the cells of the basal layer of skin and mucosa. Recognised associated factors:
- hepatitis C — the association is documented, and in widespread disease it is worth excluding;
- medicines — blood pressure drugs, diuretics, antimalarials, non-steroidal anti-inflammatories and some diabetes drugs. The drug-induced form looks similar but resolves after withdrawal;
- contact with metals in dental materials, in oral disease;
- stress, as a trigger;
- rarely, vaccines and previous infections.
Treatment
There is no curative treatment: the aim is to relieve itch, speed resolution and prevent irreversible changes.
- potent topical corticosteroids — the mainstay for skin disease;
- topical calcineurin inhibitors — for the face, genital area and mouth;
- antihistamines for itch;
- oral corticosteroids in a short course for widespread disease;
- phototherapy;
- immunosuppressants for stubborn disease;
- mouthwashes and gels for oral disease, avoiding spicy, acidic and hot food;
- withdrawal or substitution of the drug in the medication-induced form, always decided by a doctor;
- emollients for skin care.
What you can do
- do not scratch: new lesions appear precisely where the skin is injured;
- cool showers instead of hot ones, gentle cleansers instead of soap;
- moisturise daily;
- loose clothing in natural fabrics;
- for oral disease: a soft toothbrush, avoiding toothpastes with strong additives, and avoiding spicy, acidic and hot food, alcohol and smoking;
- see your dentist regularly if the mouth is involved;
- work on stress: it affects the course of the condition.
Common questions
Is it contagious? No, neither by contact nor by living together.
How long does it last? Skin lesions usually resolve within one to two years. Oral and genital disease lasts longer.
Will marks remain? On the skin, dark patches that gradually fade. Scarring is possible on the scalp and with nail involvement.
Can it come back? Yes, relapses are possible.
Online consultation
In an online consultation the doctor reviews photographs, helps distinguish lichen planus from psoriasis, eczema and other conditions, checks the link with your medication, explains whether a biopsy and hepatitis C testing are needed, and tailors treatment to the site involved.
This material is for information only and does not replace a medical consultation.
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Medically reviewed by
Reviewed on Jul 17, 2026
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