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Oral lichen planus (LIE-kun PLAY-nus) is an ongoing inflammatory condition that affects mucous membranes inside the mouth. There are several different types of lichen planus that affect the mouth, but the two main types are:
Oral lichen planus can't be passed from one person to another. The condition occurs when the immune system attacks cells of the oral mucous membranes for reasons that aren't known.
Symptoms usually can be managed. But people who have oral lichen planus need regular checkups. That's because oral lichen planus — especially the erosive type — may raise the risk of getting mouth cancer in the affected areas.
Symptoms of oral lichen planus affect the mucous membranes of the mouth.
Signs differ based on the type of oral lichen planus. For example:
Signs of the condition may appear on the:
The white, lacy patches of reticular oral lichen planus may not cause pain, soreness or other discomfort when they appear on the insides of the cheeks. But symptoms of erosive oral lichen planus that may occur along with red, swollen patches or open sores include:
If you have oral lichen planus, lichen planus may affect other parts of your body, including:
See your doctor or other healthcare professional if you have any of the symptoms listed above.
It's not known what causes oral lichen planus. But T lymphocytes — white blood cells involved in inflammation — appear to be activated in oral lichen planus. This could mean that it's an immune condition and it could involve genetic factors. More research is needed to find the exact cause.
In some people, certain medicines, mouth injury, infection or allergy-causing agents such as dental materials may cause oral lichen planus. Stress may cause symptoms to get worse or come back from time to time. But these causes are not confirmed.
Anyone can get oral lichen planus, but it's more common in middle-aged adults, particularly women over age 50. Some factors may raise your risk of getting oral lichen planus, such as having a condition that lowers your immunity or taking certain medicines. But more research is needed.
Severe cases of oral lichen planus may raise the risk of:
Your healthcare professional may make a diagnosis of oral lichen planus based on:
Your healthcare professional also may request lab tests, such as:
Oral lichen planus is a lifelong condition. Mild forms may go away on their own but flare up later. Because there is no cure, treatment focuses on healing and easing pain or other symptoms that bother you. Your healthcare professional watches your condition to find the best treatment or to stop treatment as needed.
If you have no pain or other discomfort, and you only have white, lacy signs of oral lichen planus in your mouth, you may not need any treatment. For more-severe symptoms, you may need one or more of the options below.
Treatments such as numbing agents applied to the skin can give relief for a short time in areas that are very painful.
Medicines called corticosteroids may lower inflammation related to oral lichen planus. Your healthcare professional may recommend one of these forms:
Side effects vary depending on the method you use. Talk with your healthcare professional to weigh the possible benefits and side effects.
Medicines called immunosuppressants may be used to improve severe symptoms of oral lichen planus and lessen pain. But they're only for people who do not have weakened immune systems because these medicines can weaken or change the body's immune response. They come in these forms:
The use of some medicines, such as steroids placed on the skin, can lead to the overgrowth of yeast. This is known as a secondary infection. During treatment, schedule regular follow-up visits with your primary healthcare professional to check for secondary infections and get treatment. Not treating secondary infections may worsen oral lichen planus.
Ask your doctor or other healthcare professional about the benefits and risks of using medicines in any form.
If your oral lichen planus seems linked to a trigger, such as a medicine, an allergen or stress, your healthcare professional can recommend how to deal with the trigger. For example, suggestions may include trying another medicine instead, seeing an allergist or dermatologist for more testing, or learning stress management techniques.
In addition to regular medical and dental treatment, these self-care measures may make your oral lichen planus symptoms better or help prevent episodes of severe symptoms from coming back from time to time:
You'll likely start by seeing your primary healthcare professional or dentist. You may be referred to a specialist in gum and dental diseases, also known as a periodontist, or a specialist in skin diseases, also known as a dermatologist.
To get ready for your appointment:
Also, prepare questions to ask your healthcare professional. Some basic questions to ask include:
Don't hesitate to ask any other questions during your appointment.
Your healthcare professional is likely to ask you several questions, such as:
Your healthcare professional will likely ask more questions based on your responses, symptoms and needs. Prepare for questions to make the most of your appointment time.