Lichen Planus: What It Is, How It Shows Up, and Ways to Treat It

If you’ve ever seen a purple‑red rash with tiny bumps, chances are you’re looking at lichen planus. It can pop up on your skin, mouth, or even genitals, and while it’s not dangerous, it can be itchy and uncomfortable.

Typical Signs You Might Have Lichen Planus

The skin version usually appears as flat‑topped, polygon‑shaped lesions that are purple or dark red. They often have a white line called Wickham’s striae on the surface. On the inside of your mouth, it shows up as white, lace‑like patches that may bleed if you scrape them.

Most people notice these spots first on their wrists, ankles, lower back, or shins. If you’re dealing with oral lichen planus, you might feel a burning sensation when you eat spicy foods or brush your teeth.

Why Does Lichen Planus Happen?

The exact cause is still a bit of a mystery, but doctors think it’s an over‑active immune response. Things that can trigger the reaction include certain medications (like some antihypertensives), viral infections, or even stress.

Because it’s linked to your immune system, people with hepatitis C or other autoimmune disorders sometimes develop lichen planus more often than the general population.

How to Get It Checked

The first step is a quick visit to a dermatologist or dentist. They’ll usually do a visual exam and may take a small skin biopsy to confirm the diagnosis. Blood tests aren’t routine, but they might order them if they suspect an underlying condition like hepatitis C.

Managing Symptoms at Home

Even before you see a doctor, there are simple steps that can ease itching and irritation:

• Apply over‑the‑counter hydrocortisone cream to the skin lesions once or twice daily.
• Avoid hot showers; lukewarm water is gentler on inflamed skin.
• Use a soft toothbrush and avoid toothpaste with strong flavorings if you have mouth involvement.
• Stay away from known triggers like certain medications or excessive alcohol.

Medical Treatments That Work

If home care isn’t enough, doctors may prescribe stronger options:

• Topical steroids: Higher‑potency creams can reduce inflammation faster.
• Oral corticosteroids: Short courses are used for severe or widespread cases.
• Immune‑modulating drugs: Medications like tacrolimus or cyclosporine target the immune response directly.
• Phototherapy: Controlled UV light can help stubborn skin lesions.

For oral lichen planus, a prescription mouthwash with corticosteroids is common. In some cases, dentists will recommend topical anesthetic gels to dull the burning feeling while you wait for the medication to kick in.

When to Seek Help Quickly

If your lesions start bleeding heavily, develop pus, or you notice new growths that don’t heal, get medical attention right away. Those signs could point to a secondary infection or, rarely, skin cancer.

Also, if the itching is so intense that it keeps you awake, call your doctor. They can adjust your treatment plan to keep symptoms under control.

Living With Lichen Planus

The good news is most people see improvement within a few weeks to months of proper therapy. Some experience occasional flare‑ups, especially during stressful periods, but regular follow‑up appointments help keep things in check.

Keeping a simple diary of what you eat, any new meds, and stress levels can reveal patterns that trigger flares. Sharing that info with your doctor makes it easier to fine‑tune treatment.

Remember, lichen planus isn’t life‑threatening, but taking steps early can stop the itch and keep the rash from spreading.