What is oral lichen planus?
Lichen planus is an itchy skin rash that is caused by an immune response. It can occur anywhere on your skin.
In cases of oral lichen planus, the mucous membranes inside your mouth are the only area affected. Oral lichen planus presents symptoms different from other cases of lichen planus. Instead of a rash, people may experience swollen tissues, white patches, and open sores.
Oral lichen planus isn’t contagious, and it can’t be spread to another person.
Lesions from oral lichen planus appear inside of your mouth. They can be present on these areas:
- inside of your cheeks (the most common location for these lesions)
- inner tissues of your lips
Lesions can appear as either white, lacy, raised patches of tissue that resemble spiderwebs or tender, swollen patches that are bright red. They can also appear as — or develop into — open sores (ulceration).
When the lesions are white and lacy, they typically don’t present much pain or discomfort. If they’re red and swollen or open sores, you may feel pain or discomfort. Symptoms could include:
- burning or stinging pain in the affected area
- pain or discomfort when speaking, eating, or drinking (If you have open sores, you may experience this pain even without eating or drinking.)
- increased sensitivity to acidic, spicy, coarsely textured, or hot foods
- inflammation of your gums, including bleeding when brushing your teeth
Scientists aren’t sure what causes any type of lichen planus, let alone oral lichen planus. All that’s known is that it’s tied to an immune response. Some theories point to oral lichen planus as being an autoimmune disorder of its own, while others think it could be a symptom of another autoimmune disorder.
The following factors can cause you to develop the condition. They can also be triggers in people who already have the condition:
- having an autoimmune disorder
- sustaining an injury to the mouth
- having an oral infection
- taking certain medications
- having an allergic reaction to something that came in contact with the mouth, like a food or dental appliances
If you think you’ve developed oral lichen planus, you should see your doctor. At your appointment, your doctor will ask about your medical history. Tell them how long you’ve been experiencing your symptoms and provide a full list of medications you’re taking.
They’ll examine your mouth, looking for lesions and affected areas. They may check other areas on your skin to look for other areas affected by lichen planus.
If they’re unsure of the diagnosis, they’ll likely order a biopsy of one or more of the lesions to collect samples of tissue. A laboratory will analyze the samples using a microscope to help with a diagnosis for oral lichen planus.
Your doctor may also take a swab culture from the affected area, which can look for secondary infections.
Oral lichen planus can cause significant pain when eating or drinking. Avoiding eating or drinking may lead to weight loss or nutritional deficiency.
Oral lichen planus can increase the risk of secondary yeast or fungal infections. Open sores also have a higher risk of bacterial infections.
Erosive and ulcerated lesions from oral lichen planus may cause scarring on the affected areas.
People who have oral lichen planus should have regular checkups with their dentist, as they have a higher risk for developing mouth cancer in the affected areas.
Because it’s a chronic condition, oral lichen planus can’t be cured, but it can be managed. Treatment will focus on resolving symptoms and minimizing lesions as much as possible.
Treatment options include:
- topical corticosteroids, which can come in the form of gel, ointment, or mouthwash applied directly to the affected area
- injection corticosteroids, which are applied directly to the lesion
- oral corticosteroids, which can only be taken for a short time
- immune response medications
Certain lifestyle changes can also help manage oral lichen planus. These include:
- using a mild toothpaste
- eating well and getting plenty of nutrients through foods like fruits, vegetables, nuts, and lean protein
- getting plenty of exercise
- reducing stress
Oral lichen planus is a chronic condition. The symptoms can be managed, but the condition itself can’t be cured. Because of this, maintaining regular appointments with your dentist or healthcare provider can help you manage your symptoms and adjust your treatment plan as needed. They will also watch for any potential signs of mouth cancer.