Lichen planus: Diagnosis and treatment

How do dermatologists diagnose lichen planus?

A dermatologist often can tell whether you have lichen planus by looking at your skin, nails, and mouth. To make sure that you have lichen planus, a dermatologist may remove a bit of skin. This skin will be examined under a microscope to make sure. Your dermatologist may call this a biopsy. Sometimes, you may need blood tests to rule out other diseases.

Dentists often find lichen planus in the mouth during a checkup.

How do dermatologists treat lichen planus?

There is no cure for lichen planus. It often goes away on its own. If symptoms are bothersome, treatment often brings relief and may speed healing. Treatment for the skin may include:

• Antihistamines: Pills that help alleviate itching

• Topical (applied to the skin) corticosteroid: Cream or ointment to reduce swelling and redness

• Corticosteroid: Pills (such as prednisone) or shots can help when lichen planus lasts a long time or a patient has many bumps or painful sores

• PUVA therapy: A type of light treatment that can help clear the skin

• Retinoic acid: Applied to the skin or given as a pill to clear the skin

• Tacrolimus ointment or pimecrolimus cream: Used to treat another skin problem, eczema

Ask your dermatologist about possible side effects (health problems that can result from the medicines).

When lichen planus develops in the mouth, it often does not cause pain or other symptoms. If this is the case, treatment may not be necessary. When lichen planus causes pain, burning, redness, blisters, sores, or ulcers, it can be treated. Some medicine is applied to the sores. Other medicine comes in pill form.

Any mouth disease can lead to gum disease. It is important to brush and floss as directed by your dentist. You also should keep all appointments with your dentist and get cleanings at least twice a year.

Outcome

Many cases of skin lichen planus go away within two years. About one in five people will have a second outbreak. In some people, the skin problem may come and go for years.

As lichen planus heals, it often leaves dark brown spots on the skin. Like the bumps, these spots may fade without treatment. If they do not go away, dermatologists can lighten the spots with creams, lasers, or other treatments.

Lichen planus in the mouth often lasts longer than lichen planus on the skin. In the mouth, it can be harder to treat.