Oral Lichen Planus
What is Lichen Planus?
Lichen Planus is a long-term disease, which can affect the skin and mouth and, in some cases, the genital area.
It affects 1 – 2% of men and women in the UK and is more common in people over 40-years old.
It is not a cancer or an infectious disease that can be passed on and it does not run in families.
What is the Cause of Lichen Planus?
The cause of Lichen Planus is not known but it is probably related to the immune system where cells that normally fight off germs attack normal parts of the body.
Certain drugs used in the treatment of high blood pressure, arthritis and diabetes may cause Lichen Planus-like lesions.
Also, where the cheeks or tongue have been lying against teeth have amalgam restorations, Lichen Planus-like lesions may occur. Emotional stress and spicy foods or citrus fruits can often cause symptoms to worsen.
It is not thought to be infectious.
What are the signs and symptoms?
Lichen Planus appears in a wide variety of ways and can cause pain, burning and/or soreness in the mouth.
It can often go unnoticed and may only be recognised by a dentist or hygienist during a routine examination. White, net-like lines or white patches are usually seen on the inside of both cheeks and can also appear on the tongue and gums. These do not usually cause any discomfort.
In some cases, red patches, ulcers or blisters appear which can be painful. The gums can also become thin, red and shiny in appearance and it may hurt to brush your teeth. About one third of people also get a purple, itchy rash with raised dots on the skin, especially on the wrists and shins. Very rarely, changes can be seen in the genital area, hair
How Is It Diagnosed?
Blood tests and a biopsy of an affected area may be required.
How is it treated?
As long as there is no pain, treatment is not usually necessary. In all cases, it is important to keep your mouth clean, as it stops the Lichen Planus from getting infected.
There are many different treatments available for treating the condition if it is causing a problem.
The usual treatment is steroid medication and / or antiseptic / pain-relieving mouthwashes. These are not absorbed into the body as they only work on the area they are applied to and therefore cause no side effects.
It may be an idea to try to identify factors that make the problem worse, e.g. stress, spicy food such as chillies, citrus fruit and strongly-flavoured toothpastes (containing cinnamonaldehyde).
In severe cases, the hospital doctor will prescribe some stronger medication.
Prognosis.
Most lichen planus is benign. There are some forms of lichen planus that may rarely, after years, lead to a tumour; in this case, have yourself checked regularly if the specialist advises.
