Oral lichen planus is an ongoing inflammatory condition of the tissues inside the mouth. It can look like lacy white lines on the cheeks or appear as red, sore patches. Mayo Clinic notes it can’t be passed from person to person, and symptoms usually can be managed. Because some forms may raise the risk of mouth cancer, regular checkups are important.
Types and symptoms
Mayo Clinic describes two main types:
- Reticular: white, lacy patches. It’s the most common type, usually has no symptoms and often needs no treatment.
- Erosive: red, swollen tissue or open sores that may burn or hurt. Mayo Clinic says it should be checked regularly because it can lead to mouth cancer.
Where it appears
The insides of the cheeks are the most common location. It can also appear on the gums, tongue, inner lips and palate (Mayo Clinic). MedlinePlus describes mouth sores that look like bluish-white spots forming lines in a lacy network, which may slowly grow and sometimes form painful ulcers.
Erosive symptoms
Mayo Clinic lists burning or pain, sensitivity to hot, acidic or spicy foods, bleeding and irritation with brushing, gingivitis, painful thickened tongue patches, and pain when speaking, chewing or swallowing. MedlinePlus adds dry mouth and a metallic taste.
Beyond the mouth
Lichen planus can also affect the skin (often itchy, purple or violet flat-topped bumps), nails, scalp and other areas, according to Mayo Clinic.
Causes and risk factors
The cause isn’t known. Mayo Clinic says immune cells called T lymphocytes appear to be activated, suggesting an immune condition, possibly with genetic factors. In some people, certain medicines, mouth injury, infection or allergy-causing agents such as dental materials may play a role, and stress may worsen symptoms. These links aren’t confirmed. MedlinePlus lists certain medicines and chemicals and diseases such as hepatitis C as risks. It’s most common in middle-aged adults, especially women over 50 (Mayo Clinic).
Diagnosis
MedlinePlus says diagnosis may be based on how the lesions look, and a biopsy of a mouth lesion can confirm it. A dentist may be the first to notice it during an exam. See our oral cancer screening guide.
Treatment
The goal is to reduce symptoms and speed healing. Mild cases may not need treatment. MedlinePlus lists options including:
- topical or oral corticosteroids, or corticosteroid shots into a sore
- lidocaine mouthwashes to numb sores and make eating easier
- medicines that calm the immune system in severe cases
- antihistamines and vitamin A cream or pills
If a medicine caused it, the rash should go away once that medicine is stopped. Only make changes with your prescriber.
Outlook and complications
MedlinePlus says lichen planus is usually not harmful and often clears within 18 months, though it may come and go for years. Long-lasting mouth ulcers may develop into oral cancer. Mayo Clinic says severe cases may also lead to significant pain, weight loss or poor nutrition, stress or depression, scarring and secondary yeast infections. See oral thrush.
Living with it
- Keep regular dental and medical checkups, as Mayo Clinic advises.
- If hot, acidic or spicy foods trigger pain, note which ones. See acidic drinks and teeth.
- Brush gently with a soft brush if gums are sore. See how to brush your teeth.
When to contact a provider
MedlinePlus says to contact your provider if lesions change in appearance, the condition persists or worsens despite treatment, or your dentist recommends changing medicines or treating trigger conditions.
Frequently asked questions
Is oral lichen planus contagious?
No. Mayo Clinic says it can’t be passed from one person to another.
Is it cancer?
No, but Mayo Clinic says it, especially the erosive type, may raise the risk of mouth cancer in affected areas, so regular checkups matter.
Sources
By the Dentist Review Editorial Team.
This article is for general information only and is not medical advice. Talk to a licensed dentist about your own situation. See our disclaimer.
Featured image: “Dentist Examining Patient’s Teeth with Dental Mirror” by Jameswasswa, via Wikimedia Commons, licensed CC BY-SA 4.0. Resized and compressed for the web.
Our guides are written and reviewed by the Dentist Review editorial team. We research each topic using public, authoritative sources such as the CDC, the National Institutes of Health (NIH/NIDCR), the American Dental Association (ADA) and CMS, and we update guides when guidance changes. Guides are for general information only and are not dental or medical advice; please read our disclaimer and learn more about us.