Oral Lichen Planus - Causes | Symptoms | Diagnosis | Treatment
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Oral Lichen Planus - Causes, Symptoms, Diagnosis, and Treatment

Published on Feb 04, 2020 and last reviewed on Sep 16, 2022   -  5 min read


Oral lichen planus (OLP) is an autoimmune disease affecting the oral mucous membrane and results in white, lacy lesions in the mouth. Read about its causes, symptoms, diagnosis, and treatment options.

Oral Lichen Planus - Causes, Symptoms, Diagnosis, and Treatment

What Is Oral Lichen Planus?

A chronic inflammatory disorder that affects the mucous membranes of the mouth is called oral lichen planus. Lichen planus can affect any part of your skin. It appears as white and lacy patches with swollen, red tissues and open ulcers. This condition causes pain, burning, and discomfort to the patient. It is not a contagious disease and cannot be passed from one individual to another. It occurs when your immune system attacks the cells of the mucous membrane of your mouth, but the exact cause of this attack is still not known.

The symptoms of this disorder can be managed by medicines. But this is a precancerous condition, that is, oral lichen planus increases the risk of the patient developing mouth cancer in the affected areas.

What Does Oral Lichen Planus Look Like?

Occur lichen planus can appear anywhere inside the mouth, including the inner side of your cheeks (which is the most common location), gums, tongue, the inner side of the lips, and the roof of the mouth (palate).

The lesions look like:

  • White and lacy raised patches that resemble spiderwebs or tender.

  • The tissues appear swollen and bright red.

  • Open sores or mouth ulcers can be seen in severe cases.

Oral Lichen Planus

There is no pain or discomfort seen in patients who have white lacy lesions. The symptoms associated when open sores develop are:

  1. Burning or stinging near the lesion.

  2. Pain on speaking, eating, yawning, or drinking.

  3. Stinging sensation on eating acidic, spicy, or hot food items.

  4. Gingivitis (inflammation of the gums).

  5. Bleeding from the gums when you brush.

  6. Thick and painful lesions on the tongue.

What Are the Other Types of Lichen Planus?

The other parts that lichen planus can commonly affect are:

  1. Skin - itchy, purplish, flat bumps appear on the skin.

  2. Genitals - Red and eroded lesions can appear on the female or male genitalia. It causes pain and burning sensation during sex.

  3. Eyes - when lichen planus causes lesions in the mucous membrane of the eyes, it can lead to blindness.

  4. Ears - lesions on the ears can cause hearing loss.

  5. Scalp - lesion on the scalp can lead to hair loss, which can be temporary or permanent.

  6. Esophagus - lesions on the esophagus can cause narrowing of the esophagus, and can make it difficult for the patient to swallow.

What Causes Lichen Planus?

The exact cause of lichen planus is still not known. As of now, the only thing that doctors know is that it results from an autoimmune response. Some scientists believe that these lesions are a result of some other autoimmune condition, while some say it is an autoimmune disorder on its own.

Risk Factors:

The following factors can increase the risk of developing oral lichen planus:

  • Other autoimmune disorders.

  • A positive family history.

  • Injury to the mouth.

  • Oral infection.

  • Using some specific medicines, such as painkillers, antidiabetic drugs, and antihypertensive medicines.

  • Allergic reaction to food or metal fillings or dental appliance.

  • Cheek or tongue biting habit.

  • Many hepatitis C patients might get lichen planus.

How Does a Dentist Diagnose Oral Lichen Planus?

Based on your medical and dental history, the medication that you are on, symptoms, and the characteristics of the lesion, the doctor will diagnose lichen planus. If needed, the dentist might suggest you get the following tests done:

  • Blood tests - Blood tests might be done to diagnose conditions like hepatitis C and lupus.

  • Biopsy - The dentist will collect a small tissue sample from the lesions and send it for lab testing. In the lab, the biopsy will be examined for indications of oral lichen planus under the microscope.

  • A cotton swab - Sometimes, the dentist may collect a sample of cells by rubbing a cotton swab over the lesions. The sample is then examined for secondary fungal or bacterial or viral infection.

What Are the Treatment Options for Oral Lichen Planus?

There is no cure for lichen planus, and treatment helps heal severe lesions and reduce pain. The following are the treatment options:

Medications to treat symptoms:

  1. Topical anesthetics - they numb the area temporarily, which provides temporary relief from pain and discomfort.

  2. Corticosteroids - given to reduce inflammation. They are available as mouthwash, ointment, and gel that are directly applied to the mouth. Your doctor might prescribe oral corticosteroids for some time or give corticosteroid injection into the lesion.

Immunosuppressant drugs:

These medications modify or suppress the immune response. The drugs used are:

  1. Calcineurin inhibitors - oral gel or ointment is used, which helps in suppressing the immune system. The examples include Tacrolimus and Pimecrolimus.

  2. Oral immunosuppressants are prescribed if lesions affect other areas, such as scalp, genitalia, and esophagus.

If the lesions of oral lichen planus are triggered by medicines, stress, or allergy, then the doctor will suggest ways to manage those triggers.

Home Remedies:

The following home remedies may help improve the symptoms of oral lichen planus or prevent recurrent episodes:

  1. Maintain good oral hygiene, as it helps in reducing your symptoms and help prevent secondary infection. Brush your teeth twice daily using a soft toothbrush and make sure you floss daily.

  2. Avoid eating spicy, salty, and acidic foods, as they trigger or worsen the symptoms. Include soft and bland food in your diet to reduce discomfort.

  3. Avoid drinking caffeinated beverages.

  4. Do not smoke or consume alcohol.

  5. Avoid alcohol or tobacco.

  6. Avoid habits, such as chewing your lips or cheeks.

  7. Manage stress with the help of meditation, breathing exercises, etc.

  8. Go for regular dental checkups every six months to get your teeth cleaned.

What Are the Complications of Lichen Planus?

Oral lichen planus might increase the chances of:

  • Severe pain.

  • Nutritional deficiency due to pain while chewing.

  • Depression.

  • Scarring.

  • Oral fungal infections.

  • Weight loss.

  • Stress.

  • Oral cancer.

For early detection of such lesions and other oral problems, make sure you visit your dentist regularly. As lichen planus is a chronic condition, it needs long term care. To know about how often you need to consult a dentist to get your condition evaluated, how the treatment is progressing, and for cancer screening, consult a doctor online now!

Frequently Asked Questions


What Does an Oral Lichen Planus-Affected Mouth Look Like?

The lesions of oral lichen planus are commonly found on the inner cheek region and tongue and are characterized by white dots arranged in a lace-like pattern or lacy patches. They also cause redness, sores, gum and tongue ulcers, and pain while having hot and spicy foods in severe conditions.


How Dangerous Is Oral Lichen Planus?

Though oral lichen planus cannot be cured permanently, it can be treated, and it is not a serious or dangerous disease. However, recurrence is possible in some people.


Is Oral Lichen Planus Caused by a Fungus?

No. Oral lichen planus is not caused by fungus or any microorganism, and it is not an infection.


Is Oral Lichen Planus Autoimmune in Origin?

Although the exact cause of oral lichen planus is not clearly identified, it is understood that it possibly occurs due to the body’s altered immune response. Certain precipitating factors are,
- Oral allergens (dental fillings, toothpaste ingredients, etc.).
- Viral infections.
- Drugs like antibiotics, antivirals, painkillers, etc.


What Factors Flare-up Oral Lichen Planus?

- Food allergies.
- Alcoholism.
- Smoking.
- Stress.
- Medications (antihypertensives, antidiabetic, painkillers, etc.).
- Defective dental fillings.
- Infection.


What Are the Foods That Trigger Oral Lichen Planus?

- Alcohol.
- Salty foods.
- Spicy foods.
- Hot foods.
- Orange juice.
- Lemon juice.
- Tomatoes.
- Caffeinated beverages.
- Crisps.


How Fast Does the Spread of Lichen Planus Take Place?

Lichen planus spread takes place over a period of a few weeks to months.


How Much Duration Does Lichen Planus Take To Heal?

Lichen planus usually regresses on its own within a period of six months to one and a half years.


Is Lichen Planus Very Common?

About 1 to 2% of the adult population are affected by lichen planus.


Does Stress Have a Role in Causing Lichen Planus?

Stress indeed plays a role in worsening symptoms of lichen planus or causing lichen planus to flare up.


Does Lupus Exhibit Oral Lichen Planus as Its Symptom?

Though oral lichen planus is not a symptom of lupus, both lupus and lichen planus can coexist. Oral lichen planus is associated with systemic lupus erythematosus in its lesions and microscopic appearance.


Does Oral Lichen Planus Resolve on Its Own?

Oral lichen planus usually resolves on its own and does not require treatment if it is mild. Treatment is aimed to reduce and ease the symptoms.


What Natural Methods Help Treat Oral Lichen Planus?

- Intake of vitamin A-rich foods like sweet potatoes, spinach, etc.
- Turmeric ointments.
- Coconut oil pulling.
- Stress management.


What Does Untreated Lichen Planus Cause?

Mild oral lichen planus does not cause any serious effects. Still, regular monitoring of the lesions and condition is necessary as in rare cases, they tend to become cancerous. If left untreated, it might cause pain while eating and drinking.


What Treatment Methods Help Me Get Rid of Lichen Planus?

Mild oral lichen planus does not need any treatment and needs regular monitoring to note any worsening symptoms.
- Eliminating triggering factors and the following medications help in relieving symptoms.
- Topical anesthetic gel application.
- Tretinoin gel application.
- Steroid injections.
- Steroid ointments.
- Good oral hygiene maintenance.
- Refraining from smoking.
- Using Dexamethasone, Cyclosporine, or Tacrolimus containing mouth rinses.


Which Mouthwash Is Best to Manage Oral Lichen Planus?

- Chlorhexidine mouthwash.
- Hydrogen peroxide mouthwash.
- Benzydamine mouthwash.
- Triamcinolone acetonide mouthwash.
- Clobetasol mouthwash.


Does Saltwater Help to Manage Oral Lichen Planus?

There are no evident studies that support the beneficial effects of saltwater rinses in the management of oral lichen planus.


Does Oral Lichen Planus Have a High Cancer Transformation Rate?

The chances of an oral lichen planus transforming into cancer are rare. There are three types of oral lichen planus, namely, reticular, erosive, and plaque type. Of the three, only the erosive type is prone to become malignant.

Article Resources

Last reviewed at:
16 Sep 2022  -  5 min read




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