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Lichen Planus

Lichen planus is a condition that affects the lining of the mouth and tongue, as well as the skin, and very occasionally the genital area. Not all areas may be affected. It is unusual to have it affecting the mouth as well as the skin. It is not an infection; it cannot be caught or passed on.

The cause of lichen planus is not well understood, but it is known that it is an inflammatory condition. It causes soreness, sensitivity and discomfort in the areas affected.

The condition has a variety of appearances. It is commonly seen as a network of fine white lines on the inside of the cheeks, often on a reddish background. Less commonly it can appear as white patches of different sizes and shapes on the tongue or roof of the mouth. Occasionally the gums can be affected, both with white patches and, sometimes, shiny red sore-looking gums.

In the mouth, lesions similar to those described above, can occasionally be seen which have a different cause. These are called lichenoid lesions, and may be triggered by particular substances. For example, some medicines can cause them, commonly blood-pressure medications and anti-diabetic tablets. Also, some dental filling materials such as amalgam fillings and occasionally white filling materials can cause a lichenoid reaction. Before replacing fillings to try and remove the lesion, it would be sensible to see a hospital specialist such as an oral medicine consultant to confirm the diagnosis.

For some patients there is no discomfort as a result of the lichen planus. Other patients may well notice that the soreness is made worse when eating spicy or hot foods, citrus fruits and using strongly flavoured toothpastes and mouthwashes.

The nature of lichen planus is that it goes through periods of increasing soreness and periods when there is little or no discomfort. The condition will eventually disappear of its own accord, but the period for which it is present varies from a couple of years to many years. The average length of time it may be present is about seven years.

No treatments are available which will cure the condition. Some medications can be bought over the counter in a pharmacy. Other treatments, which can be prescribed by a dentist or doctor, are available which can lessen the discomfort. These include chlorhexidine antiseptic mouthwashes or sprays; a paste, spray or tablet application of a mild steroid.

Other more complex treatments are available for the treatment of lichen planus, and these will be used under the direction of a specialist in oral medicine after referral as appropriate.