Lichen Planus – Symptoms and Causes
Overview
Lichen planus is a skin condition that can affect multiple body areas, including the skin, mouth, genitals, hair, and nails.
When it appears on the skin, it typically shows up as flat, purplish bumps that cause itching. These bumps usually develop gradually over several weeks.
In the mouth and genital areas, the condition creates distinctive white, lacy patches that may be accompanied by painful sores.
For mild cases affecting only the skin, treatment may not be necessary. However, if the condition causes significant discomfort through pain or severe itching, medical treatment with prescription medications might be required.
Signs and Problems
Lichen planus creates different symptoms based on where it appears on the body. You might notice:
- Purple, shiny, flat bumps (often found on inner forearms, wrists, or ankles)
- Rash lines in areas where skin has been scratched
- White, lacy patches inside the cheeks or on the tongue
- Itchy skin
- Painful sores in the mouth or genital areas
- Nail damage or loss
- Dark lines running from nail tip to base
- Rarely, loss of hair
When You Should Contact a Healthcare Provider
Contact your healthcare provider if you notice unexplained tiny bumps or a rash on your skin. You should also seek medical attention if you experience any lichen planus symptoms affecting your mouth, genitals, scalp, or nails.
Getting an early and accurate diagnosis is important. Many different conditions can cause similar sores and pain, so proper identification leads to better treatment.
Causes
Lichen planus occurs when the immune system attacks skin or mucous membrane cells. Scientists don’t fully understand why this abnormal immune response happens.
The condition cannot spread from person to person.
Several factors may trigger lichen planus:
- Hepatitis C virus infection
- Medications – particularly certain pain relievers
- Metal allergies – especially reactions to metals in dental fillings
These triggers can start the immune response that leads to the characteristic skin or mucous membrane changes seen in this condition.
Risk Factors
Lichen planus can affect anyone, but certain factors may increase risk:
- Age: Middle-aged adults face a higher risk.
- Gender: Women are more likely to develop oral lichen planus than men.
These patterns help doctors identify who might need closer monitoring for this condition.
Complications
Lichen planus can cause several challenging complications, particularly when it affects certain body areas.
Genital Complications
When lichen planus affects the vulva and vagina, it often proves difficult to treat. The condition can lead to:
- Severe pain in the genital area
- Formation of scars on genital tissues
- Painful sexual intercourse due to sores
Skin and Nail Issues
After lichen planus heals, affected areas may experience:
- Post-inflammatory hyperpigmentation (darker skin patches)
- Permanent nail damage in cases of nail lichen planus
Oral Complications
Mouth involvement can result in significant problems:
- Difficulty eating due to painful sores
- Increased risk of oral cancer (patients need regular monitoring)
- Burning sensation when consuming spicy or acidic foods
Rare Complications
In uncommon cases, lichen planus can affect the ear canal. Without proper treatment, this might lead to hearing loss over time.
Psychological Impact
The visible nature of lichen planus can cause:
- Emotional distress
- Social withdrawal
- Reduced quality of life
Medication Side Effects
Treatments for lichen planus may sometimes cause their own complications:
| Treatment | Potential Side Effects |
|---|---|
| Topical corticosteroids | Skin thinning, stretch marks |
| Oral corticosteroids | Weight gain, mood changes, bone loss |
| Immunosuppressants | Increased infection risk |
Long-term Management Challenges
Managing lichen planus often requires:
- Regular medical follow-ups
- Consistent treatment application
- Lifestyle modifications to avoid triggers
Some patients experience recurring episodes of lichen planus even after successful treatment. These flare-ups may happen without warning and require prompt medical attention.
For patients with genital or oral lichen planus, specialized care from healthcare providers familiar with these specific manifestations is important for proper management and prevention of complications.
