Flat Lichen: Causes, Symptoms and Treatment

Lichen planus is a disease that can cause swelling and irritation of the skin, scalp, nails and mucous membranes. On the skin, lichen planus usually appears as flat, itchy purplish bumps that develop over several weeks. In the mouth, vagina, and other areas lined with mucous membranes, lichen planus forms net-like white patches that sometimes present as painful sores.

Most people can control typical, mild cases of oral lichen planus at home, without medical attention. If the disorder causes pain or a lot of itching, you may need prescription medication. Flat lichen is not contagious.

Signs and symptoms of lichen planus vary depending on the affected area. Typical signs and symptoms are:

Flat, purplish bumps, most often on the inside of the forearm, wrist, or ankle and sometimes on the genitals Itching Blisters that burst to form scabs or scabs White, web-like patches in the mouth or on the lips or tongue Ulcers in the mouth or vagina Hair loss Change in color of the scalp Damage or loss of nails

See your doctor if small bumps or a rash develops on your skin for no apparent reason, such as a known allergic reaction or contact with poison ivy. Also see your doctor if you have any signs or symptoms associated with lichen planus on your mouth, genitals, scalp, or fingernails.

It is best to receive a quick and accurate diagnosis, as various skin and mucous membrane conditions can cause injury and discomfort.

Anyone can get lichen planus. However, this disease usually affects middle-aged adults more. Oral lichen planus, in general, affects middle-aged women more.

The doctor makes a diagnosis of lichen planus based on symptoms, medical history, physical exam, and, if necessary, lab test results. Some of these tests are:

Biopsy.

The doctor takes a small sample of the affected tissue for examination under a microscope. The tissue is analyzed to determine if it has the characteristic cellular patterns of lichen planus.

Hepatitis C test.

You may have a blood test to test for hepatitis C, which is a possible trigger for lichen planus.

Allergy tests.

Your doctor may refer you to an allergy specialist (allergist) or dermatologist to see if you are allergic to anything that may trigger lichen planus.

Other tests may be needed if your doctor suspects you have one of the many variants of lichen planus, such as the type that affects the esophagus, genitals, ears, or mouth.

Lichen planus of the skin often goes away on its own over months or years. If the disease affects the mucosa, it tends to be more resistant to treatment and prone to recurrence. Whatever treatment you use, you will need to see your doctor for follow-up visits about once a year.

Medications and other treatments can help relieve itching and pain and aid healing. Treatment can be difficult. Consult your doctor to weigh the possible benefits against the possible side effects of treatment.

If your doctor suspects your lichen planus is related to hepatitis C infection, allergies, or a medication you’re taking, you may need other treatment. For example, you may need to switch medications or avoid irritating allergens. Your doctor may refer you to an allergist or, in the case of hepatitis C infection, to a liver disease specialist (hepatologist) for treatment.