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Lichen planus is a long-lasting disease, which can affect the mouth and sometimes other areas of the body. When it appears in your mouth it is called 'oral lichen planus'. It can appear on its own or as part of a disease affecting other parts of your body. Oral lichen planus usually happens in middle to late life and more women get it than men.
Lichen planus shows in many different ways. . The most common signs are white patches on the lining of your mouth (usually your cheeks, tongue and gums). These don't usually hurt, but sometimes there can be redness, ulcers or, very rarely, blistering as well as the white patches. If so, you may find it painful to eat hot or spicy foods.
We don't know the cause of lichen planus with most patients. It may be a sign of a mild weakness in the body's immune (defence) system, but patients with lichen planus are otherwise well. Occasionally it can be caused by a reaction to medicines such as some painkillers, diabetic treatments, drugs for high blood pressure, beta-blockers, gold, penicillamine and a number of other drugs.
Oral lichen planus does not seem to be caused by an infection, nor does it run in families.
Usually it will be diagnosed after a careful examination by a specialist. Because the signs and symptoms of oral lichen planus can be like those of some other disorders, a 'biopsy' is usually needed to be sure about the diagnosis. A biopsy is a very simple procedure, done under a local anaesthetic, where a small piece of tissue is removed from the mouth. The area usually heals within 7 to 10 days.
Usually lichen planus only needs to be treated when there are painful symptoms. Sometimes patients with white patches that are not painful complain of a mild roughness of the lining of the mouth. But this usually does not need any treatment.
When oral lichen planus does need treating, it is usually done by putting a corticosteroid cream on the area. Some areas may need other treatments, such as immunosuppressants applied to the area, and very rarely you might need to take a corticosteroid or other similar tablets.
Oral lichen planus generally never goes away. Patients will usually continue to have white patches on the lining of the mouth. Treatment will lessen the pain, although it is not usually possible to tell when painful periods are likely.
There may be some connection between oral lichen planus and cancer of the mouth in perhaps 1% to 3% of patients who have had the condition a long time. The exact connection between oral lichen planus and cancer is not certain, and only a very few patients with oral lichen planus ever have such complications.
As the cause is usually not known it is impossible to stop oral lichen planus happening. To avoid the risk of serious disease of the lining of your mouth:
Everyone, whether they have oral lichen planus or not, should clean their teeth regularly twice a day with a fluoride toothpaste. They should also have their teeth and gums checked regularly by a dentist so that any changes in the lining of the mouth can easily be spotted.