10 Lichen Planus Symptoms
Article Sources
- 1. 'Lichen Planus.' British Association of Dermatologists, September 2014, www.bad.org.uk/shared/get-file.ashx?id=168&itemtype=document. Pamphlet
- 2. 'Lichen Planus: Signs and Symptoms.' American Academy of Dermatology, www.aad.org/public/diseases/a-z/lichen-planus-symptoms
- 3. Welz-Kubiak, Kalina, and Adam Reich. 'Mediators of Pruritus in Lichen Planus. Autoimmune Diseases, vol. 2013, 2013, pp. 1-4, doi:10.1155/2013/941431
- 4. Usatine, Richard P., and Michelle Tinitigan. 'Diagnosis and Treatment of Lichen Planus.' American Family Physician, vol. 84, no. 1, 1 July 2011, pp. 53-60, www.aafp.org/afp/2011/0701/p53.html
- 5. 'Lichen Planopilaris.' British Association of Dermatologists, April 3013, https://www.bad.org.uk/shared/get-file.ashx?id=97&itemtype=document. Pamphlet
- 6. Great Western Hospitals. 'Lichen Planus of the Vulva.' NHS, December 2018, www.gwh.nhs.uk/media/343574/Lichen-Planus-of-the-Vulva.pdf. Pamphlet
- 7. Khurana, Ananta, et al. 'Genital lichen planus: An underrecognized entity.' Indian Journal of Sexually Transmitted Diseases and AIDS, vol. 40, no. 2, 2019, p. 105, doi:10.4103/ijstd.IJSTD/45/19
- 8. 'Lichen Planus.' DermNet NZ , dermnetnz.org/topics/lichen-planus/
Lichen planus is a type of rash that can appear in different parts of the body. It's named after its appearance, with lichen meaning small skin bumps and planus, meaning flat. Lichen planus is neither hereditary nor contagious. Although not widely understood, it is thought to be an autoimmune disorder.
Statistically, lichen planus affects up to 1 percent of the global population. While there is no cure, it commonly resolves within around 18 months, though lichen planus in the mouth can take longer to disappear. There are diverse lichen planus symptoms and various methods to control the condition, depending on the severity and location.1‘Lichen Planus.’ British Association of Dermatologists, September 2014, www.bad.org.uk/shared/get-file.ashx?id=168&itemtype=document. Pamphlet
Bumps on the Skin
A lichen planus rash can occur on the skin anywhere around the body. It commonly manifests on the wrists, ankles and lower back, though some individuals may have a rash in the genital area.
Lichen planus typically causes bumps that are a purple-red color, though a rash on the legs may be darker. Fine white lines, known medically as Wickham's striae, may pass through the bumps. Skin lumps are usually hard and may be shiny. Some people have just a few bumps, while others have many. New lichen planus bumps can appear as older bumps resolve.2‘Lichen Planus: Signs and Symptoms.’ American Academy of Dermatology, www.aad.org/public/diseases/a-z/lichen-planus-symptoms
Scaly Skin
Scaly skin can be a sign of lichen planus. The skin may harden and become thick and scaly if a rash repeatedly appears on the same part of the body. It typically takes time for scaly patches of skin to appear, after a person has had lichen planus for a while.
Rough scaly skin is commonly experienced on the ankles or shins, although it can occur anywhere around a person's body. Rarely, blisters may form too.
Itchiness
A rash caused by lichen planus may be itchy. Itchiness can vary in severity and there is commonly no relief when using traditional itch-relief remedies. Skin itching can be uncomfortable and bothersome.
Itchiness typically affects skin that has become rough and hardened. Reasons for such itching are unknown, though studies suggest various possibilities. These include secretions of inflammatory cells and stimulation of special receptors in the skin's nerve cells.3Welz-Kubiak, Kalina, and Adam Reich. ‘Mediators of Pruritus in Lichen Planus. Autoimmune Diseases, vol. 2013, 2013, pp. 1-4, doi:10.1155/2013/941431
Nail Changes
Lichen planus can affect the nails of the hands or feet. It is typically present on a few nails as opposed to all. Symptoms of lichen planus of the nails include nail weakness and the development of grooves or ridges. It can also cause thinning of the nails, which can result in splitting.
People may also experience nail loss, which can be temporary or permanent. Some people may find nail changes unsightly and upsetting.
White Spots in the Mouth
White spots in the mouth may be a lichen planus symptom. Spots can appear in the cheeks, on the lips, on the gums or on the tongue. Studies suggest that people who have oral lichen planus commonly have a rash elsewhere on the body too.
Typically, there are no other symptoms associated with lichen planus in the mouth. Occasionally, however, individuals might have mouth sores, blisters, red patches, pain or swelling.4Usatine, Richard P., and Michelle Tinitigan. ‘Diagnosis and Treatment of Lichen Planus.’ American Family Physician, vol. 84, no. 1, 1 July 2011, pp. 53-60, www.aafp.org/afp/2011/0701/p53.html
Hair Loss
Lichen planus can affect the scalp, or other parts of the body that have hair. This condition is known as lichen planopilaris. It can cause small bumps on the skin, irritation, redness and hair loss.
Hair loss occurs because the lichen planus rash is caused by an autoimmune reaction, where the immune system attacks hair follicles. The follicles are destroyed, leaving scars in their place. Any hair loss caused by lichen planus is permanent. The visible effect may be thinning hair or bald patches.5‘Lichen Planopilaris.’ British Association of Dermatologists, April 3013, https://www.bad.org.uk/shared/get-file.ashx?id=97&itemtype=document. Pamphlet
Vaginal Changes
If lichen planus affects a woman's vagina, it can cause patches of discoloration of the vulva. Skin may look red raw, sometimes with thin white lines running through the patches. Typically, there is associated itching and soreness. Pain may be worse during sex.
Discolored patches may bleed, and scarring may develop. In severe cases, scarring can alter the shape and structure of the vagina and vulva. Some women with vaginal lichen planus experience vaginal discharge.6Great Western Hospitals. ‘Lichen Planus of the Vulva.’ NHS, December 2018, www.gwh.nhs.uk/media/343574/Lichen-Planus-of-the-Vulva.pdf. Pamphlet
Penis Discoloration
When lichen planus affects a man's genitalia, symptoms include reddish-brown spots on the penis or scrotum. The edges of the lesions may be paler in color, and there may be white lines through the discolored areas. Sometimes, lesions appear in a ring-shaped formation on the tip of the penis.
Other lichen planus symptoms of the male genitalia include burning sensations, itchiness and pain. Sex can be difficult or impossible. Lichens planus is not contagious and cannot be passed on through sexual intercourse.7Khurana, Ananta, et al. ‘Genital lichen planus: An underrecognized entity.’ Indian Journal of Sexually Transmitted Diseases and AIDS, vol. 40, no. 2, 2019, p. 105, doi:10.4103/ijstd.IJSTD/45/19
Yellow-Brown Spots
While most skin lumps caused by lichen planus are purple-red in color, spots on the soles of the feet or palms of the hand typically take on a yellow-brown hue. Apart from being a different color, these spots typically manifest in the same way as a lichen planus rash elsewhere on the skin.
People may experience hardening of the skin on the soles or palms, itchiness or blisters. There may be few or many spots.8‘Lichen Planus.’ DermNet NZ , dermnetnz.org/topics/lichen-planus/
Skin Discoloration
Lichen planus can sometimes cause hyperpigmentation, or darker patches, of the skin without first having an inflammatory stage. While the skin typically has red-purple bumps when inflamed, occasionally lichen planus can present as irregularly shaped gray-brown patches on the skin. These marks commonly appear on the neck, arms, legs or torso.
Known specifically as lichen planus pigmentosus, the rash may be worsened by sun exposure. There are typically no other symptoms, although people may occasionally have mild itchiness.
