Lichen planus is a long-term condition affecting your skin and mucous membranes. When the infection or skin rash affects the mouth, it is called oral lichen planus. They appear as white patches or web-like threads inside the cheeks.

Lichen planus is a disease that may affect your skin and any lining mucosa. It could be the oral, vaginal, esophageal mucosa, and skin. 

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Often, the infection is found only in the oral cavity. On average, lichen planus may affect approx 2 percent of the population. However, this disorder might occur in all age groups. Women who are over the age of 50 years are mostly affected. 

What is Oral Lichen Planus?

Lichen planus is a chronic, long-term disease that may affect your mouth’s skin and mucous membranes. Mucous membranes are thin layers of tissue that line all your body cavities and secrete mucus. When lichen planus appears in your mouth, they are called oral lichen planus.

Lichen planus is an itchy skin rash usually caused by an immune response. It may occur anywhere in your body. But when they happen in your mouth, they might be irritating. 

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Note that in the case of this disease, the mucous membranes inside your mouth are generally the ones affected. It is important to understand that the disease presents signs and symptoms quite different from other cases of lichen planus. Instead of a rash, individuals may experience white patches, swollen tissues, and open sores.

This lichen planus in your mouth is not contagious, and it can not spread to another person.

How Common is Oral Lichen Planus?

The oral and skin types of lichen planus affect an estimated two percent of the population.

Who is Likely to Have Oral Lichen Planus?

Anyone can develop this condition. But women are twice as likely as men to develop the disease. Most cases often occur in adults aged 50 and older.

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The cause of this disease is not completely understood. But experts believe that genetics and immunity might be involved. 

Several findings suggest that the human body reacts to an antigen, meaning an allergic reaction within the surface of the skin or mucosa. However, some think that lichen planus is an autoimmune disorder. The skin cells lining your mouth are attacked by the white blood cells. However, more research is needed in this area. 

Others classify lichen planus as a cell-mediated immune response. They believe that since a specific antigen has not been identified, it is premature to classify the disorder as autoimmune.

Is oral lichen planus contagious?

No, the diasease generally do not spread from person to person.

What Causes Oral Lichen Planus?

The exact cause of this infection is unknown. Research suggests that the condition is related to your immune system and genetic makeup.

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However, some people develop the condition after taking certain medications. These medicines could be beta-blockers and nonsteroidal anti-inflammatory drugs, or NSAIDs. It is also important to know that diseases such as primary biliary cirrhosis and hepatitis B may also cause the conditon.

What are the Symptoms of Oral Lichen Planus?

For most people, oral lichen planus, especially the reticular type, appears as white patches. One may notice web-like threads on the inside of the cheeks. These threads and patches are often raised slightly. Note that this type of lichen planus is usually not painful.

In some cases, the disease, especially the erosive type appears as bright red gum tissue. Moreover, in severe cases, ulcers may also develop on the gums of mucosal tissues on the tongue or inside the mouth. Eating and drinking hot, spicy, or acidic foods items or beverages could be painful for individuals with suffering from the disease.

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Note that skin lesions are commonly noticed in individuals having the disorder. Nearly half of the people with this condition also have skin lichen planus, which might cause itching.

How is oral lichen planus diagnosed?

Your doctor diagnoses the condition by examining your mouth. In many cases, your doctor may take a tissue sample or biopsy to confirm the diagnosis and rule out other diseases.

How is Oral Lichen Planus Treated?

Mild conditions might not need any treatment. Instead, your doctor will constantly monitor your condition. Your doctor will recommend specific treatments only if symptoms worsen.

Milder forms of the infection usually go away on their own over time. Especially if you discontinue the medication that triggers the condition. Your doctor will usually treat more severe cases of oral lichen planus with one or more medications.

What complications are associated with oral lichen planus?

As it is a chronic or long-term condition, chances of complications are rare. Occasional flare-ups are common among patients.

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However, a more severe form of the condition is called erosive lichen planus. It can make it painful to eat, drink or even brush your teeth.

However, some researchers indicate a greater likelihood of developing oral cancer if one has erosive oral lichen planus. Approximately 1 to 3 percent of individuals with the disease eventually develop oral cancer. But this issue still needs to be resolved as some cases may not have been true lichen planus. So whatever be the case, patients with erosive lichen planus should strictly follow three months for evaluation.

Appearance in the Mouth

Lichen planus often appear in the mouth in several different patterns. You can notice the reticular pattern on the cheeks as lacy web-like, white threads that are usually slightly raised. You can refer to them as Wickham’s Striae. The name lichen comes from a plant that grows on rocks with its mossy, web-like appearance.

The erosive or atrophic pattern may affect any mucosal surface. It may include the tongue, cheeks, and gums. This form often appears as bright red because there is a loss of the top layer of the mucosa in the affected zone. In most instances, people with erosive lichen planus feel uncomfortable eating and drinking. Especially when they eat stuff with extremes of temperature, acidic, coarse, or spicy foods.

In severe cases, ulceration may develop. You may experience pain even when you are not eating or drinking once you get affected by ulcerations. A less common form of lichen planus is the one plaque-like lichen planus – which appears as a dense thickening of your mucosal tissue.

It is important to know that the lichenoid reactions are instances of mucosal disease that often resemble lichen planus both microscopically and clinically. They happen due to an allergic response. The best treatment options include oral hygiene products, medications, and occasionally, metallic filling materials placed by your dentist. It is difficult to identify the causes of a lichenoid reaction. 

The severity and subsequent disability caused by lichen planus vary from inconsequential to severe. In addition to the oral mucosa, lichen planus may occur on other mucosal surfaces like the eyes, esophagus, and genitalia.

Can Oral Lichen Planus be Prevented?

Unfortunately, there is no way to prevent oral lichen planus. You can lower your risk for infection and other oral conditions by eating various fruits and vegetables, not drinking large amounts of alcohol, and quitting smoking.

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For many individuals, the infection eventually disappears. However, it is essential to note that the condition can take years to resolve. One might notice flare-ups as they are pretty common. 

Conclusion

As you might have understood, it is a chronic condition. You can manage the signs and symptoms but your doctor cannot cure the condition. Because of this, you need to maintain regular appointments with your dentist to help you manage your symptoms. Your doctor will also watch for any potential signs of mouth cancer.