Lichen Planus in the Mouth (Oral Lichen Planus): Causes, Symptoms and Care

The commonest form shows as fine white lines in a net or lace pattern, most often on the inner cheeks, usually on both sides. These may cause no symptoms. Other forms appear as red, raw areas, or as ulcers that sting with hot, spicy or acidic food. The gums, tongue and lips can be involved, and some people have gums that look red and peel.

It is not an infection and not contagious. It tends to flare and settle over months and years. Because other white patches look similar, our guide on white patches in the mouth helps in telling them apart.

It is thought to be an immune reaction in which the body's own defence cells attack the lining of the mouth. The reason is not fully understood. Stress can bring on flares. In some people a reaction to a medicine or a dental filling material sits behind it, which is why dentists look at medicines and at fillings next to the affected area.

Rough teeth, tobacco, paan and very spicy food irritate the lining and can make it worse. Some skin and nail changes occur in the same condition, so mention any rash to your doctor.

Many people need no treatment beyond monitoring. For sore patches, the first steps are to avoid spicy, acidic and hot food, stop tobacco and paan, brush gently with a soft brush and mild toothpaste, and keep teeth and gums clean, since plaque can aggravate sore gums. Smooth any sharp tooth or filling edge.

For painful flares, a dentist or doctor may prescribe a steroid gel, rinse or other medicine, and sometimes a small sample (biopsy) is taken to confirm the diagnosis. Do not use steroid creams without advice. Sore areas often look like ulcers, so see the mouth ulcers guide and stomatitis meaning.

A small number of people with oral lichen planus, especially the red and ulcerated forms, go on to develop mouth cancer over many years. The risk is small, but it is the reason regular check-ups are advised and why tobacco, paan and alcohol are best avoided. This is awareness, not a reason to panic.

Get a dentist or doctor to look if a patch changes, thickens, becomes harder, or an ulcer or lump has not healed in about two to three weeks. Our mouth cancer first stage guide and the page on leukoplakia of the tongue describe what to watch for.