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Dr. Chrysoula I. Liakou MD, PhD
- Treated online: Yes, usually. The skin rash shows well on camera and is treated with prescription creams; some forms need a specialist.
- What it is: an inflammatory condition that causes shiny, purple-red bumps on the skin and white patches in the mouth, and can affect the genitals, nails and scalp.
- Not contagious: you cannot catch lichen planus, and it does not usually come back once it has cleared.
- Usual course: on the skin it usually clears in about 9 to 18 months; in the mouth it can last for years.
- Emergency: call 112 for blistering or peeling skin with sores in the mouth or eyes, or difficulty breathing or swallowing.
Lichen planus is not urgent. Blistering or peeling skin with sores in the mouth, eyes or genitals needs 112. A mouth so sore that you cannot eat or drink enough needs prompt care. A sore in the mouth or on the genitals that does not heal, or a white patch that thickens or changes, needs an in-person examination.
Can an online doctor treat lichen planus?
Yes, usually. Lichen planus on the skin has a typical look, with shiny, flat-topped, purple-red bumps crossed by fine white lines, so a doctor by video can recognise it and prescribe treatment for the itch and rash. Mouth symptoms can often be managed online too, alongside your dentist. Lichen planus with open sores in the mouth or genitals, on the scalp or in the nails needs a specialist in person, and the doctor tells you when.
How an online consultation helps with lichen planus
- A clear diagnosis: Lichen planus, psoriasis, eczema or a rash from a medicine: the doctor tells them apart.
- Relief from the itch: Strong steroid creams or ointments used the right way, and what to do about scratching.
- A sore mouth eased: Mouthwashes and sprays, and foods and habits that keep soreness down.
- The right specialist: When the mouth, genitals, scalp or nails need a dermatologist or oral specialist.
What the doctor checks in an online consultation
The doctor asks about:
- The rash: where it is, how long it has been there, and how itchy it is.
- Your mouth: white patches, burning or soreness when eating, and bleeding gums.
- Genitals: sore patches on the vulva or penis.
- Nails and scalp: thinning or ridged nails, and patches of hair loss.
- Medicines: anything new in the months before the rash, as some medicines cause a rash like lichen planus.
- Your health: hepatitis C or liver problems, and other skin conditions.
Before the call, find good light, and if you can, take a clear photo of the inside of your mouth.
Lichen planus symptoms
Lichen planus can affect the skin, the inside of the mouth, the genitals, the nails and the scalp. The symptoms depend on where it is:
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| Area | What you may notice |
|---|---|
| Skin | Clusters of shiny, slightly raised, flat-topped, purple-red bumps a few millimetres across, often with fine white lines across them, most often on the inner wrists, around the ankles and on the lower back; often itchy, but not always |
| Mouth | White, lacy patches on the gums, tongue or inside of the cheeks; burning or stinging, especially when eating or drinking |
| Genitals | Sore red patches on the vulva, or ring-shaped purple or white patches on the penis |
| Nails | Rough, thin nails with grooves; nails may shed or stop growing |
| Scalp | Patches of hair loss, which can scar |
On black or brown skin, the rash may be harder to see: it can look darker or purplish, with lighter streaks, and on the palms and soles it can look yellowish-brown. New bumps often appear in lines where the skin has been scratched or injured. About half of people with lichen planus on the skin also have it in the mouth, and about 1 in 10 have nail changes. You may have only one of these symptoms.
Types of lichen planus
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| Type | What it looks like | Where |
|---|---|---|
| Hypertrophic | Thick, wart-like patches | Usually the shins |
| Annular | Ring-shaped patches | Armpits, groin and genitals |
| Lichen planopilaris | Redness, scale and patches of hair loss that is usually permanent | Scalp |
| Erosive | Painful raw areas and sores | Mouth, gums and genitals |
| Actinic | Patches triggered by sunlight | Sun-exposed skin, such as the face |
| Pigmentosus | Flat grey-brown marks, without a rash first, more common on darker skin | Often the face |
What causes lichen planus?
Lichen planus is an autoimmune condition: the immune system attacks the skin or the lining of the mouth. It affects about 1% of people, mostly adults aged 30 to 60. It is not an infection, you cannot catch it, and it is not usually inherited, although a tendency to it can run in families. Things linked to it include:
- hepatitis C infection, so the doctor may suggest a blood test
- some medicines, including some blood pressure and antimalarial medicines, which can cause a very similar rash called a lichenoid drug reaction
- physical and emotional stress, which can trigger it or make it worse
- skin injury, such as cuts, burns and scratches, where new bumps can appear
- a contact allergy to dental amalgam fillings, in some people with lichen planus only in the mouth where the cheek touches a filling; replacing fillings helps only when an allergy is shown
Lichen planus or something else?
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| Condition | What points to it |
|---|---|
| Lichen planus | Shiny, flat-topped, purple-red bumps with fine white lines; white lacy patches in the mouth |
| Psoriasis | Thicker, red, scaly plaques, often on the elbows, knees and scalp |
| Eczema | Dry, itchy, rough patches, often in the skin creases |
| Lichen sclerosus | Itchy, white, fragile patches on the genitals |
| Pityriasis rosea | One larger scaly patch first, then oval patches on the chest and back |
How to ease lichen planus at home
On the skin
- Wash with warm water, and avoid soaps and body washes.
- Wash your hair over a sink or bath so shampoo does not run over the rash.
- Use a moisturiser, and try not to scratch, as new patches can appear where the skin is damaged.
In the mouth
- Avoid foods and drinks that make your mouth sore: often spicy or salty foods, citrus fruits and juices, tomatoes, caffeinated drinks and alcohol.
- Brush your teeth carefully twice a day with a soft toothbrush and a mild toothpaste without sodium lauryl sulfate.
- Use an alcohol-free mouthwash if alcohol stings.
- Have regular dental check-ups and cleaning, and try not to chew your lips or the inside of your cheeks.
- Stop smoking and avoid alcohol: both raise the risk of mouth cancer.
On the genitals
- Have showers rather than baths, and avoid tights and close-fitting clothes.
- For itching or swelling, hold a bag of frozen peas wrapped in a clean tea towel on the area.
- Dry carefully after peeing, without rubbing, and use a lubricant if sex is painful.
Nails
- Keep nails short and smooth, and moisturise the nails and cuticles.
- Wear gloves for wet work and cleaning, and do not bite or pick the nails.
Which lichen planus treatment might the doctor recommend?
Treatment depends on where lichen planus is and how much it bothers you. This is the framework the doctors use, in line with NHS and dermatology guidance.
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| What you have | Likely first step | Suitable for online care? | When in-person care is needed |
|---|---|---|---|
| Itchy rash on the skin | A strong steroid cream or ointment | Yes | If it does not respond |
| Thick, stubborn patches | A stronger steroid, or a steroid injection into the patch | Yes, to assess | For injections |
| Widespread or severe rash | A short course of steroid tablets, or light therapy | Yes, to assess | For light therapy |
| White patches in the mouth, no soreness | Care at home and regular dental checks | Yes | At dental check-ups |
| Sore, burning mouth | A steroid mouthwash or spray | Yes | If sores do not heal |
| Sores in the mouth or genitals, scalp or nail changes | A specialist’s care | Yes, to assess | For specialist treatment |
Itchy rash or a sore mouth that will not settle? A doctor can assess it and plan treatment in one consultation.
See available times →Treatment options for lichen planus
What you can do yourself
- Keep soaps and perfumed products off the rash, and moisturise.
- Avoid scratching, which brings new patches.
- In the mouth, avoid foods and drinks that sting, and keep up careful brushing.
Prescription treatment
A prescription is never issued without a consultation. On the skin, a strong steroid cream or ointment controls the rash and eases itching; once the bumps have flattened and turned brown, it is stopped, because it does not speed up the fading and can thin the skin. Non-steroid creams called calcineurin inhibitors, such as tacrolimus, are an alternative for delicate areas. For a sore mouth, the doctor may prescribe a steroid mouthwash, spray or sticky ointment. When creams do not work, or lichen planus is severe, a short course of steroid tablets or light therapy can help, and specialists sometimes use other tablets, such as acitretin, methotrexate or hydroxychloroquine. None of these cures lichen planus: they control it while it settles. If the doctor prescribes, use the prescription at a pharmacy near you.
What does not help
Scratching makes new patches appear, and soaps and perfumed products irritate the rash. Salty, spicy or acidic food and alcohol can make a sore mouth worse.
How long does lichen planus last?
On the skin, lichen planus usually improves by itself in about 9 to 18 months, and in most people it has cleared within a couple of years. It does not usually come back once it has cleared, although some people have another episode months or years later. As it fades, it can leave darker patches that may last for years, especially on darker skin.
In the mouth and genitals, lichen planus is more persistent and can last for 10 years or more, and on the scalp and nails the damage can be permanent. Long-standing lichen planus with open sores in the mouth, on the vulva or on the penis, and the thick hypertrophic type, carries a small risk of skin cancer in that area, so regular checks matter. See a doctor promptly about a sore that does not heal, a lump, or a patch that thickens or changes.
Special situations
Lichen planus in the mouth
Tell your dentist about lichen planus in your mouth, so the patches can be watched at your check-ups. Mouthwashes and sprays ease burning or sore gums.
Scalp and nails
Lichen planus on the scalp can cause permanent bald patches, and in the nails it can make them shed or stop growing, so early specialist treatment matters. Other causes of hair loss are covered on the alopecia page.
Brown and black skin
The thick hypertrophic type, the sun-related actinic type, the grey-brown pigmentosus type and dark marks after healing are all more common on darker skin. The marks fade slowly, over months to years, and steroid creams do not speed this up.
A rash after a new medicine
Some medicines cause a rash that looks like lichen planus. Tell the doctor about anything you started in the months before the rash; do not stop a prescribed medicine without advice.
Children
Mobi Doctor consultations are for adults aged 18 and over. A child who is unwell needs a paediatrician or a local doctor in person, and emergency signs in a child mean 112.
When lichen planus is treated online, and when you need in-person care
Treated online: lichen planus on the skin, itch relief, steroid creams and ointments, sore mouth symptoms with mouthwashes and sprays, short courses of tablets, and blood tests when they are needed.
In-person care: open sores in the mouth or genitals, scalp and nail lichen planus, steroid injections and light therapy, specialist tablets, and any sore that does not heal or patch that changes.
When to get in-person care
Call 112 or go to an emergency department now for:
- blistering or peeling skin with sores in the mouth, eyes or genitals
- swelling of the lips, tongue or throat, or difficulty breathing or swallowing
Get medical advice the same day for:
- a mouth so sore that you cannot eat or drink enough
- a rash that is spreading quickly, with a high temperature
How Mobi Doctor works
- Book a time that suits you: daily 7am–11pm CEST. You can see a doctor over video, usually within 15 minutes. No subscription, and the exact price is shown before you pay.
- Speak to a licensed doctor about lichen planus: show the rash on camera in good light, describe any mouth, nail or scalp symptoms, and list your medicines.
- Leave with a plan: what to do, what to use and for how long, and which signs mean you should be seen in person. If the doctor prescribes, use the prescription at a pharmacy near you.
No sign-up needed
Not sure it’s lichen planus? Tick every symptom you have to see each condition page that mentions it. It finds the right page, not a diagnosis: a doctor gives you that on a video call.
Tap the body — an area or a point — to browse symptoms anywhere
Similar symptoms, different condition? Psoriasis can start the same way. Compare them, or look up any other symptom in the full symptom checker.
Frequently asked questions about lichen planus
What is lichen planus?
Lichen planus is an inflammatory condition that causes shiny, purple-red, often itchy bumps on the skin and white patches in the mouth. It can also affect the genitals, nails and scalp. Planus means flat, after the flat, shiny tops of the bumps.
Is lichen planus contagious?
No. Lichen planus is an autoimmune reaction, not an infection, so you cannot catch it or pass it on by touch, sharing cutlery or sex, and it does not usually come back once it has cleared. It is linked with hepatitis C in some people, which is why the doctor may suggest a blood test, but the hepatitis is what is infectious, not the lichen planus.
What causes lichen planus?
It is an autoimmune condition: the immune system attacks the skin or the lining of the mouth. Hepatitis C, some medicines, stress and skin injury are linked to it, and in some people with lichen planus in the mouth, an allergy to amalgam fillings.
Is it lichen planus or something else?
Lichen planus bumps are shiny, flat-topped, purple and intensely itchy, often with fine white lines on their surface, on the wrists, ankles and lower back. Psoriasis plaques are thicker, pinker and scaly on the elbows and knees; eczema is dry and ill-defined in the creases; and a drug rash is more widespread and starts after a new medicine. In the mouth, lacy white streaks are typical of lichen planus, whereas thrush wipes off. The doctor can usually tell them apart on camera.
How long does lichen planus last?
On the skin lichen planus usually clears in about 9 to 18 months, but it can leave darker marks that fade over months to years. In the mouth and genitals it can last for many years.
Can lichen planus be cured?
There is no cure, but on the skin lichen planus usually goes away by itself and does not come back. Treatment controls the itch and soreness, limits the spread and reduces damage while it settles.
How do I stop lichen planus spreading?
Avoid scratching, rubbing and injuring the skin, because new lichen planus bumps appear where the skin is damaged. Use a moisturiser and a cool compress for the itch, manage stress, and use the treatment the doctor prescribes.
What is the best treatment for lichen planus?
On the skin, a strong steroid cream or ointment. In the mouth, a steroid mouthwash or spray if it is sore. Severe lichen planus may need steroid tablets, light therapy or a specialist.
What foods should I avoid if I have lichen planus?
If your mouth is sore with lichen planus, avoid spicy and salty foods, citrus fruits and juices, tomatoes, caffeinated drinks and alcohol. Rough, crunchy foods can hurt too.
What does lichen planus in the mouth look like?
Oral lichen planus shows as white, lacy, net-like streaks on the inside of the cheeks, gums or tongue, sometimes with red, sore areas or shallow ulcers that burn or sting with spicy, acidic or hot food and drink; it can also make the gums red and peeling. It is usually painless in its lacy form and is often first noticed by a dentist.
Is lichen planus serious?
Usually not. Long-standing lichen planus with open sores in the mouth or genitals carries a small risk of cancer in that area, so regular checks matter.
Can you get lichen planus on your scalp?
Yes. Lichen planus on the scalp is called lichen planopilaris. It causes redness, scale and patches of hair loss that are usually permanent, so it needs early treatment from a dermatologist.
Can an online doctor treat lichen planus?
Yes, usually. A doctor can recognise lichen planus on camera and prescribe creams, ointments or mouthwashes. Open sores, scalp and nail lichen planus need a specialist.
- Lichen planus, NHS, National Health Service (UK), reviewed 2 August 2023.
- Lichen planus, DermNet, New Zealand, 2023.
- Lichen planus: patient information leaflet, British Association of Dermatologists, updated March 2024.
- Lichen planus: dermatologists’ tips to help you feel better, American Academy of Dermatology, updated 27 January 2025.
- Lichen planus: patient information, Sussex Community Dermatology Service, accessed 15 October 2026.
This page is for information only and is not a substitute for a medical consultation. Guideline links are provided for transparency; treatment decisions are made with your doctor.
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