Lichen planus

What is lichen planus?

It is a condition that causes either inflammation and erosive changes, or patches of thickened skin.

It is not contagious. You cannot get it from or give it to others.

It is not a type of cancer.

It can happen on any part of the body, such as the:

  • Vulva and vagina
  • Gums or inside of the mouth (oral lichen planus)
  • Skin or scalp

Who gets lichen planus?

Any person can get lichen planus. It is most often seen in middle-aged adults.

Lichen planus of the vulva and vagina happens more often in women of childbearing age.

Women get lichen planus in their mouths more often than men do.

What causes lichen planus?

The cause is unknown.

It may be caused by an allergic or autoimmune disease. Antibodies are made by the body to fight infections. With lichen planus, the antibodies attack normal skin and tissue causing damage.

Some medicines can cause a rash that looks like lichen planus. Be sure to tell your doctor about all medicines you take.

What are the signs?

Vaginal signs are:

  • More vaginal discharge than normal that does not get better with after treatment for vaginitis.  The discharge is often:
    • Sticky
    • Yellow
    • Green
    • And/or bloody
  • Redness, soreness, burning, and raw skin
  • Bleeding and/or pain with intercourse
  • Scarring, which may cause the vagina to shorten, narrow, or close
  • Patches of thickened skin

These change from woman to woman. They can be mild to severe.

Mouth sores may:

  • Be tender or painful (mild cases may not cause pain)
  • Be on the sides of the tongue, inside the cheek, or on the gums
  • Form lines in a lacy network
  • Lead to dry mouth

Skin sores:

  • Often appear on the inner wrist, legs, torso, or genitals
  • Are very itchy
  • Have even sides (symmetrical) and sharp borders
  • Can be alone or in clusters, often at the site of a skin injury
  • May be covered with thin white streaks or scratch marks
  • Are shiny or scaly looking
  • Have a dark, violet color
  • May lead to blisters or ulcers

How is it diagnosed?

A provider will look for skin changes often found with lichen planus.

Vaginal discharge is tested.

A biopsy or small skin sample might be needed to confirm.

How is it treated?

It tends to be a long-term condition. Symptoms can often be kept under good control when treated. Have regular follow-up with your provider.

Vulvar/vaginal lichen planus may be treated with:

  • Follow the vulvar skin care guidelines.
  • Steroid ointments, creams, or vaginal inserts
    • Put them on affected areas, as ordered.
    • These will help lessen soreness, burning, redness, and discharge.
    • Caution: Use only as prescribed by your provider. Overuse may cause thinning of the skin. This will make the problem worse rather than helping it.
  • Tacrolimus (Protopic) ointment
    • Put it on affected areas, as ordered.
    • It helps lessen the immune response in skin disease.
    • Caution: Use only as prescribed by your provider. It may cause a slight burning sensation.
  • Pimecrolimus (Elidel) cream
    • This cream is put into the vagina with an applicator.
    • It helps lessen the immune response in skin diseases.
    • Caution: Use only as prescribed by your provider. It may cause a slight burning sensation.
  • Vaginal dilators or intercourse:
    • Your provider will teach you how to use dilators, if you choose to use this method.
    • This prevents a decrease in the length or depth of the vagina due to scarring. It gently stretches the skin.

Lichen planus in the mouth may be treated with:

  • Tacrolimus/steroid ointments, creams, or solutions
  • Pimecrolimus

Your provider may consult with dentistry also.

About half of the women with vulvar/vaginal lichen planus also have oral lichen planus.

Last reviewed: 
May 2020
Alternative Names: 
Vaginal lichen planus
Vulvar lichen planus
Oral lichen planus
Lichen planus of the mouth

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