Lichen planus: symptoms, photos, AI analysis ⚠️ ICD-10: L43 | ICD-11: EA91

Lichen planus is a chronic inflammatory disease affecting the skin and mucous membranes. It typically presents as flat-topped, purple-red papules and is often associated with itching. It may involve not only the skin but also the oral cavity, nails, and hair.

The condition is not contagious and is not transmitted from person to person. It is related to immune system dysfunction and is not caused by fungi or parasites.

The course is usually relapsing, with periods of flare-ups and improvement. In many cases, the condition can be controlled, and in some people, symptoms may eventually resolve completely.

What to do if suspected

If you develop itchy skin lesions or changes in the oral mucosa, it is important not to delay medical evaluation.

The first step is to consult a dermatologist.

If the oral cavity is affected, a dentist should also be consulted.

Depending on the situation, other specialists may be involved.

Additionally:

• do not self-medicate
• do not use strong medications without medical advice
• avoid trauma or irritation of the skin

This is important because without proper treatment the condition may persist, cause significant itching, and in some cases lead to long-lasting changes in skin, nails, or hair.

How it looks

The classic presentation includes small, flat-topped papules with a characteristic color and shine.

They are usually:

• purple-red or violaceous
• smooth and slightly shiny
• may show fine white lacy patterns on the surface

Common locations include:

• wrists and forearms
• shins
• lower back
• lateral trunk

Other possible forms:

• oral mucosa — white lacy lines or patches
• scalp — areas of hair loss
• nails — ridging, thinning, brittleness

Lesions may appear in groups and sometimes merge. Clinical appearance can vary significantly between individuals.

Below in the article you can view real photos to better understand how the condition looks.

Main symptoms

The main symptom is itching, which can be quite intense.

Other signs include:

• characteristic skin eruptions
• dry skin
• burning or discomfort (especially in mucosal involvement)

With long-standing disease, the skin may become thicker due to chronic irritation.

Causes

The exact cause is unknown.

It is believed that the immune system mistakenly attacks skin and mucosal cells, triggering inflammation.

Possible triggers include:

• certain medications
• viral infections
• stress
• skin trauma
• chronic diseases

Important: it is not an infection and is not contagious.

How it develops

The immune system mistakenly identifies skin cells as foreign and triggers an inflammatory response.

As a result:

• papules appear
• itching develops
• normal skin structure is disrupted

When the scalp is involved, inflammation may affect hair follicles and sometimes lead to hair loss.

Forms and types

The condition may present in different forms:

• cutaneous form — most common
• oral mucosal involvement
• scalp involvement
• nail involvement

By course:

• acute — lasting several months
• chronic — with recurrent flare-ups

When to see a doctor

See a specialist if:

• lesions are accompanied by severe itching
• oral mucosa is affected
• nail or hair changes occur
• symptoms persist for a long time

Also seek medical advice if the condition worsens or causes significant discomfort.

Treatment

Treatment aims to reduce inflammation and itching.

Main approaches include:

• topical anti-inflammatory medications
• anti-itch treatments
• skin care measures

In more severe cases, systemic therapy may be used to modulate immune activity.

Additionally:

• avoid triggering factors
• care for the skin gently
• manage underlying conditions

Treatment is always individualized by a physician.

Q&A

Can lichen planus be cured?

In many cases, symptoms can be controlled, and in some people the condition resolves over time.

Is it contagious?

No, it is not transmitted between people.

Should mild cases be treated?

Yes, medical evaluation is still recommended to prevent progression.

Is it dangerous?

Usually not, but it can significantly affect quality of life due to itching.

Why does itching occur?

It is caused by an inflammatory reaction in the skin.

Can it come back?

Yes, relapses are possible, especially with triggers.

Do lesions leave marks?

Sometimes temporary pigmentation changes may remain.

Can the course be influenced?

Yes, proper care and treatment help control symptoms.

Check Your Skin Instantly

Use Dermatology scanner app – Skinive AI to take a photo of a skin lesion and get an AI-based risk assessment. It helps determine whether professional consultation is recommended, giving you fast guidance and peace of mind.

Used medical sources

• Fitzpatrick’s Dermatology, 9th Edition
• European Academy of Dermatology and Venereology (EADV) Guidelines
• American Academy of Dermatology (AAD)
• Clinical Dermatology (Bolognia et al.)

Images of lichen planus: