Lichen Planus

Lichen planus is an inflammatory condition that can affect the skin, mouth, and genital area.

On the genitals, it often appears as shiny, flat bumps that may look purple or reddish-brown. You might also notice fine, white, lace-like lines on the surface. The area is usually itchy and can sometimes feel sore or cause a burning sensation.

In more severe cases, the skin may become very red and painful, or develop open sores (ulcers). This can make sexual intercourse or passing urine uncomfortable.

Lichen planus can also affect other parts of the body. For example, it may cause:

• Itchy rashes on the wrists or ankles
• White patches inside the mouth
• Changes to the nails

Because these symptoms can look similar to other conditions, a proper examination is important to confirm the diagnosis.

Lichen planus usually appears as small, shiny, flat-topped bumps that are purple or reddish in colour. These may have fine, white, lace-like patterns on their surface.

In the genital area, it can also appear as:

• White streaks or patches
• Bright red, inflamed skin
• Thin or raw-looking areas

The affected skin is often itchy or sore. As its appearance can vary and may resemble other skin conditions, a clinical assessment is needed to confirm the diagnosis.

Lichen planus most commonly develops in adults between the ages of 40 and 60, but it can occur at any age. It is uncommon in children.

Symptoms may appear suddenly over a few days or develop gradually over several weeks. In the genital area, it often starts as red, sore patches or white, lacy streaks.

If you notice new or persistent symptoms, it is important to have them checked. A clinical assessment can help confirm the diagnosis and guide appropriate treatment.

If left untreated, lichen planus can lead to long-term complications.

Ongoing inflammation may cause scarring in the genital area. This can lead to:

• Pain during sex
• Discomfort when passing urine
• Changes in the shape or structure of the genital skin

In some cases, painful sores may persist and take time to heal.

There is also a small increased risk of developing a type of skin cancer (squamous cell carcinoma) in affected areas, so monitoring is important.

In addition to physical symptoms, the condition can affect emotional wellbeing, including confidence and intimacy.

Early treatment and regular follow-up can help prevent complications and keep symptoms under control.

The exact cause of lichen planus is not fully understood, but it is thought to be an autoimmune condition. This means the immune system mistakenly attacks healthy skin or the lining of the mouth or genital area.

Lichen planus is not an infection. It is not sexually transmitted, cannot be passed to others, and is not related to hygiene.

In some cases, it may be triggered by certain medications (such as some treatments for blood pressure or heart conditions) or viral infections.

However, in many people, no clear trigger is identified.

While the exact cause is unclear, some factors may increase the likelihood of developing lichen planus or triggering symptoms.

These include:

• Being over the age of 40
• A family history of the condition
• Certain medications (e.g. for blood pressure, heart disease, or arthritis)
• Viral infections such as hepatitis C (less common)
• Physical or emotional stress
• Other autoimmune conditions

Not everyone will have an identifiable trigger, and the condition can still occur without any of these factors.

Several factors can make lichen planus more severe or trigger flare-ups.

These include:

• Delayed treatment, which can lead to more painful or erosive forms
• Emotional stress
• Friction or irritation (e.g. tight clothing or sexual activity)
• Irritants such as scented soaps or harsh products
• Secondary infections (fungal or bacterial)
• Scratching, which can worsen the skin changes

Managing these triggers early can help reduce symptoms and prevent complications.

Yes. Lichen planus is not a sexually transmitted infection, so condoms do not prevent it.

It is an inflammatory condition caused by the immune system, not by sexual contact. Although it can affect the genital area, it is not contagious and cannot be passed between partners.

No. Lichen planus is not an infection and cannot be passed from one person to another.

It is an inflammatory condition caused by the immune system, so it is not linked to sexual contact, hygiene, or anything another person has done.

There is currently no known way to prevent lichen planus, as the exact cause is still unclear.

Because it is not an infection, it is not related to hygiene or sexual activity.

If you already have lichen planus, you can help reduce flare-ups by:

• Avoiding scented or harsh products
• Wearing loose, breathable clothing (such as cotton underwear)
• Minimising friction or irritation

If you notice new or persistent symptoms, it is best to have them assessed so treatment can be started early.

Lichen planus is usually diagnosed through a physical examination. A clinician will look at the affected skin and ask about your symptoms, such as itching, soreness, or how long the changes have been present.

In many cases, the diagnosis can be made based on how the skin looks. However, a skin biopsy may be recommended to confirm it. This involves taking a very small sample of skin under local anaesthetic, which is then examined in a laboratory.

This helps ensure an accurate diagnosis and rule out other conditions.

A correct diagnosis is based on a combination of factors.

These include:

• A clear medical history and description of your symptoms
• A careful physical examination of the affected area (and sometimes other areas like the mouth or scalp)
• A skin biopsy, if needed, to confirm the diagnosis

In some cases, additional tests such as swabs or blood tests may be done to rule out infections or other conditions.

Sharing information about any treatments you have already tried can also help guide an accurate diagnosis.

Yes, lichen planus can sometimes be mistaken for other conditions because the symptoms can look similar.

These may include:

• Fungal infections such as thrush
• Certain sexually transmitted infections
• Other skin conditions like psoriasis or lichen sclerosus

Because lichen planus is not an infection, the treatments are different. This is why a proper diagnosis is important to ensure you receive the right care.

A physical examination is usually the first step in diagnosis. If the diagnosis is unclear, a skin biopsy is the most reliable way to confirm it.

This involves taking a small sample of skin under local anaesthetic and examining it in a laboratory.

In some cases, blood tests may also be recommended to check for related conditions or rule out other causes.

No, there is no medical requirement to tell your partner.

Lichen planus is not a sexually transmitted infection and cannot be passed on through sexual contact or physical touch.

However, some people choose to share this information with their partner, especially if symptoms such as soreness affect intimacy. This is entirely a personal decision.

Yes, lichen planus can be treated and managed effectively, although it may require ongoing care.

There is no permanent cure, but treatment focuses on relieving symptoms such as itching and soreness, and helping the skin heal.

The most common treatment is topical steroid creams or ointments, which reduce inflammation. Many people see significant improvement with regular use. You may also be advised to use gentle skincare, such as soap substitutes and moisturisers, to protect the skin.

In more persistent cases, other treatments (such as immune-based creams or tablets) may be considered. Regular follow-up is important to monitor progress and adjust treatment if needed.

Treatment can significantly improve both comfort and long-term skin health.

Key benefits include:

• Relief from itching, burning, and soreness
• Healing of painful areas or sores
• Reduced risk of scarring or long-term skin changes
• Improved comfort during daily activities and intimacy

Ongoing care also allows the condition to be monitored, so any changes can be managed early. This helps maintain both physical comfort and peace of mind.

No, lichen planus is almost always treated with medication rather than surgery.

Treatment usually involves medicated creams (such as topical steroids) and gentle skincare to reduce inflammation and relieve symptoms.

Surgery is only considered in very rare cases, for example if significant scarring has developed and is causing physical problems. This is uncommon.

While medical treatment is usually needed, there are simple steps you can take at home to help manage symptoms and reduce irritation:

• Avoid scented products (such as soaps, bubble baths, or wipes)
• Use a gentle, fragrance-free cleanser or soap substitute
• Wear loose, breathable clothing (e.g. cotton underwear)
• Apply a plain, unperfumed moisturiser (emollient) regularly
• Avoid scratching the area

These measures can help soothe the skin, but prescribed treatments are often needed to control inflammation effectively.

Most people can be treated, but a few factors may affect how treatment is given.

These include:

• The need to confirm the diagnosis first, as symptoms can be similar to other conditions
• The presence of a separate infection, which may need treatment before starting certain creams
• Your medical history, including pregnancy or breastfeeding, which may limit some treatment options

In some cases, further tests such as a biopsy may be recommended before continuing treatment.

Your care plan will always be tailored to ensure it is safe and appropriate for you.

The long-term outlook depends on where the condition occurs.

On the skin, lichen planus often clears on its own within 6 to 18 months. However, in the genital area, it is usually a longer-term condition that may come and go over time.

Although there is no permanent cure, symptoms can be well controlled with treatment. Many people experience long periods where their skin feels normal.

There is a very small risk of skin cancer developing in affected areas over many years, so regular check-ups are recommended.

With proper care and monitoring, most people are able to manage their symptoms and live comfortably.

No, there is no medical requirement to tell your partner.

Lichen planus is not a sexually transmitted infection and cannot be passed on through sexual contact or physical touch.

However, some people choose to share this information, especially if symptoms affect comfort or intimacy. This is a personal decision.

Lichen planus does not affect your ability to get pregnant and is not harmful to your baby. It is not an infection and cannot be passed on during pregnancy or childbirth.

Most women can have a normal vaginal delivery. However, if there is significant inflammation or scarring in the genital area, your doctor may discuss alternative delivery options to ensure your comfort.

It is important to review your treatment if you are pregnant or planning to conceive, as some medications may need to be adjusted. A healthcare professional can guide you on safe and effective options.

No, you do not become immune to lichen planus.

It is not an infection, so it does not work like illnesses where you gain immunity after having it once. The condition can come and go over time.

Some people may only have one episode, while others may experience flare-ups months or years later. Early treatment can help manage symptoms more effectively.

There is no known way to fully prevent lichen planus, as the exact cause is still unclear.

If you have had it before, the focus is on reducing flare-ups and protecting your skin. This can include:

• Avoiding scented or harsh products
• Using gentle, fragrance-free cleansers
• Reducing friction or irritation in the area

Regular monitoring and early treatment can help keep symptoms under control.

No, lichen planus cannot be passed to your baby during pregnancy or childbirth.

It is an inflammatory skin condition, not an infection, so it is not contagious and cannot be transmitted through physical contact or during delivery.

Lichen planus is not known to harm your baby or increase the risk of pregnancy complications.

The main focus during pregnancy is managing your symptoms, as hormonal changes may sometimes trigger flare-ups. Treatments such as certain topical steroid creams are generally safe when used as directed, but some medications may need to be avoided.

Most people can have a normal vaginal delivery. If there is significant discomfort or scarring, your medical team will discuss the best options with you.

Lichen planus is uncommon during pregnancy.

It is not usually caused by pregnancy itself, but it may still occur or continue if you already have the condition. Some people notice their symptoms improve, while others may still experience flare-ups.

If you notice any new or unusual symptoms, it is important to have them checked to ensure safe and appropriate management.

Treatment during pregnancy focuses on relieving symptoms while keeping your baby safe.

Common options include:

• Topical steroid creams (generally safe when used as directed)
• Fragrance-free moisturisers (emollients) and gentle cleansers

Some medications, especially certain oral treatments, are not safe during pregnancy and should be avoided.

Your treatment plan should always be reviewed to ensure it is appropriate for pregnancy.

While lichen planus cannot be prevented, there are ways to reduce irritation and manage symptoms during pregnancy.

These include:

• Using gentle, fragrance-free products
• Avoiding soaps, perfumes, or products that may irritate the skin
• Wearing loose, breathable clothing (such as cotton underwear)

It is also important to review your treatment plan to ensure it is safe during pregnancy. If you notice new or worsening symptoms, seek medical advice.

Lichen planus may affect comfort after childbirth, especially if the genital area is involved. Hormonal changes can sometimes trigger flare-ups, which may cause soreness or itching during recovery.

It does not usually affect your ability to breastfeed. However, if the nipples are affected (which is rare), it may cause discomfort.

When breastfeeding, it is important to ensure that any treatments you are using are safe. Most topical treatments are suitable, but they should be used carefully and as advised.

If your symptoms change after birth or you have concerns about treatment, it is best to seek medical advice for safe and effective management.