Oral Lichen Planus

Medically Reviewed by Robert Brennan on March 23, 2023
4 min read

Oral lichen planus is a long-lasting disease that affects your mouth with symptoms such as white patches, redness, and swelling. It doesn't go away, but you can keep it under control.

It’s not contagious, but anybody can get it. Women are more likely to have it than men. It's most common in people older than 40. But kids and young adults can also get it.

Doctors aren't sure what causes oral lichen planus, but several things could play a part:

  • It may run in your family.
  • It could be linked to your immune system. Most of the time, your immune cells keep you safe by attacking bacteria and viruses. With oral lichen planus, some doctors believe, those cells get confused and attack the lining of your mouth.
  • It could be linked to hepatitis C. Many people infected with the virus get it.


Some things can set off the condition for the first time, or they can trigger it if you already have the condition. These include:


What is certain is that you can’t pass it to anyone else and you didn't catch it from someone.

Symptoms can come on slowly or start all at once. You may start out with:

  • Dryness
  • A metallic, burning taste in your mouth

Then you may see:

  • White patches on your tongue, cheeks, and gums. They can be tiny dots or lines that make a lace-like pattern.
  • Redness and swelling
  • Peeling or blistering

These sores may burn and be painful. They’ll likely hurt the most when you eat or drink foods that are spicy, salty, acidic (orange juice, tomatoes), or alcoholic. Crispy treats and drinks with caffeine can also cause problems.

Your doctor can diagnose oral lichen planus by taking a small piece of skin from inside your mouth. This is called a biopsy. They’ll run tests on it in the lab to see what the problem is. You may also need blood tests to rule out other conditions.

If you feel only a slight roughness in your mouth, you may not need treatment. If you’re in pain or have sores, your doctor may suggest a corticosteroid cream. In rare cases, they might prescribe steroid pills.

If your doctor suspects your immune system is causing your symptoms, they may suggest a medication that turns down its normal response. These include:

  • Topical ointment or gel. Calcineurin inhibitors are medications that work somewhat like those you’d take after an organ transplant to help prevent your body from rejecting the new organ. But they come with an FDA warning because they may increase your risk of cancer.
  • Systemic medications. You take these by mouth. Your doctor may prescribe them if you’re dealing with oral lichen planus in other parts of your body such as your scalp, genitals, or esophagus.


Watch what you eat and drink. Certain foods and drinks -- especially spicy or citrus ones -- can make your symptoms worse. Hot or cold foods and drinks can also make you more uncomfortable.

Stress can also make things worse.

Get rid of any problems that could trigger oral lichen planus or make it worse:

  • Have your dentist polish sharp teeth or replace damaged fillings or crowns.
  • Talk to your doctor about changing medications that may be to blame.
  • Brush twice a day, and floss daily.
  • See your dentist twice a year for a cleaning and checkup.
  • Use a mild toothpaste and a soft toothbrush.

You also need to keep track of your symptoms and tell your doctor about any changes in your mouth. There's a slight chance that oral lichen planus can lead to oral cancer. Make sure to get a screening for oral cancer every 6 to 12 months.

It's also important to enjoy a diet rich in fruit and vegetables. If you smoke, quit. Don't drink large amounts of alcohol. See your doctor regularly to look for any changes in your mouth.