Treatment

Oral lichen planus is a chronic condition. There is no cure, so the treatment focuses on helping severe lesions heal and reducing pain or other discomfort. Your doctor will monitor your condition to determine the appropriate treatment or stop treatment as necessary.

If you have no pain or discomfort and if only white, lacy lesions are present, you may not need any treatment. For more-severe symptoms, you may need one or more of the options below.

Symptomatic treatment

Treatments such as topical numbing agents can be used to provide temporary relief for areas that are particularly painful.

Corticosteroids

Corticosteroids may reduce inflammation related to oral lichen planus. One of these forms may be recommended:

• Topical. Mouthwash, ointment or gel is applied directly to the mucous membrane — the preferred method.
• Oral. Corticosteroids are taken as a pill for a limited amount of time.
• Injection. The medication is injected directly into the lesion.

Side effects vary, depending on the method of use. Talk with your doctor to weigh the potential benefits against possible side effects.

Immune response medicines

Medications that suppress or modify your body's immune response may be used to improve more-severe lesions and lessen pain. They come in these forms:

• Topical ointments or gels. Calcineurin inhibitors, similar to oral drugs used to prevent rejection of transplanted organs, may be effective for treating oral lichen planus. But these medications have a Food and Drug Administration warning because of an unclear association with cancer. Examples include tacrolimus (Protopic) and pimecrolimus (Elidel).
• Systemic medication. For severe cases where oral lichen planus also involves other areas — such as the scalp, genitalia or esophagus — systemic medications that suppress the immune system may be used.

The use of some medications, such as topical steroids, can lead to the overgrowth of yeast. During treatment, schedule regular follow-up visits with your primary care provider to check for secondary infections and receive treatment. Not treating secondary infections may worsen the condition.

Dealing with triggers

If your doctor suspects that oral lichen planus may be related to a trigger, such as a drug, an allergen or stress, he or she can recommend how to address the trigger. For example, you may be advised to try another drug instead, to see an allergist or dermatologist for additional testing, or to learn stress management techniques.