What should you know about face lichen planus?

Facial lesions may be purple, reddish, or darker than the surrounding skin, and irritation can leave colour changes after the active inflammation settles. The appearance can overlap with eczema, acne, contact dermatitis, or other rashes, so a clinician may inspect the skin closely and sometimes arrange a biopsy. Lichen planus can also affect the mouth, scalp, nails, or genital skin, which is worth mentioning during assessment.

Use a bland cleanser and moisturiser, avoid scratching, and pause fragranced or harsh products that sting. Keep a list of medicines and supplements because some eruptions can resemble lichen planus. A clinician may recommend topical corticosteroids for local inflammation; more extensive disease may need oral corticosteroid treatment or another option. Use sun protection because ultraviolet exposure can make residual dark marks more noticeable.

Arrange assessment for a new persistent facial rash, especially when it is spreading, intensely itchy, painful, or leaving marked colour change. Seek prompt care for mouth sores that make eating difficult, eye symptoms, scalp hair loss, genital involvement, blistering, pus, or fever. Rapid swelling of the lips, tongue, or face with breathing difficulty requires emergency help.

Could this be lichen planus or another rash? Do I need a biopsy? Which topical corticosteroid strength and duration are appropriate for facial skin? How should I manage itch and leftover colour change? Should my mouth, nails, scalp, or other skin be checked?