What should you know about hyperpigmented lichen planus?

Lichen planus is an inflammatory condition that can produce itchy, flat-topped or raised lesions. When inflammation settles, pigment may remain darker than the surrounding skin, especially where lesions were scratched or repeatedly irritated. Dark marks can last after active bumps have disappeared, so colour alone does not show whether the condition is still active.

The distribution, itch, bumps, mouth or genital symptoms, nail changes, and scalp involvement help guide diagnosis. A clinician may need to examine the skin closely and sometimes take a sample because several rashes can resemble lichen planus.

Avoid scratching and use gentle, fragrance-free skin care. Keep appointments if new itchy lesions or bumps appear, because treating inflammation can reduce ongoing irritation and new pigment. Topical corticosteroids may be prescribed for selected areas; oral corticosteroid treatment may be considered when disease is extensive or difficult to control.

Do not start a strong lightening product over inflamed skin. Once activity is controlled, a dermatologist can discuss whether pigment-focused care is appropriate and whether it could irritate your skin.

Seek assessment for persistent itchy skin, spreading bumps, painful mouth sores, genital symptoms, nail changes, scalp hair loss, or a lesion that bleeds or ulcerates. Prompt review is useful when a rash changes quickly or treatment causes thinning, marked burning, or a new reaction.

Ask whether the darker areas show active lichen planus or leftover pigment, whether a biopsy is needed, where to apply treatment, and how long to use it. Ask about mouth, nail, scalp, and genital checks, plus warning signs that should bring you back sooner.