Mild lichen planus of the nails: what to know

Lichen planus is an inflammatory condition that can affect skin, mouth, scalp, and nails. Nail involvement may appear as fine longitudinal ridges, roughness, thinning, grooves, splitting, or a nail lifting from its bed. Changes can affect one or several nails and may become more noticeable as the nail grows.

Nail fungus, trauma, psoriasis, and other disorders can look similar. A clinician may inspect the nail and surrounding skin and may arrange testing before treatment.

Keep nails short but do not cut into the surrounding skin. Wear gloves for wet work and household chemicals, avoid biting or scraping beneath the nail, and reduce repeated pressure from manicures or tight footwear. Moisturise the hands and nail folds with a bland product.

Treatment depends on the nail pattern and other affected sites. A clinician may discuss [Topical Corticosteroids](/treatments/medical-dermatology/topical-corticosteroids/) for accessible inflammation or [Oral Corticosteroid Treatment](/treatments/medical-dermatology/oral-corticosteroid-therapy/) when broader disease requires it. Do not apply steroid medicine without instructions.

Arrange a dermatology review if a nail is progressively thinning, splitting, lifting, painful, or changing colour. Seek prompt care for pus, marked swelling, severe tenderness, or a dark new streak. Review is especially useful when nail changes occur with [Itchy Skin](/symptoms/itchy-skin/) or [Skin Bumps](/symptoms/skin-bumps/).

Ask whether the nail pattern fits lichen planus, whether testing is needed, which nails need treatment, and how to prevent permanent scarring of the nail matrix. Mention mouth sores, scalp symptoms, itchy skin, or new bumps.