Pigmented Lichen Planus: What to Know

Lichen planus is an inflammatory condition that can produce itchy, raised, or flat-topped bumps. When inflammation settles, pigment can remain in the skin, creating brown or grey-brown patches. Pigmented lichen planus may be more noticeable in areas exposed to friction or sunlight, and the colour can persist after the active rash is quiet.

A clinician may examine the pattern and ask about itch, new bumps, medicines, and mouth or nail changes. A biopsy may be considered if the appearance is unclear or another pigmented disorder needs exclusion.

Use a gentle cleanser and moisturiser, avoid scratching, and reduce rubbing from clothing or accessories. Topical corticosteroids may calm local inflammation and itch when prescribed. More widespread or stubborn disease may lead to a discussion of oral corticosteroid treatment or another specialist option.

Protecting exposed skin from sunlight can reduce additional darkening. Do not use bleaching products or strong exfoliants on inflamed skin without medical advice, because irritation can deepen the colour change. Keep photographs to compare gradual changes at follow-up.

Arrange a review if patches spread, new bumps become numerous, itch disrupts sleep, or treatment causes burning or thinning skin. Seek prompt assessment for painful mouth sores, difficulty eating, eye symptoms, genital involvement, blistering, or rapidly changing pigmentation.

Ask whether the colour is post-inflammatory, whether a biopsy is useful, which areas need treatment, and how to use corticosteroids safely on each body site.