Skin lichen planus on the face: what to know

The rash may appear on the forehead, cheeks, around the mouth, or other areas of facial skin. Colour changes can remain after active inflammation settles, especially in darker skin tones.

Lichen planus is an inflammatory skin condition. On the face, it may look like small, raised or flat-topped bumps with a dusky red, purple, or brown appearance. Itching can be strong, and rubbing may worsen irritation or leave darker marks.

A clinician may diagnose it by examining the pattern and, when needed, taking a small skin sample. Facial rashes can resemble eczema, contact dermatitis, or other conditions, so appearance alone cannot confirm the cause.

Arrange a dermatology appointment if the rash is new, persistent, spreading, or interfering with sleep. Until then, use a gentle fragrance-free cleanser, lukewarm water, and a plain moisturiser. Avoid scrubbing, picking, fragranced products, and unapproved steroid or bleaching creams on the face.

Treatment depends on the location and activity of the rash. A dermatologist may prescribe a carefully selected topical corticosteroid for a limited course or discuss another anti-inflammatory option. Stronger or more extensive disease may need treatment taken by mouth, with medical monitoring.

Seek prompt medical care if facial lesions involve the eyes, cause vision changes, become painful or infected-looking, or develop open sores. Contact a clinician soon if the rash affects the lips or mouth, or if itching is severe and persistent.

Do not delay assessment for a rapidly changing lesion, repeated bleeding, or a sore that does not heal. These features can have several explanations, but they require an in-person examination.

Ask whether the facial pattern fits lichen planus, whether a biopsy is needed, which products should be stopped, and how long a prescribed treatment should be used. Also ask how to protect treated skin from irritation and how to manage lingering colour changes.