What should you know about white lichen planus?

Lichen planus is an inflammatory skin condition that may affect the skin, mouth, scalp, nails, or genital area. Its more familiar lesions can be itchy, raised, and violaceous, while healing areas or certain forms may look lighter or white. A pale patch is not enough to confirm lichen planus; fungal infection, eczema, pigment changes, and other disorders can overlap in appearance.

A clinician may ask when the patch appeared, whether it itches or changes, and whether similar areas are present elsewhere. The examination may include the mouth, nails, and scalp when relevant.

Arrange a dermatology assessment if a new pale patch persists, spreads, becomes scaly, or is uncomfortable. Until then, use gentle fragrance-free products, avoid scratching, and protect exposed skin from strong sunlight so colour differences are less noticeable.

Treatment depends on the site and activity. A clinician may consider topical corticosteroids for local inflammation; more extensive disease can require a different plan, sometimes including oral corticosteroid treatment. Do not use a steroid on the face, mouth, or genital skin without specific instructions.

Seek prompt medical advice for painful mouth sores, difficulty eating or swallowing, rapidly changing patches, eye symptoms, widespread blistering, or signs of infection such as increasing warmth, swelling, pus, or fever. A patch that repeatedly bleeds or does not heal also deserves examination.

Ask whether the pattern fits lichen planus or another cause, whether any test is needed, which products are safe for the affected site, and how long to try treatment before review.