Lichen planus - Symptoms of lichen planus

The symptoms of lichen planus vary, depending on which area of the body is affected.

Areas of the body most commonly affected by the condition include the:

• skin
• mouth
• penis
• vulva (external female sex organs) and vagina

Lichen planus of the skin

The symptoms of lichen planus of the skin are:

• purple-red coloured bumps (papules) that are slightly raised, shiny and have a flat top. The papules usually measure 3-5mm in diameter and may also have irregular white streaks (Wickham's striae)
• thicker scaly patches can appear, usually around the ankles – this is known as hypertrophic lichen planus
• itchy skin

Lichen planus of the skin often affects the wrists, ankles and lower back, although other parts of the body can also be affected.

Thickened (hypertrophic) lichen planus affects the shins, and ring-shaped lichen planus affects creases in the skin, such as the armpits.

After the papules have cleared, the affected area of skin can sometimes become discoloured.

Lichen planus of the mouth (oral lichen planus)

The symptoms of oral lichen planus are:

• a white pattern on the tongue and inner cheeks
• red and white patches in the mouth
• burning and discomfort in the mouth while eating or drinking
• painful red gums

Mild cases of oral lichen planus don't usually cause any pain or discomfort.

Lichen planus of the penis

The symptoms of lichen planus of the penis are:

• purple or white ring-shaped patches on the tip of the penis (glans)
• bumps (papules) that are flat-topped and shiny
• a non-itchy rash

Lichen planus of the vulva and vagina

The symptoms of lichen planus of the vulva and vagina include:

• soreness, burning and rawness around the vulva
• the vulva may be covered in white streaks and be a red, pink or pale white colour
• if the vagina is affected, sexual intercourse can be painful
• if the outer layers of skin break down, moist, red patches can form
• scar tissue can form, which distorts the shape of the vagina
• a sticky yellow or green discharge, which may be bloodstained
• the opening of the vagina can become narrowed

Other areas

Lichen planus can sometimes affect other areas, including:

• the nails – which can become thinner, ridged and grooved, or they may become darker, thicker or raised; they may sometimes shed or stop growing
• the scalp – red patches can appear around clusters of hair; in some cases, permanent hair loss can occur