Dermatologist explains lichen planus, a chronic inflammatory condition that can affect the skin, mouth, nails, scalp, and even the genitals. If you’ve noticed itchy red or purplish bumps on your skin, white patches in your mouth, or unexplained nail or hair changes, this video will help you understand what’s happening and what to do next.
In this video, board-certified dermatologist Dr. Dray takes a deep dive into lichen planus, covering symptoms, causes, diagnosis, and effective treatment options. This condition is often under recognized and can be mistaken for eczema, psoriasis, or other skin problems. Learn how to spot it early and get the right care.
Watch until the end to hear expert dermatologist insights on how to manage symptoms, avoid common triggers, and find the best treatments for lichen planus.
🕒 Timestamps:
0:00 Introduction: What is lichen planus
0:49 Why it’s less talked about than eczema or psoriasis
1:15 Causes and who it affects
2:04 Symptoms and where it commonly appears
3:10 Skin lichen planus: Itchy purple bumps and Wickham’s striae
4:02 Oral lichen planus: White patches and mouth sensitivity
4:52 Genital lichen planus: How it appears and why it’s often missed
5:35 Scalp lichen planus (lichen planopilaris): Hair loss and scarring risk
6:25 Nail changes caused by lichen planus
6:52 Common triggers: Medications, infections, and stress
7:48 How dermatologists diagnose lichen planus
8:33 Treatment options: Topical, oral, and light-based therapies
9:48 Supportive care and symptom management tips
10:35 Why early diagnosis is so important
11:10 Recap and encouragement for those with lichen planus
💡 Key Takeaways:
Lichen planus is not contagious and not caused by poor hygiene.
It can affect the skin, scalp, mouth, nails, or genital areas.
Early diagnosis and treatment can prevent scarring and long-term damage.
Seeing a board-certified dermatologist is key to getting the right diagnosis and treatment.
FTC: This video is not sponsored. Links are commissionable, meaning I may earn commission from purchases made through links.
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Disclaimer: This video is not intended to provide diagnosis, treatment or medical advice. Content provided on this Youtube channel is for informational purposes only. Please consult with a physician or other healthcare professional regarding any medical or health related diagnosis or treatment options. Information on this Youtube channel should not be considered as a substitute for advice from a healthcare professional. The statements made about specific products throughout this video are not to diagnose, treat, cure or prevent disease.
Happy Friday Dr Dray so excited to be here love the videos have a nice day ❤️
You too!!
Hi Dr. Dray. I have this condition for past 10 years. I noticed this on my shins and weeks later orally. My primary did not know what it was but my dentist knew. It flares up if I am eating spicy foods or any mouthwash or whitening toothpaste. I have not taken any medication for this condition but try to keep the flare ups under control by avoiding trigger foods or drinks.
Thank you for your detailed explanation of this skin issue. Greatly appreciated.
Thank you Dr Dray, i have been dealing with it past 2 years mow
I have had oral lichen planus and it was so painful that I could barely speak and eating was impossible. My doctor was perplexed by what was happening, so I went to my dentist and he was able to diagnose me.
please please please get your oral lichenplaus checked yearly.. my mom never smoked or drank… had oral lichenplanus tested every year as as very low percentage can develop oral cancer .. 5 years she tested positive for cancer cells got it removed …then it came back 2 years ago and spread to her lungs which is extremely rare . Make sure you test every year
Yes, I’ve had it orally and had three biopsies ,all linked to mercury in teeth fillings
@MFightonUSCthank you. I had no idea.
@moonlightshadow2664I think that is my problem. I had a biopsy about a year ago that came back as lichen planus. I no longer have the issues with the white lacy looking patches on the inside of my cheeks, but on the top, around my back teeth is very sore and red. I have very old fillings in those 2 teeth. Were you told that if you change the filling it would help?
OMG, this is eye opening! I’ve been struggling with all these symptoms, except for the nails for over 3 years and no one can tell me what is going on. This includes , 2 different Primary care, dentist, ENT, infectious disease doctor, pain management and now they are sending me to a cardiologist and a neurologist. I’m currently waiting for a referral to go through to a new dermatologist. My current dermatologist that diagnosed 5 of the removed skin cancers would no longer take me because I had to go on Medicaid after loss of income over all these issues basically ruining my life and lifestyle. I think this is what I have been struggling with for so many years. Thank you for your video and insightful information 🙏🏼
So great that you did this vid today because of personal issues with my scalp. I have progressive MS and have been going nuts with itch and bumps and little pimples. Nothing has worked to date but I’m booked for a biopsy in a week and am hopeful for a treatment!
I hope you get some answers and treatment! ❤
It’s ironic that you just posted this. I was diagnosed w lichen planopilaris the past week. It has been devastating bcuz I have lost a good portion of my hair. The itching and pain are intense.
Have ytried berberine?
@jeffbrown9060no, is that something that helps?
@jeffbrown9060no I’ve never heard of it
I have had it since 2009 and it was miss diagnosed for years.
I’m so sorry. How did you get diagnosed? I’ve been dealing with intense scalp itch for 8 years with accompanying hair loss. It’s been terrible. Had a biopsy done in 2019, and it mentioned LPP as a possibility, but nothing conclusive. Had another biopsy in 2024, but again, nothing conclusive. But something tells me that what I have is actually LPP. Anything you’d like to share would be most appreciated.
Thank you. I was diagnosed with this 2 years ago by my dentist. I see an oral surgeon every 6 months because of the increased risk of oral cancer. I rinse with prednisone every second day. It was suggested I keep it in the fridge (which I do) because it makes the taste slightly more palatable. Even though I am rinsing and spitting it out it is not nice as it warms up.
Thank you Dr Dray for talking about this as it needs more studies! I have oral lichen planus and was diagnosed via a biopsy. For toothpastes, I noticed an improvement when I got SLS free ones. I have happily been stable for 5 years now 😊
I also have a white tongue, it didn’t go away with dexamethasone rinsing. The doctor said I need a biopsy. I’m afraid of a biopsy. Tell me about toothpaste.
For toothpaste I use Squigle. It is mail order product from PA.
I have lichen planus for 15 yrs and it was all over my body, especially in my back. I have tried about 10 different creams and I still have it in my legs. I got it in Indonesia. A doctor in Singapore made a biopsy and told me that it was lichen planus, after several doctors couldn’t tell me what I had. The itchiness and discomfort that I suffered and I still is depressing. Now I using two different creams that a dermatologist recommended but not good results. At least I didn’t get it in my mouth or hair. I am using now castor oil and that is helping more that the medication. Hope that less people get this condition.🙏
How are you applying the castor oil?
@seeki@seekingmyself4myselfrry that I didn’t see your question. I apply castor oil mix with rose hip oil, squalane and coconut oil. The mix is mostly castor oil. I applied every morning to the affected area and I have gotten better results than the steroid cream, which I am worry than it was thinning my skin. I have been struggling with this condition for more than 15 years. I had it all over my body but now it is in the front of my legs. This condition is misery and I hope that you get it under control soon🙏
Try Vaseline Deep Restore cream, yellow bottle. Fixed 4 I had on my lower legs.
Happy Halloween Dr Dray…see you tomorrow x💙🤩🎃
I had a biopsy 3 years ago & was diagnosed with this because my hair had fallen out
My dermatologist said that flares can be triggered by other skin issues, such as contact dermatitis. My last really bad flare was triggered by a patch of contact dermatitis from a piece of jewelry that probably contained nickel. After he told me that I thought back to the origin point of my first outbreak and it had started where I had nicked myself shaving my legs.
Ive been diagnosed with Lichen Planus Pilaris. I’m a little confused about Hydroxychloroquine being a trigger as I was treated with Hydroxychloroquine to quite down the inflammation. I’m no longer on the oral medication after a scalp biopsy did not confirm the diagnosis. I now use topical steriod to control the hair loss. Unfortunately it is now effecting my nails. I’m in the process of seeking treatment options for that. It’s a nightmare, wouldn’t wish it on anyone. Thank you for covering the subject ❤.
Hydroxychloroquine (HCQ) is an immunomodulatory med and is often the first med given for autoimmune diseases. Oral Lichen Planus is autoimmune in nature, which is why it worked. HCQ has lots of potential side effects but I would imagine Lichen Planus is more rare, so the chance of it helping it vs worsening it is much higher. All the other options for autoimmune are really strong immunosuppressant and steroid drugs so they’re not going to go right for any of those if HCQ is an option. The side effects and risks of those drugs just FAR outweigh the slight risk of HCQ worsening the Lichen Planus rather then helping it.
I used to be a nail technician. Seeing pictures of those nails makes me think this could be easily misdiagnosed as nail fungus. Yes , when moisture gets trapped under the nails it causes them to turn green but over time , people who have chronic nail fungus have nails that look just like that condition .
thank you Dr dray my moms oral LP turned into cancer ..horrific. Has had it removed and it came back .. tongue was cut twice poor thing. Her second time it spread to lymph nodes and lungs . She just finished her lung radiation ..and will need immunotherapy for two years every 6 weeks. Never smoked or drank. It’s been an unbelievable journey
Poor thing! I wish her a speedy recovery. So scary
@Hemmyiithank you so much.. it’s been very tough ..
That is not good I have had oral lichen Plantus for years before I was tried by a Dermatologist I had vulva cancer.
Hope she is doing better now.❤
😢 I was just diagnosed with OLP in April and im just learning how it can change to oral cancer. I’m so sorry to hear what your Mom has been through. I pray that she is doing better.
I had my first severe outbreak in 2013 when I was 17. All over my body. Went through light therapy then. I still have hyperpigmentation all over my skin, I’d say 50% faded in 12 yrs. 3 yrs ago I had second outbreak and it still shows up in between. I try to keep healthy lifestyle but have no idea what triggers it. I have just accepted that it’s gonna stay with me for lifetime.
anything that helps during flare-ups?
This is my story. I first came down with Linchen Planus in my early teens. After countless doctor visits, my mother found a doctor that knew what it was at first sight. He prescribed a medication and within about 6 weeks I was cured and it never returned until now at the age of 50. It’s like i’m living my teenage years twice. I know exactly why I came down with this issue, but have not found a doctor to explore other avenues of treatment. Six years ago , there was a major hurricane here in the Bahamas. To get to and from my home , I had to swim through five feet of water for about five days until the water subsided. About seven days after, I noticed my skin started to break out. I did a biopsy and found out that it was indeed Lichen Planus. The water that I swam through definitely is the culprit. It all made sense, when I was a teenager rain water would settle in the yard where I lived because it flooded. And there were times as a child, I submerged myself in the flooded yard. I cannot remember the medication that was prescribed to me as a teenager. But I know for sure that there is a simple treatment out there.
Can u pls tell how u cured….
How were you cured
How were you cured?
Please which madicine u try
It will help all of us if you try and recollect the medication name
Was diagnosed with “LP” today. The itching is TERRIBLE!!!! I’m just happy to finally know what’s going on.
Same here too. TY ❤
My grandmother had it in her mouth ,then her legs. I have developed it also ,but I my lady parts . It sucks worse then anything I’ve ever experienced in my life .
I just got diagnosed. Many doctors told me I had Scabies. But a dermatologist did a biopsy.