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Lichen planus: Signs and symptoms

The signs and symptoms of lichen planus depend on where it appears on the body.

Signs on the skin

On the skin, lichen planus often causes bumps that are shiny, firm, and reddish purple. Sometimes the bumps have tiny white lines running through them. These lines are called Wickham’s striae.

Lichen planus on the skin

When bumps appear on the skin, the bumps are often shiny, firm, and reddish purple.

Lichen planus bumps on the wrist

Most people get a few bumps. Some people get many bumps, which can appear on different parts of the body. The most common places for these bumps to appear are the wrists, lower back, and ankles, but they can appear anywhere on the skin, including the genitals.

On the legs, the bumps tend to be darker.

New bumps may appear as older bumps clear.

When lichen planus develops on the skin, a person can have the following:

  • Thick patches of rough, scaly skin. If bumps continue to appear in the same place, thick patches of rough, scaly skin can form. These patches develop with time and are most common on the shins and around the ankles.

  • Itch. Sometimes the bumps and patches itch. The thick patches are most likely to itch.

  • Blisters. These are rare.

  • Pain, especially on the genitals. The skin can be bright red and raw. Open sores can appear. These can make sex painful or impossible.

Lichen planus on the skin

Some people get many bumps on their skin.

Several lichen planus skin bumps on a person's back

Signs inside the mouth (oral lichen planus)

When lichen planus appears inside the mouth, it most commonly occurs on the insides of the cheeks. It also can appear on the tongue, lips, and gums. Inside your mouth, you may have:

  • Patches of tiny white dots and lines that can look like lace

  • Redness and swelling

  • Peeling on the gums

  • Painful sores (can hurt or burn)

Lichen planus inside the mouth

On the tongue, lichen planus can cause patches of tiny white dots.

Lichen planus on the tongue can cause patches of tiny white dots

Oral lichen planus

On the gums, oral lichen planus can cause redness and sores.

Lichen planus can cause redness and sores on the gums inside the mouth

Signs on the nails

When lichen planus appears on the nails, it often appears on just a few nails. Sometimes it appears on all of the nails on a hand or foot. You may see:

  • Ridges or grooves on the nails

  • Splitting or thinning

  • Loss of nails (can be temporary or permanent)

Lichen planus on the nails

On a fingernail or toenail, lichen planus can lead to nail loss.

Lichen planus on a fingernail

Signs on the scalp (lichen planopilaris)

It is rare, but this disease can develop on the scalp. If it does, you may have the following on your scalp:

  • Redness and irritation

  • Tiny bumps

  • Thinning hair or patches of hair loss

  • Scars (appear slowly)

Images used with permission of the American Academy of Dermatology National Library of Dermatologic Teaching Slides.