Lichen planus

What is lichen planus?

Lichen planus is an inflammatory skin condition triggered by the immune system. This condition affects about 1% of the population. It’s more common in women than men and it mainly affects adults aged 40 years and over. About 50% of people with the condition have it in their mouth.

Lichen planus is not contagious and can’t be spread through sex. But it is a lifelong condition that will need to be treated and monitored.

Lichen planus and lichen sclerosus can occur together.

Symptoms of lichen planus

Symptoms of lichen planus vary depending on the areas affected. When lichen planus affects the vulva and vagina, you may notice:

• lacy, white lesions on your vulva and at your vaginal opening
• reddish brown patches on the inner part of your vulva
• painful, burning sores in your vagina
• red, raw skin around your vulva
• scarring
• the sides of your vagina sticking together.

You may also have:

• painful erosions and ulcerations
• severe itching
• painful vaginitis (inflammation of the vagina) with vaginal discharge
• vulval bleeding that happens easily on contact, especially after sex
• stinging when weeing
• painful sex (dyspareunia).

What causes lichen planus?

It’s thought that lichen planus is an autoimmune condition. These conditions cause the immune system to attack the body’s own tissues.

Other factors associated with lichen planus include:

• stress
• genetics
• injury to your skin (caused by scratching)
• hepatitis C
• viruses like those that cause chicken pox (herpes varicella) and shingles (herpes zoster)
• bacteria (Helicobacter pylori)
• vaccines and medicines.

How is lichen planus diagnosed?

Your doctor will ask about your symptoms and medical history. They will also ask to examine your vulva. They may take a small sample (biopsy) of vulval skin and send it to a laboratory for testing.

Depending on your situation, your doctor may refer you to a skin specialist (dermatologist) or gynaecologist who specialises in vulval conditions.

Treatments for lichen planus

There is no cure for lichen planus, and you won’t be able to get rid of it completely, but treatment should reduce symptoms and stop the condition from getting worse.

Treatments may include:

• corticosteroid ointment applied on your vulva and in your vagina to reduce pain, itching and inflammation
• medicines and ointments to help reduce the body’s immune response
• surgery to remove scar tissue or adhesions that cover the entrance to your vagina – surgery is rare.

The ointments will provide symptom relief, reduce inflammation and limit the risk of adhesion and scarring. It’s important to use the ointments long-term and as prescribed. Your doctor will need to review this treatment regularly.

What you can do

It’s important to take extra care of your vulva and vagina when managing this condition. For example, use a soap-free wash, avoid tight-fitting clothes and try not to rub or scratch affected areas.

Learn more about vulval care.

Risks of lichen planus

Lichen planus can lead to changes in your vulva and vagina, including:

• disappearance of your clitoral hood
• shrinkage of your inner lips (labia)
• your inner lips sticking together
• scarring that narrows your vaginal entrance.

Lichen planus doesn’t cause cancer, but it is associated with an increased risk of vulval cancer.

When to see your doctor

See your doctor if you notice any symptoms. Sometimes lichen planus can be mistaken for other skin conditions, including lichen sclerosus, so it’s important to get the right diagnosis and treatment. If you are diagnosed with lichen planus, you will need to have regular, ongoing check-ups with your doctor to monitor your condition.

Related resources

Download our vulval health fact sheets in English and other languages.