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• #1 Therapeutic strategies for oral lichen planus: State of the art and new insights

  https://pmc.ncbi.nlm.nih.gov/articles/PMC9578567/

  Oral lichen planus (OLP) is a chronic inflammatory disease of the oral mucosa. […] While reticular OLP is relatively easy to control, erosive OLP is extremely painful and refractory to therapies, limiting the quality of life of the patients. In addition, treating erosive OLP is extremely tricky, and a gold standard treatment has not yet been established. However, several therapeutic approaches have been reported as effective, including systemic corticosteroids, systemic retinoids, and anti-interleukin (IL)-17/anti-IL-23 drugs. […] In this paper, we reviewed the English- and German-language literature about therapeutic strategies for treating OLP, focusing on new systemic therapies for erosive OLP. […] Several therapeutic options can be used in OLP. Non-erosive OLP can be usually treated with topical potent corticosteroids (CS) (e.g., clobetasol propionate 0.05%). Intralesional injection of triamcinolone can be useful in erosive OLP. In case of severe erosive OLP or refractory forms, several systemic therapies have been proposed as effective, including systemic CS, apremilast, hydroxychloroquine (HCQ), and systemic retinoids. […] For practical purposes and easier consultation for clinicians, we reported the therapies in alphabetical order in the text, while in the Table 1 we finally listed the recommended therapies for OLP based on the review of the literature and the clinical experience of the authors.

• #1 Oral lichen planus: Management and prognosis – UpToDate

  https://www.uptodate.com/contents/oral-lichen-planus-management-and-prognosis

  Oral lichen planus (LP) is a mucosal subtype of LP that presents with a variety of clinical features. Clinical subtypes include reticular oral LP (white striations, papules, and plaques), erythematous (atrophic) oral LP (mucosal atrophy and red patches), and erosive oral LP (erosions or ulcers) (picture 1A-B). […] The primary goal of treatment is to reduce the pain and morbidity typically associated with erythematous and erosive disease. […] Initial management includes topical corticosteroids, oral hygiene, and trigger avoidance. […] Insufficient response to topical corticosteroids may require patient assessment and selection of subsequent therapy, including topical calcineurin inhibitors and intralesional corticosteroid injections. […] For severe or refractory disease, systemic glucocorticoids may be used, along with additional therapies such as oral metronidazole, hydroxychloroquine, and retinoids.

• #1 Oral Lichen Planus

  https://www.aaom.com/oral-lichen-planus

  A: Often the reticular form of oral lichen planus does not require any treatment, except periodic observation by a health care professional. The erosive and ulcerative forms can usually be controlled with the use of topical corticosteroids. In some cases, systemic steroids or other medicines may be prescribed by your doctor. […] A goal of therapy is to convert bothersome erosive or ulcerative oral lichen planus to the asymptomatic reticular form. Individuals with oral lichen planus often require some form of maintenance therapy to keep their disease under control. Oral lichen planus can be controlled but often will exhibit disease flare-ups requiring additional. Finally, following a healthy lifestyle consisting of a well-balanced diet, exercise and stress reduction is also beneficial.

• #1 Diagnosis and Treatment of Lichen Planus | AAFP

  https://www.aafp.org/pubs/afp/issues/2011/0701/p53.html

  High-potency topical corticosteroids are first-line therapy for all forms of lichen planus, including cutaneous, genital, and mucosal erosive lesions. […] In addition to clobetasol, topical tacrolimus appears to be an effective treatment for vulvovaginal lichen planus. […] Topical corticosteroids are also first-line therapy for mucosal erosive lichen planus. […] Systemic corticosteroids should be considered for severe, widespread lichen planus involving oral, cutaneous, or genital sites. […] Referral to a dermatologist for systemic therapy with acitretin (an expensive and toxic oral retinoid) or an oral immunosuppressant should be considered for patients with severe lichen planus that does not respond to topical treatment. […] Various treatments have been employed to treat symptomatic oral lichen planus, but complete resolution is difficult to achieve.

• #1 Oral Lichen Planus – European Association of Oral Medicine

  https://eaom.eu/education/eaom-handbook/oral-lichen-planus/

  Patients with white patches are generally asymptomatic, although they may complain of mild oral roughness, soreness or dryness of the oral mucosa. This generally does not require treatment. Individuals with erosive, ulcerative or bullous disease generally tend to have oral discomfort, particularly with spicy or acidic foods, and thus require treatment. […] The management of painful oral lichen planus usually comprises: […] Relief of painful symptoms – this can best be achieved with regular use of benzydamine hydrochloride (0.15%) spray or mouthrinse. When this is not available, it may be appropriate for the patient to apply 2% lidocaine gel to painful areas; […] Treatment of definitive disease – topical corticosteroids are the mainstay of treatment of oral lichen planus. A wide range of agents are suggested to be effective. These include:

• #1 Oral Lichen Planus – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK578201/

  Oral lichen planus (OLP) is a chronic T-cell mediated inflammatory disease that affects the oral mucosa. […] The primary aim of treatment is to reduce inflammation and provide symptomatic relief. Topical corticosteroids are the first-line treatment for OLP and can be applied as an adhesive gel or used as a mouth rinse. […] While triamcinolone acetonide gel is commonly used in treating patients with OLP, higher potency corticosteroids such as clobetasol propionate are more effective in providing symptomatic relief. […] Patients applying the topical gel are instructed to dry the oral mucosa before application and avoid eating and drinking for 30 minutes after the application to provide sufficient contact time with the oral mucosa. […] Intralesional corticosteroid injections may also be administered to treat persistent erosive OLP.

• #1 Diagnosis and Treatment of Lichen Planus | AAFP

  https://www.aafp.org/pubs/afp/issues/2011/0701/p53.html

  Topical corticosteroids are first-line therapy. […] High-potency topical steroids are the most effective, with response rates up to 75 percent compared with placebo. […] Topical corticosteroids are also first-line therapy for mucosal erosive lichen planus. […] Systemic corticosteroids, such as oral prednisone, should be considered only for severe, widespread oral lichen planus and for lichen planus involving other mucocutaneous sites. […] Topical calcineurin inhibitors, such as tacrolimus and pimecrolimus (Elidel), are second-line therapies for oral lichen planus. […] A comparative study showed that topical tacrolimus is as effective as the high-potency corticosteroid clobetasol in the treatment of oral lichen planus. […] A randomized controlled trial revealed that pimecrolimus 1% cream effectively treats erosive oral lichen planus with long-lasting therapeutic effects. […] If topical corticosteroids are ineffective, carbon-dioxide laser evaporation can lead to long-term remission of symptoms, and may be appropriate as first-line therapy in patients with painful oral lichen planus.

• #1 Lichen planus – A refractory autoimmune disorder – IJCED

  https://www.ijced.org/html-article/18573

  A topical corticosteroid is always considered first-line therapy for patients with oral lichen planus. […] Intralesional Triamcinolone injection in ulcerative OLP is effective and safe in achieving lesion and pain regression. […] Acitretin is preferred in the hyperkeratotic variant of lichen planus for its modulating effect on keratinization. […] Topical Tacrolimus has been shown to inhibit T-lymphocyte activation by inhibiting the phosphatase activity of calcineurin. […] Pimecrolimus 1% cream seems to be an effective and well-tolerated treatment for oral erosive lichen planus. […] Cyclosporine can be used either in the form of mouthwashes or in the form of an adhesive base. […] Levamisole reduces the levels of tumor necrosis factor-, interleukin-6 and interleukin-8 in patients with oral lichen planus and it has been found to be effective in oral lichen planus either alone or as an adjuvant to Systemic corticosteroids.

• #1 Oral Lichen Planus – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK578201/

  Systemic corticosteroids are primarily used to treat recalcitrant OLP that is resistant to topical therapies, severe OLP with widespread ulceration and erythema, and lichen planus with extra-oral involvement affecting multiple sites. […] Second-line therapies can be considered to manage recalcitrant OLP that does not respond to topical corticosteroids. […] Newer calcineurin inhibitors such as tacrolimus should be used with caution, given the Food and Drug Administration (FDA) black box warning regarding the reported increased risk of squamous cell carcinoma and lymphoma. […] The use of retinoids is also cautioned in pregnant women as it is potentially teratogenic.

• #1 Oral Lichen Planus Treatment & Management: Medical Care, Diet, Activity

  https://emedicine.medscape.com/article/1078327-treatment

  Medical treatment of oral lichen planus (OLP) is essential for the management of painful, erythematous, erosive, or bullous lesions. The principal aims of OLP therapy are as follows: […] The main concerns with available therapies are the local and systemic adverse effects and the possibility of lesion recurrence after treatment is withdrawn. No treatment of OLP is curative. […] Topical corticosteroids are the mainstay of medical treatment, though in rare cases, corticosteroids may be administered intralesionally for a focal lesion or systemically for diffuse recalcitrant lesions. […] Erosive OLP that is unresponsive to topical corticosteroids may respond to topical tacrolimus. […] Other potential therapies for recalcitrant OLP include cyclosporine, hydroxychloroquine, azathioprine, dexamethasone elixir, mycophenolate mofetil, dapsone, systemic corticosteroids, and topical and systemic retinoids.

• #1 Oral lichen planus | Cleveland Clinic Journal of Medicine

  https://www.ccjm.org/content/90/12/717

  Intralesional injection of triamcinolone acetonide in concentrations of 10 to 20 mg/mL is helpful in persistent oral lichen planus. […] Systemic corticosteroids like methylprednisolone or prednisolone (11.5 mg/kg daily) may be indicated in patients unresponsive to topical steroids. […] Other medications such as topical calcineurin inhibitors, oral retinoids, hydroxychloroquine, mycophenolate mofetil, and oral and topical cyclosporine have also been used in the treatment of oral lichen planus. […] Oral lichen planus, especially the erosive type, is a potentially premalignant disorder with a higher risk of progression to squamous cell carcinoma and necessitates periodic follow-up.

• #1 Treatment of Oral Lichen Planus with Intralesional Injection of Steroids: Case Reports

  https://www.journalomp.org/journal/view.html?doi=10.14476/jomp.2024.49.4.158

  Oral lichen planus (OLP) is a chronic inflammatory disease of unknown etiology affecting the oral mucosa. As it is difficult to cure, long-term management aims to improve the patients quality of life by reducing inflammation and alleviating pain. While systemic and topical corticosteroids are commonly used treatments, their efficacy is often limited by side effects or poor compliance. This study investigates the effectiveness of intralesional steroid injections (ILIs) in patients resistant to conventional therapies. […] Intralesional steroid injections (ILIs) have emerged as a promising alternative for patients who do not respond to topical steroid treatments or have adverse effects on systemic treatments. Intralesional therapy delivers corticosteroids directly into the affected tissues, providing high local concentrations of the drug while minimizing systemic exposure. Several studies have demonstrated the efficacy of intralesional triamcinolone in reducing the size and severity of OLP lesions, as well as in alleviating pain and discomfort.

• #1 Therapeutic strategies for oral lichen planus: State of the art and new insights

  https://pmc.ncbi.nlm.nih.gov/articles/PMC9578567/

  The use of topical calcineurin inhibitors, such as tacrolimus and pimecrolimus, in OLP is extremely diffuse in the clinical practice, although more placebo-controlled, randomized studies are needed to evaluate effectiveness and safety of topical calcineurin inhibitors in comparison to topical CS. […] However, Volz et al. reported a significant reduction in oral erosions with topical pimecrolimus 1% compared to placebo in a prospective randomized double-blind vehicle-controlled study. […] Topical CS represent the first-line approach in OLP. […] The authors concluded that Rivelin -CLO patches were superior to placebo, demonstrating statistically significant objective and subjective improvement and a favorable safety profile. […] Cyclosporine (CsA) is a calcineurin inhibitor, used as an immunosuppressant medication. […] In addition, in a randomized, comparative, double-blind study on 40 patients, topical clobetasol was more effective in comparison to topical CsA in inducing a clinical improvement.

• #1 Therapeutic strategies for oral lichen planus: State of the art and new insights

  https://pmc.ncbi.nlm.nih.gov/articles/PMC9578567/

  PDT combines the use of a photosensitive agent and a harmless light source with a particular wavelength. […] Adverse events after PDT include erythema, pain, edema, and contact dermatitis at the site of application of the photosensitizer. […] Retinoids are derivative of vitamin A and have been widely used for treatment of acne and photoaging because of their activity in blocking inflammatory mediators and reducing keratinization of epithelial cells. […] The authors concluded that alitretinoin should be preferred to acitretin because of its efficacy, tolerability, and better teratogenic profile. […] The use of anti-IL-17, anti-IL-12/IL-23, and anti-IL-23 monoclonal antibodies was reported as extremely effective in refractory erosive OLP. […] In our experience, anti-IL-17, anti-IL-12/IL-23, and anti-IL-23 monoclonal antibodies represent an effective and safe alternative therapy in refractory erosive/ulcerative OLP.

• #1 Lichen planus Information | Mount Sinai – New York

  https://www.mountsinai.org/health-library/diseases-conditions/lichen-planus

  The goal of treatment is to reduce symptoms and speed healing. If your symptoms are mild, you may not need treatment. […] Treatments may include: […] Antihistamines […] Medicines that calm down the immune system (in severe cases) […] Lidocaine mouthwashes to numb the area and make eating more comfortable (for mouth sores) […] Topical corticosteroids or oral corticosteroids to reduce swelling and lower immune responses […] Corticosteroid shots into a sore […] Vitamin A as a cream or taken by mouth […] Other medicines that are applied to the skin […] Dressings placed over your skin with medicines to keep you from scratching […] Ultraviolet light therapy.

• #1 Lichen Planus: What It Is, Causes, Types & Treatments

  https://my.clevelandclinic.org/health/diseases/17723-lichen-planus

  Replacing dental fillings. Though rare, some people have allergies to the mixtures of different metals (amalgams) used in tooth fillings. These allergic reactions may look similar to lichen planus. Replacing amalgam fillings with a hypoallergenic material that wont cause an allergic response may improve your irritation or sores. […] There are several over-the-counter products or home remedies that can help stop your rash from itching. […] Aloe vera. Aloe vera is a wound care gel that can moisturize, heal and treat sores. Some research suggests that it can relieve lichen planus symptoms in your mouth or on your vulva. […] Antihistamines. Antihistamines are a class of drugs commonly used to treat allergy symptoms, including itchy skin. […] Hydrocortisone creams or ointments. Over-the-counter (OTC) hydrocortisone is a corticosteroid combined with an anesthetic pain reliever.

• #1 Oral Lichen Planus: A Narrative Review Navigating Etiologies, Clinical Manifestations, Diagnostics, and Therapeutic Approaches

  https://www.mdpi.com/2077-0383/13/17/5280

  Systemic therapies are used in instances when topical treatments prove ineffective, with an initial recommended dosage of 0.5–1 mg/kg/day for severe cases. […] Tacrolimus has shown promise in reducing symptoms of OLP. […] Both topical and systemic retinoids have been used to treat OLP. […] Laser therapy, particularly the use of a CO2 laser, has shown potential in adjunctive therapies, with several studies supporting its effectiveness. […] Photodynamic therapy (PDT) is another treatment option. […] Vitamin D has been increasingly recognized for its potential therapeutic benefits in managing OLP, largely attributable to its immunomodulatory and anti-inflammatory properties. […] In the treatment of refractory OLP, various biologic therapies targeting cytokines such as anti-TNF-alpha, anti-IL17, and anti-IL12/23 have been employed with variable outcomes.

• #1 Oral Lichen Planus – European Association of Oral Medicine

  https://eaom.eu/education/eaom-handbook/oral-lichen-planus/

  Severe disease may warrant short-term systemic corticosteroid therapy (e.g. prednisolone or deflazacort), with additional corticosteroid-sparing immunosuppressant regimes such as azathioprine. Patients with symptomatology affecting other mucosal surfaces or the skin require referral to appropriate specialist for further evaluation.

• #1 Commentary: Systemic Therapy for Mucosal Lichen Planus with a Focus on Oral Lichen Planus: Update and Review of Challenges and Successes

  https://www.dermatoljournal.com/articles/commentary-systemic-therapy-for-mucosal-lichen-planus-with-a-focus-on-oral-lichen-planus-update-and-review-of-challenges-and-success.html

  Therapy for OLP should begin with supportive measures such as gentle oral hygiene, control of gingivitis and oral candidiasis, smoking cessation, and limitation of alcohol intake, under the care of the patients dental practitioner. Topical therapy with fluorinated corticosteroids and calcineurin inhibitors, singly or in combination is the mainstay of treatment. […] The administration of systemic corticosteroids alone or as a bridge to other anti-inflammatory immunomodulating agents is an effective short-term treatment option. Systemic corticosteroids are used to control acute exacerbations and to achieve control of severe disease activity. […] If the MLP is not controlled with first-level immunomodulatory agents, the clinician should seek improvement with second-level drugs. Antimetabolites such as methotrexate (MTX), mycophenolate mofetil (MMF), or azathioprine are second-level options.

• #1 Therapeutic strategies for oral lichen planus: State of the art and new insights

  https://pmc.ncbi.nlm.nih.gov/articles/PMC9578567/

  Dapsone is used in combination with clofazimine and rifampicin for the treatment of leprosy. […] Therefore, because of its important hematological adverse effects, including methemoglobinemia and hemolytic anemia, and the several alternative therapeutic options, dapsone cannot be recommended as routine therapy in OLP. […] HCQ is generally well tolerated with minor gastrointestinal symptoms (e.g. nausea, vomiting, and diarrhea) and neuromuscular symptoms (e.g. headaches, myalgia, and fatigue). […] In a recent prospective clinical trial on 45 patients with erosive OLP, HCQ 200 mg p.o. twice daily as monotherapy was reported as effective and safe. […] JAKI are emerging as a new class of drugs, which can be used in several dermatological diseases, including atopic dermatitis and alopecia areata. […] The use of JAKI is limited to case reports.

• #1 Therapeutic strategies for oral lichen planus: State of the art and new insights

  https://pmc.ncbi.nlm.nih.gov/articles/PMC9578567/

  Lasers represent a non-pharmacological and non-invasive alternative option for the treatment of OLP. […] The positive effects of LLL on erosions and ulcerations in OLP could be explained by its biological activity on different cells, such as fibroblasts and epithelial cells, which play a pivotal role in the wound healing process. […] Methotrexate (MTX) can be administered orally or subcutaneously and is useful in several inflammatory dermatoses, including psoriasis and bullous pemphigoid. […] The authors concluded that MTX can be considered as first line options in patients with moderate to severe OLP, either alone or in combination with topical triamcinolone. […] Mycophenolate mofetil (MMF) represents a valid therapy in several autoimmune skin diseases. […] In conclusion, weak evidence exists so far to support the routinary use of MMF in OLP.

• #1 Therapeutic strategies for oral lichen planus: State of the art and new insights

  https://pmc.ncbi.nlm.nih.gov/articles/PMC9578567/

  Apremilast is an oral phosphodiesterase type 4 inhibitor approved for the management of psoriasis and psoriasis arthritis. […] The authors concluded that apremilast was effective in some of patients, making its use in recalcitrant cases a possible therapeutic option. […] Azathioprine (AZA) has been used in several skin diseases, such as pemphigus vulgaris, bullous pemphigoid, and pyoderma gangrenosum. […] Therefore, the use of AZA in OLP may be recommended as off-label therapy in OLP. […] Several biologic therapies have been used in patients with refractory OLP, including anti-CD2, anti-TNF-alpha, anti-IL2, anti-IL17, anti-IL12/23, and anti-IL23 drugs. […] The clinical improvement was linked to a strong reduction of the Th1 and Th17/Tc17 cellular mucosal infiltrate, suggesting that IL-17-producing T cells play a pivotal role in OLP.

• #1 Oral lichen planus | UM Health-Sparrow

  https://www.uofmhealthsparrow.org/departments-conditions/conditions/oral-lichen-planus

  The use of some medicines, such as steroids placed on the skin, can lead to the overgrowth of yeast. This is known as a secondary infection. During treatment, schedule regular follow-up visits with your primary healthcare professional to check for secondary infections and get treatment. Not treating secondary infections may worsen oral lichen planus. […] Medicines called immunosuppressants may be used to improve severe symptoms of oral lichen planus and lessen pain. But they’re only for people who do not have weakened immune systems because these medicines can weaken or change the body’s immune response. […] If your oral lichen planus seems linked to a trigger, such as a medicine, an allergen or stress, your healthcare professional can recommend how to deal with the trigger.

• #1 Oral lichen planus

  https://dermnetnz.org/topics/oral-lichen-planus

  Oral lichen planus can be very painful and ulceration may lead to scarring. Sometimes eating is so uncomfortable that the affected person is unable to maintain adequate nutrition. […] It is important to identify and remove or avoid any potential agent that might have caused a lichenoid reaction, such as drugs that have been started in recent months and contact allergens identified by patch testing. Most people get satisfactory control of symptoms with the following measures. […] In severe cases systemic corticosteroids may be used. […] Other possible therapeutic agents may include: Systemic retinoids (acitretin or isotretinoin) – in a randomised trial, adding acitretin to topical steroids affected significant improvement. […] Targeted molecular medicines are under investigation for the treatment or recalcitrant disease, with apremilast reported effective in a few patients.

• #1 Lichen planus: Diagnosis and treatment

  https://www.aad.org/public/diseases/a-z/lichen-planus-treatment

  Medication that works throughout the body: If you have symptoms, such as painful sores or erosions in your mouth, you may need an oral (take by mouth) corticosteroid like prednisone or an oral retinoid like isotretinoin. […] Help finding and avoiding your triggers: Finding what causes your oral lichen planus to flare and avoiding these causes can reduce symptoms and flare-ups. […] To prevent nail disease from worsening, your dermatologist may include one or more of the following in your treatment plan. […] Corticosteroid injections: This medication can prevent the disease from worsening and allow you to keep your existing nails. […] Prednisone (pill): This medication can decrease symptoms like swelling and slow an overactive immune system. […] Acitretin: This medication is an oral (take by mouth) retinoid that can clear or markedly reduce lichen planus on your skin.

• #1 Lichen planus: Symptoms, Types, and Treatment with Images — DermNet

  https://dermnetnz.org/topics/lichen-planus

  Oral lichen planus, the mouth is often the only affected area and often involves the inside of the cheeks and the sides of the tongue, but the gums and lips may also be involved. […] In oral lichen planus, limited evidence is found in using apremilast. Successful treatment of oral and cutaneous lichen planus with adalimumab has previously been reported. Tildrakizumab has been shown to demonstrate positive results in erosive oral lichen planus in an isolated case study. […] In cases of oral lichen planus affecting the gums and buccal mucosa with contact allergy to mercury, the lichen planus may resolve on replacing the fillings with composite material. If the lichen planus is not due to mercury allergy, removing amalgam fillings is very unlikely to result in a cure.

• #1 Managing Lichen Planus – The Dermatology Digest

  https://thedermdigest.com/managing-lichen-planus/

  According to Dr. Friedman, he has had success treating both cutaneous and nail disease with ixekizumab (Taltz, Lilly) and secukinumab (Cosentyx, Novartis). […] Interestingly, one case report showed benefit with dupilumab (Dupixent, Sanofi and Regeneron) for severe lichen planus. […] According to Dr. Friedman, the overall takeaway here is that dermatologists need to be creative with available options for treating lichen planus. […] The end all be all is we need things on label because that then allows easier access, hopefully, to these drugs.

• #1 Azthena logo with the word Azthena

  https://www.news-medical.net/news/20250203/New-targeted-therapy-could-bring-relief-to-people-with-lichen-planus.aspx

  Mayo Clinic researchers have identified a targeted therapy that could bring relief to people living with lichen planus, a chronic inflammatory skin condition of the skin, hair, nails, mouth and genitals. […] The researchers then used baricitinib, a medication that selectively blocks the specific inflammatory pathways of lichen planus, to treat patients in the study. […] The patients with treatment-refractory disease experienced early and sustained clinical response to the treatment, resulting in an 83% improvement in symptom responsiveness within 16 weeks of treatment, a marked improvement over baseline. […] This research provides valuable insights into the pathophysiology of lichen planus and demonstrates the potential of baricitinib as a promising treatment option.

• #1 Successful Treatment of Lichen Planus With Oral Upadacitinib – JDDonline – Journal of Drugs in Dermatology

  https://jddonline.com/articles/successful-treatment-of-lichen-planus-with-oral-upadacitinib-S1545961623P1058X/

  Lichen planus is an auto-inflammatory skin disorder marked by intensely pruritic, violaceous papules that commonly affect the extremities of middle-aged adults. There are several treatment options available, but alternative therapies to target disease refractory to standard interventions remain necessary. […] Though they have not been FDA-approved for lichen planus, Janus kinase (JAK) inhibitors have demonstrated significant potential as a therapeutic intervention across an array of dermatoses. […] Herein, we present a case of refractory, biopsy-proven lichen planus successfully treated with the oral JAK1 inhibitor, upadacitinib. […] First-line treatment options consist of corticosteroids, retinoids, and phototherapy. Other medications with reported benefits include methotrexate, metronidazole, and sulfasalazine. […] Upadacitinib was started at the dose of 15 mg by mouth once daily. In addition, she was supplemented with hydroxyzine as needed for pruritus at bedtime and topical tacrolimus ointment.

• #1

  https://journals.lww.com/aomr/fulltext/2022/34010/evaluation_of_efficacy_of_three_treatment.5.aspx

  Oral lichen planus (OLP) is currently managed by various treatment protocols, the most common being topical and systemic corticosteroid therapy. Low-level laser therapy (LLLT), or photo-biomodulation, is gaining popularity as a palliative treatment for OLP. […] The present study was aimed to compare the efficacy of LLLT, topical corticosteroid therapy, or a combination of both in the management of OLP. […] A reduction in scores in VAS, WHO oral mucositis assessment scale, global healing index, and WU et al. (2010) disease scoring system with the combination of LLLT and topical corticosteroid therapy was observed. […] Both LLLT and TCT were effective against the symptom control and improvement in clinical manifestation of oral lichen planus, nevertheless; a combination of the two was found to be more beneficial in treatment of symptomatic OLP.

• #1

  https://journals.lww.com/aomr/fulltext/2022/34010/evaluation_of_efficacy_of_three_treatment.5.aspx

  This study is in consistent with Jajarm et al. wherein they concluded that the LLLT could be used as effectively as topical corticosteroid therapy and could be used as a possible substitute in the coming years. […] The current study also corroborates with Mahdavi O. et al. wherein they found out that low-level laser therapy could be used as a replacement in the management of atrophic/erosive OLP; their study also depicted that a significant decrease happens in the disease process as a cumulative effect of various irradiations with LLLT. […] Despite the limited sample size, it appears that 904 nm LLLT was much more effective and better than the topical corticosteroid therapy in the treatment of OLP and even exhibited greater results in long-term follow-up.

• #1 Oral Lichen Planus Treatment & Management: Medical Care, Diet, Activity

  https://emedicine.medscape.com/article/1078327-treatment

  Platelet-rich plasma (PRP) and platelet-rich fibrin (PRF) have been suggested as possible alternatives to corticosteroids in the treatment of OLP. […] Some evidence suggests that topical curcumin may help palliate pain and promote clinical healing in patients with OLP. […] All OLP patients should be informed of the slightly increased risk of oral squamous cell carcinoma (SCC), the most common of all oral malignancies. […] Erosive and atrophic lesions can be converted into reticular lesions by using topical steroids. […] A 2025 study found that photobiomodulation (PBM; also referred to as low-level laser therapy [LLLT]) using an 810-nm diode was effective for treating OLP, though more so for erosive OLP than for keratotic OLP.

• #1

  https://journals.lww.com/aomr/fulltext/2022/34010/evaluation_of_efficacy_of_three_treatment.5.aspx

  LLLT has a number of advantages over other traditional techniques, such as corticosteroids, including its safety and lack of side effects. […] Although largely palliative, a variety of therapeutic techniques, such as topical therapy and laser therapy, are used. Over the years, topical corticosteroid therapy (TCT) has been the most common treatment for OLP, while low-level laser therapy (LLLT) is a more recent development. […] The aim and objective of the study was to compare different management modalities in oral lichen planus on the basis of pain and percentage of healing using VAS, WHO oral mucositis assessment scale, and global healing index, respectively. […] Group 1 patients received TCT, Group 2 patients received LLLT, and Group 3 patients received both the above therapies. […] Results of this study indicated that a combination of LLLT and TCT was remarkably effective in alleviation of signs and symptoms of OLP. The percentage of healing in Group 3 patients was found to have a significant increase from baseline visit to the fifth visit followed by Group 2 and then Group 1 patients.

• #1 Photodynamic therapy in oral lichen planus: A prospective case-controlled pilot study | Scientific Reports

  https://www.nature.com/articles/s41598-020-58548-9

  Oral lichen planus (OLP) is a common, chronic relapsing inflammatory disorder of the mucous membranes, which causes major discomfort. Current treatment includes topical/systemic glucocorticoids, immune modulators and systemic immunosuppressants, which may lead to considerable side-effects. The aim of this study was to determine the clinical and immunological efficacy of photodynamic therapy (PDT) in OLP as an alternative, easy-to-use, safe and non-invasive treatment. […] PDT led to a statistically significant reduction of clinical parameters (lesion size, ABSIS, Thongprasom-score) and improvement of all evaluated quality-of-life (QOL) items. […] PDT treatment in OLP leads to lesion reduction and improvement of QOL, and induces local and systemic anti-inflammatory effects. The study identifies PDT as a novel therapeutic option in OLP.

• #1 Lichen planus – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/lichen-planus/diagnosis-treatment/drc-20351383

  If you have no pain or discomfort, you may not need any treatment. Lichen planus on the skin often clears up on its own in months to years. […] Medicines and other treatments might help relieve itching, ease pain and speed healing. Talk with your health care provider to weigh the pros and cons of treatment options. You may need more than one approach to control your symptoms. […] If the disease affects your mucous membranes and nails, it tends to be harder to treat. Even if treatment works, the symptoms may return. You’ll likely need to visit your health care provider for follow-up care at least once a year. […] Often, the first choice for treatment of lichen planus of the skin is a prescription corticosteroid cream or ointment. This may help ease pain, swelling and inflammation. […] If a topical corticosteroid doesn’t help and your condition is severe or widespread, your health care provider might suggest corticosteroid pills or injections.

• #1 Lichen planus – A refractory autoimmune disorder – IJCED

  https://www.ijced.org/html-article/18573

  Enoxaparin sodium 3-mg subcutaneous injections of weekly for 4 to 14 weeks and then followed up for 1 year. […] Basiliximab, Etanercept, Efalizumab and Alefacept have been proposed for the treatment of OLP. […] Oral Lichen Planus was treated using a Low-Level Laser Therapy with a 660 nm diode laser. […] Photodynamic therapy (PDT) has been considered as an alternative/complementary therapeutic modality for the management of premalignant lesions. […] Photochemotherapy with 8-methoxy psoralen and long-wave ultraviolet light (PUVA) has become a useful alternative in LP. […] Cryotherapy with nitrous oxide gas is as effective as topical triamcinolone acetonide in the treatment of OLP with no systemic side effects and needs less patient compliance. […] The curcumin is found to be an effective treatment in oral lichen planus even in the cases where topical steroids have been used and recurrence was seen. […] Surgical excision of OLP is considered an effective treatment for isolated plaques or nonhealing erosions.

• #1 Oral lichen planus: a case series with emphasis on therapy.

  https://vivo.weill.cornell.edu/display/pubid17438185

  Oral lichen planus (OLP) is a chronic inflammatory disorder that can cause local irritation and discomfort with attendant poor dentition and nutrition. […] Although a range of therapeutic options is available, data on the long-term efficacy of treatments for this chronic disease are limited. […] To identify agents that might be effective in OLP treatment over a longer term, and to explore their sequential use in treatment-refractory patients, we studied patients who received multiple OLP therapies and who were followed up for an average of more than 2 years. […] Patients were treated according to a therapeutic ladder of sequential treatments, beginning with topical corticosteroids and progressing through topical immunomodulators, systemic retinoids, methotrexate, and thalidomide. […] Most patients eventually achieved a substantial response with limited toxic effects. […] Our results identify low-dose methotrexate as an agent with substantial activity in OLP. […] We also demonstrate that a laddered therapeutic approach to patients with this disease can achieve substantial lesion regression even in heavily pretreated and treatment-refractory patients.

• #1 Oral lichen planus – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/oral-lichen-planus/diagnosis-treatment/drc-20350874

  In addition to regular medical and dental treatment, these self-care measures may make your oral lichen planus symptoms better or help prevent episodes of severe symptoms from coming back from time to time: […] See your dentist twice a year for checkups and cleanings, or more often as directed. Because long-term treatment for oral lichen planus is often needed, talk with your healthcare professional about how often you should be seen to track how your treatment is working and to get cancer screening.

• #1 Oral Lichen Planus: Symptoms, Causes & Treatment

  https://my.clevelandclinic.org/health/diseases/17875-oral-lichen-planus

  Corticosteroids. You may get a gel or ointment to rub on the lesions. If that doesnt work, your provider may prescribe this medicine as a shot or a pill that you take by mouth. […] Calcineurin inhibitors. Providers may prescribe this type of medicine if corticosteroids arent helping. The most common type is an ointment you rub on the lesions. […] Pain relievers. Often, over-the-counter medicines reduce pain from OLP. Options include acetaminophen and NSAIDs. You may need medicines like lidocaine to numb the pain. […] Making small changes to your routine can help prevent flare-ups. Not everyone has the same triggers. But for many people, it helps to: […] Avoid acidic, crunchy, salty or spicy foods […] Avoid drinking alcohol or using tobacco products […] Use a soft-bristled toothbrush or an electric toothbrush on the lowest setting

• #1 Oral Lichen Planus: Symptoms, Causes & Treatment | Colgate®

  https://www.colgate.com/en-us/oral-health/mouth-sores-and-infections/oral-lichen-planus-symptoms-causes-treatment

  immune response medications, such as pimecrolimus cream and tacrolimus ointment, applied directly to the affected area […] systemic medications taken internally […] ultraviolet light therapy […] antihistamines to relieve itching […] aloe vera. […] If an allergic reaction is triggering your outbreak, you may be referred to a dermatologist or allergist. […] Good oral health care is essential to managing oral lichen planus. Patients should brush gently twice a day with a soft-bristled toothbrush and a mild toothpaste. They should avoid salty, spicy or acidic foods. Caffeine, alcohol and tobacco should also be avoided, and one should eat soft foods that don’t irritate the mouth tissues. Patients who have the habit of chewing their lips or gums should try to stop because mouth injuries can trigger an attack.

• #1 Oral lichen planus – BAD Patient Hub

  https://www.skinhealthinfo.org.uk/condition/oral-lichen-planus/

  An antiseptic mouthwash or gel may be recommended to help control the plaque, particularly at times when the gums are sore. […] In severe cases of oral lichen planus, systemic treatment (medicine taken by mouth) may be required for several months or years. […] Oral corticosteroids (steroids) may be prescribed for a few months. […] Other drug treatments that can reduce the immune system are introduced so that the dose of corticosteroid can be reduced as soon as possible. […] Avoid spicy, acidic or salty foods if these make your mouth sore. […] Keep your teeth clean by using a soft brush and a small interdental brush to clean between the teeth. […] In view of the small risk of cancerous change in oral lichen planus, it is important to ensure the mouth is checked on a regular basis by a dentist or oral specialist, so that any early changes can be spotted. […] It is advisable to stop smoking and reduce your alcohol intake to the recommended limits (currently 14 units a week for both men and women) as these are the main risk factors for mouth cancer.

• #1 Integrative approach in managing oral lichen planus – JOOO

  https://www.joooo.org/html-article/22042

  The major objective of the OLP treatment is to improve the level of stress and fear, thus expecting the reduction of the symptoms. […] Different therapeutic options are available to treat oral lichen planus. Non-erosive OLP is generally managed using topical potent corticosteroids (CS) (like 0.05% clobetasol propionate). In case of erosive OLP, intralesional injection of triamcinolone is useful. Various systemic therapies are used in case of severe refractory and erosive OLP. These therapies consists of hydroxychloroquine (HCQ), apremilast, systemic retinoids and CS. […] It has been advocated that potent topical corticosteroids can be a well accepted first-line of treatment; but still no firm scientific evidence is available that supports this fact. […] Now-a-days, perilesional and topical corticosteroids administration is mainly utilized as the first-line of treatment for the erosive type of OLP.

• #1 Oral Lichen Planus: Symptoms, Causes & Treatment

  https://my.clevelandclinic.org/health/diseases/17875-oral-lichen-planus

  Use mild, unflavored toothpaste and dental floss (no mint, cinnamon or sodium lauryl sulfate) […] Practice stress management techniques daily […] Stop taking medications that cause flare-ups. […] Most people notice major symptom relief within a month of using topical corticosteroids (the type you rub on the lesions). With a shot, it may take two to three treatments to feel better. With pills, it may take a few weeks. […] If youre experiencing a symptom flare-up, let your provider know. They can start you on treatments that can help you feel better.

• #1 Oral Lichen Planus: Symptoms, Causes, and Treatment

  https://www.healthline.com/health/oral-lichen-planus

  Oral lichen planus can cause white lesions to appear in your mouth, often on the insides of your cheeks. […] Because its a chronic condition, oral lichen planus cant be cured, but it can be managed. Treatment will focus on resolving symptoms and minimizing lesions as much as possible. […] Treatment options include: topical corticosteroids, which can come in the form of gel, ointment, or mouthwash applied directly to the affected area; injection corticosteroids, which are applied directly to the lesion; oral corticosteroids, which can only be taken for a short time; immune response medications. […] Certain lifestyle changes can also help manage oral lichen planus. These include: using a mild toothpaste; eating well and getting plenty of nutrients through foods like fruits, vegetables, nuts, and lean protein; getting plenty of exercise; reducing stress. […] Oral lichen planus is a chronic condition. The symptoms can be managed, but the condition itself cant be cured. Because of this, maintaining regular appointments with your dentist or healthcare provider can help you manage your symptoms and adjust your treatment plan as needed.

• #1 Oral lichen planus – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/oral-lichen-planus/diagnosis-treatment/drc-20350874

  Side effects vary depending on the method you use. Talk with your healthcare professional to weigh the possible benefits and side effects. […] Medicines called immunosuppressants may be used to improve severe symptoms of oral lichen planus and lessen pain. But they’re only for people who do not have weakened immune systems because these medicines can weaken or change the body’s immune response. […] The use of some medicines, such as steroids placed on the skin, can lead to the overgrowth of yeast. This is known as a secondary infection. During treatment, schedule regular follow-up visits with your primary healthcare professional to check for secondary infections and get treatment. Not treating secondary infections may worsen oral lichen planus. […] If your oral lichen planus seems linked to a trigger, such as a medicine, an allergen or stress, your healthcare professional can recommend how to deal with the trigger.

• #1 Oral Lichen Planus

  https://ent-hns.net/oral-lichen-planus

  Oral lichen planus is a disease of chronic inflammation in the mouth. […] Patients experience patches, ulcers, or blisters inside their mouths which can vary from painless to painful and can persist for years between flareups. […] Therefore, its important for patients with this condition to consult their primary care physician about possibly establishing care with an ENT (ear, nose, and throat) specialist, or otolaryngologist. […] Discuss all medications you are taking with your physician(s). Practice proper oral hygiene and talk to your dentist about possibly changing your toothpaste. Any sharp teeth near the lesions should be filed by your dentist. Fillings or dentures that are irritating your mouth should be polished or replaced. If stress and anxiety are worsening your condition, consider speaking with someone who can help you bring these conditions under control.

• #1

  https://www.cgh.com.sg/patient-care/conditions-treatments/oral-lichen-planus

  Oral Lichen Planus – Treatments […] Symptom-free cases will not require any treatment but should be reviewed by the dental surgeon or physician every six months to one year. […] For symptomatic cases, much of the discomfort can often be reduced simply by avoiding triggering factors such as spicy food or certain toothpastes or mouthwashes, and maintaining good oral hygiene. Medications or dental fillings may need to be changed if these are suspected to be associated with the appearance of the disease. Change of medications would require approval from your physician. […] Various medications have been used to treat oral lichen planus, the most common being a steroid paste/ointment applied directly onto the affected area(s) inside the mouth. Depending on the severity of the disease and its symptoms, steroid injections directly into the affected areas or oral steroid tablets may be necessary. Sometimes, an anti-fungal medication or mouthwash may also be prescribed. […] Other less common medications used include vitamin A analogues, anti-malarials, immuno-suppressants like cyclosporine and aziathioprine. […] Laser treatment to remove the affected area(s) can also be performed but the condition tends to recur. The treated area can sometimes become pigmented or darkened.

• #1 Oral Lichen Planus Treatment – Harley Street Maxillofacial Clinic

  https://harleystreetmaxillofacialclinic.com/oral-conditions/lichen-planus-treatment/

  A disease with many triggers deserves thorough diagnosis and personal treatment. […] However, effective treatment is available and should be tailored to meet your individual needs. […] If a specific trigger for your oral lichen planus can be identified, such as a medication or allergen, it can often be addressed quickly. […] In the short term, analgesic mouthwashes, ointments, or gels can help alleviate symptoms. Treatment may also focus on helping unpleasant lesions heal. […] If no clear cause can be found, topical corticosteroids are often effective. In more serious cases, a course of systemic corticosteroids may be considered. […] Your consultant will focus on developing the best treatment plan for you, considering everything from medication and treatment options to advice on diet and oral hygiene.

• #1 Oral lichen planus: comparative efficacy and treatment costs—a systematic review | BMC Oral Health | Full Text

  https://bmcoralhealth.biomedcentral.com/articles/10.1186/s12903-022-02168-4

  Based on the estimated cost/month and the evidence for efficacy and side-effects, topical steroids (fluocinonide, dexamethasone, clobetasol, triamcinolone) appear to be more cost-effective than topical calcineurin inhibitors (tacrolimus, pimecrolimus, cyclosporine) followed by intra-lesional triamcinolone. […] In this systematic review, topical steroids were found to be potentially the most economical and efficacious treatment modality followed by topical calcineurin inhibitors supporting the use of topical steroids as the first-line treatment with escalation to other treatment modalities only as needed.

• #1 Managing Lichen Planus – The Dermatology Digest

  https://thedermdigest.com/managing-lichen-planus/

  Dr. Adam Friedman discusses off-label lichen planus treatments that show promise for treating the disease. […] The focus of my talk was predominantly treatment. how do we use immunomodulators [off-label] to hopefully give these patients some relief and get this disease under control? […] According to Dr. Friedman, oral retinoids acitretin and isotretinoin have the best evidence for systemically treating moderate-severe disease more than light therapy, metronidazole, griseofulvin, and immunosuppressants. […] According to Dr. Friedman, doxycycline can be effective in treating oral lichen planus. […] Additional therapies used in other areas of dermatology may also hold promise for off-label treatment of lichen planus, said Dr. Friedman. […] Interleukin (IL)-17 biologics are even more promising, said Dr. Friedman.

• #1 Oral Lichen Planus Treatment – Harley Street Maxillofacial Clinic

  https://harleystreetmaxillofacialclinic.com/oral-conditions/lichen-planus-treatment/

  While there may not always be a complete cure for oral lichen planus, many patients experience significant improvement, and in some cases, the condition can be resolved. For others, the symptoms can be managed to improve quality of life. […] For those cases, and in others, regular monitoring by your consultant is crucial. This allows for early intervention to alleviate flare-ups and reduces the risk of complications, such as mouth cancer developing in affected areas.

• #2 Oral lichen planus | UM Health-Sparrow

  https://www.uofmhealthsparrow.org/departments-conditions/conditions/oral-lichen-planus

  Oral lichen planus is a lifelong condition. Mild forms may go away on their own but flare up later. Because there is no cure, treatment focuses on healing and easing pain or other symptoms that bother you. Your healthcare professional watches your condition to find the best treatment or to stop treatment as needed. […] If you have no pain or other discomfort, and you only have white, lacy signs of oral lichen planus in your mouth, you may not need any treatment. For more-severe symptoms, you may need one or more of the options below. […] Treatments such as numbing agents applied to the skin can give relief for a short time in areas that are very painful. […] Medicines called corticosteroids may lower inflammation related to oral lichen planus. Your healthcare professional may recommend one of these forms:

• #2 Treatment trends in oral lichen planus and oral lichenoid lesions (Review)

  https://www.spandidos-publications.com/10.3892/etm.2020.9328

  Oral lichen planus (OLP) is a chronic inflammatory disease, associated with altered cell-mediated immunological function. […] A wide spectrum of therapeutic options is available, but none are curative. […] Current OLP therapy aims at eliminating all mucosal-related lesions, reduce symptomatology and decrease the risk of oral cancer and include corticosteroids, immunomodulatory agents, retinoids, ultraviolet irradiation and/or laser therapy. […] The aims of treatment are elimination of painful symptoms, healing of ulcerative lesions, decreasing the risk or oral cancer, prolongation of symptom free periods and the maintenance of good oral hygiene and dental status. […] No therapy for OLP is completely curative because of its recalcitrant nature and also its idiopathic etiology, several treatments may need to be tried.

• #2 Oral Lichen Planus: Symptoms, Causes & Treatment

  https://my.clevelandclinic.org/health/diseases/17875-oral-lichen-planus

  Oral lichen planus isnt dangerous. Its not contagious, so you cant spread it to others. But it can cause abnormal tissue (lesions) to form in your mouth. It can make your mouth hurt. […] This is why you should see a dental care provider if you notice signs of this disease. Theres no cure for oral lichen planus, but treatments can provide relief. […] Treatment for OLP focuses on reducing symptoms and preventing flare-ups. This means you may not need treatment if you dont have symptoms that are bothering you. […] Treatment usually involves a mix of medications and lifestyle changes to avoid triggers. […] If you have symptoms, your healthcare provider will likely recommend medications. Some may calm your immune system so theres less inflammation. Others relieve pain. Common oral lichen planus treatments include:

• #2 Therapeutic strategies for oral lichen planus: State of the art and new insights

  https://pmc.ncbi.nlm.nih.gov/articles/PMC9578567/

  The use of topical calcineurin inhibitors, such as tacrolimus and pimecrolimus, in OLP is extremely diffuse in the clinical practice, although more placebo-controlled, randomized studies are needed to evaluate effectiveness and safety of topical calcineurin inhibitors in comparison to topical CS. […] However, Volz et al. reported a significant reduction in oral erosions with topical pimecrolimus 1% compared to placebo in a prospective randomized double-blind vehicle-controlled study. […] Topical CS represent the first-line approach in OLP. […] The authors concluded that Rivelin -CLO patches were superior to placebo, demonstrating statistically significant objective and subjective improvement and a favorable safety profile. […] Cyclosporine (CsA) is a calcineurin inhibitor, used as an immunosuppressant medication. […] In addition, in a randomized, comparative, double-blind study on 40 patients, topical clobetasol was more effective in comparison to topical CsA in inducing a clinical improvement.

• #2 Oral Lichen Planus – European Association of Oral Medicine

  https://eaom.eu/education/eaom-handbook/oral-lichen-planus/

  Triamcinolone acetonide (0.1%) and 1% carboxymethylcellulose paste […] Betamethasone mouthrinse (500mcg dissolved in 10-15ml of water) used as a mouthrinse up to 3 times daily […] Fluticasone spray (50mcg per puff) – sprayed on affected areas up to 3-4 times daily […] Prednisolone mouthwash (5mg dissolved in 10-15ml of water) and used as a mouthrinse up to 4 times daily […] Beclometasone spray (100mcg per puff) – sprayed 3-4 times daily on affected sites […] Clobetasol ointment (0.05%) applied to painful areas 3-4 times daily […] Fluticasone cream (0.05%) applied to painful sites 3-4 times daily. […] Where disease appears to be recalcitrant to such therapy, a number of other strategies may be considered: […] Topical tacrolimus (0.1%) applied to painful areas twice daily […] Ciclosporin mouthwash (100mg per ml) used as a swill and spit mouthwash twice daily.

• #2 Treatment of symptomatic oral lichen planus: a literat…

  https://otorhinolaryngologypl.com/seo/article/01.3001.0009.5279/en

  Corticosteroids are the first therapeutic choice for symptomatic OLP lesions. […] Clobetasol propionate is mainly indicated for the atrophic, erosive and ulcerative variants of OLP. […] The best results were obtained with the use of clobetasol propionate as a mouthwash, based on its comfortable application, easy accessibility to oral lesions and contact time with lesions. […] Currently, high-potency topical corticosteroids are considered the first line of treatment for symptomatic OLP in whichever area. […] There are alternative therapies for those patients who do not respond adequately to treatment with corticosteroids or are allergic or insensitive to topical glucocorticoids. These therapies include topical retinoids, immunosuppressants, laser, photodynamic therapy, ultraviolet treatment, aloe vera and green tea. […] Based on the literature reviewed, it can be concluded that topical therapy in the form of solution is the presentation most frequently used for the treatment of symptomatic OLP lesions and presents greatest ease of application with the least adverse effects.

• #2 Diagnosis and Treatment of Lichen Planus | AAFP

  https://www.aafp.org/pubs/afp/issues/2011/0701/p53.html

  Topical corticosteroids are first-line therapy. […] High-potency topical steroids are the most effective, with response rates up to 75 percent compared with placebo. […] Topical corticosteroids are also first-line therapy for mucosal erosive lichen planus. […] Systemic corticosteroids, such as oral prednisone, should be considered only for severe, widespread oral lichen planus and for lichen planus involving other mucocutaneous sites. […] Topical calcineurin inhibitors, such as tacrolimus and pimecrolimus (Elidel), are second-line therapies for oral lichen planus. […] A comparative study showed that topical tacrolimus is as effective as the high-potency corticosteroid clobetasol in the treatment of oral lichen planus. […] A randomized controlled trial revealed that pimecrolimus 1% cream effectively treats erosive oral lichen planus with long-lasting therapeutic effects. […] If topical corticosteroids are ineffective, carbon-dioxide laser evaporation can lead to long-term remission of symptoms, and may be appropriate as first-line therapy in patients with painful oral lichen planus.

• #2 Treatment of Oral Lichen Planus with Intralesional Injection of Steroids: Case Reports

  https://www.journalomp.org/journal/view.html?doi=10.14476/jomp.2024.49.4.158

  These case reports demonstrate that ILI is a highly effective treatment modality for OLP, particularly in patients resistant to conventional therapies such as topical corticosteroids or systemic steroids. This approach has shown sustained effectiveness with minimal frequency of injections and without severe side effects, even in challenging clinical scenarios, such as patients unable to tolerate systemic steroids due to adverse effects or those with poor compliance with topical therapies. […] The efficacy of ILIs in OLP likely arises from their ability to deliver high concentrations of corticosteroids directly to the affected tissues. Corticosteroids, such as triamcinolone acetonide, clobetasol propionate and fluocinonide, function by inhibiting the release of pro-inflammatory cytokines like interleukin-6 (IL-6) and tumor necrosis factor-alpha (TNF-), which play key roles in the pathogenesis of OLP.

• #2 Integrative approach in managing oral lichen planus – JOOO

  https://www.joooo.org/html-article/22042

  The short-term systemic corticosteroids use is advocated to control the signs and symptoms of OLP rapidly, and even they are used to treat the persistent lesions that are not being treated using topical steroid therapy. […] For treating OLP, azathioprine, cyclosporine, pimecrolimus, and tacrolimus are used. […] Retinoids are vitamin A (rethionol) metabolites and these are either used systemically or topically for treating OLP. […] Lycopene supplementation may have shown positive results. […] Dapsone reveals promising results in case of treatment of the erosive form of OLP. […] Cryosurgery and Surgical excision are also successfully utilized for managing the cases of erosive OLP when such lesions are resistant to most of the therapeutic options. […] Photodynamic therapy (PDT) is a substitute management option for OLP.

• #2 Oral Lichen Planus – European Association of Oral Medicine

  https://eaom.eu/education/eaom-handbook/oral-lichen-planus/

  Patients with white patches are generally asymptomatic, although they may complain of mild oral roughness, soreness or dryness of the oral mucosa. This generally does not require treatment. Individuals with erosive, ulcerative or bullous disease generally tend to have oral discomfort, particularly with spicy or acidic foods, and thus require treatment. […] The management of painful oral lichen planus usually comprises: […] Relief of painful symptoms – this can best be achieved with regular use of benzydamine hydrochloride (0.15%) spray or mouthrinse. When this is not available, it may be appropriate for the patient to apply 2% lidocaine gel to painful areas; […] Treatment of definitive disease – topical corticosteroids are the mainstay of treatment of oral lichen planus. A wide range of agents are suggested to be effective. These include:

• #2

• #2 Integrative approach in managing oral lichen planus – JOOO

  https://www.joooo.org/html-article/22042

  The major objective of the OLP treatment is to improve the level of stress and fear, thus expecting the reduction of the symptoms. […] Different therapeutic options are available to treat oral lichen planus. Non-erosive OLP is generally managed using topical potent corticosteroids (CS) (like 0.05% clobetasol propionate). In case of erosive OLP, intralesional injection of triamcinolone is useful. Various systemic therapies are used in case of severe refractory and erosive OLP. These therapies consists of hydroxychloroquine (HCQ), apremilast, systemic retinoids and CS. […] It has been advocated that potent topical corticosteroids can be a well accepted first-line of treatment; but still no firm scientific evidence is available that supports this fact. […] Now-a-days, perilesional and topical corticosteroids administration is mainly utilized as the first-line of treatment for the erosive type of OLP.

• #2 Lichen planus – A refractory autoimmune disorder – IJCED

  https://www.ijced.org/html-article/18573

  Mycophenolate mofetil (MMF) is an immunosuppressive drug that specifically and reversibly inhibits the proliferation of activated T cells. […] Azathioprine has been shown to be an effective steroid sparing treatment for generalized lichen planus. […] Dapsone is effective for erosive lichen planus. […] Interferon in noncontrolled studies have suggested that a topically applied gel preparation containing human fibroblast interferon (HuIFN-beta) and interferon-alpha (IFN-alpha) cream may improve outcome of erosive oral LP. […] Thalidomide is useful for erosive lichen planus. […] Griseofulvin in the dose of 500mg daily for about 6 months provided improvement in patients with recalcitrant, symptomatic oral lichen planus. […] Adalimumab may be a promising biologic treatment option for patients with LP who have failed conventional therapies.

• #2 Lichen Planus: What It Is, Causes, Types & Treatments

  https://my.clevelandclinic.org/health/diseases/17723-lichen-planus

  Retinoids (vitamin A derivatives). Retinoids are a pill or ointment that help your body produce more collagen and blood vessels, which can help your rash. Retinoids may cause birth defects, so its a good idea to check with your healthcare provider if youre pregnant or planning to become pregnant. […] If you have lichen planus in your mouth, in most cases, it goes away within five years. If you experience irritation or sores, you can help alleviate your symptoms by: […] Practicing good oral hygiene. Regularly brush and floss your teeth, and get your teeth professionally cleaned by your dentist at least twice a year. […] Minimize injuries (trauma). Injuries to your mouth can increase the severity of your sores, as well as how often flare-ups occur. Gently brush your teeth, put dental wax around braces or orthodontic wires and consider removing any piercings that bump or rub against the inside of your mouth.

• #2 Managing Lichen Planus – The Dermatology Digest

  https://thedermdigest.com/managing-lichen-planus/

  According to Dr. Friedman, he has had success treating both cutaneous and nail disease with ixekizumab (Taltz, Lilly) and secukinumab (Cosentyx, Novartis). […] Interestingly, one case report showed benefit with dupilumab (Dupixent, Sanofi and Regeneron) for severe lichen planus. […] According to Dr. Friedman, the overall takeaway here is that dermatologists need to be creative with available options for treating lichen planus. […] The end all be all is we need things on label because that then allows easier access, hopefully, to these drugs.

• #2 Therapeutic strategies for oral lichen planus: State of the art and new insights

  https://pmc.ncbi.nlm.nih.gov/articles/PMC9578567/

  Apremilast is an oral phosphodiesterase type 4 inhibitor approved for the management of psoriasis and psoriasis arthritis. […] The authors concluded that apremilast was effective in some of patients, making its use in recalcitrant cases a possible therapeutic option. […] Azathioprine (AZA) has been used in several skin diseases, such as pemphigus vulgaris, bullous pemphigoid, and pyoderma gangrenosum. […] Therefore, the use of AZA in OLP may be recommended as off-label therapy in OLP. […] Several biologic therapies have been used in patients with refractory OLP, including anti-CD2, anti-TNF-alpha, anti-IL2, anti-IL17, anti-IL12/23, and anti-IL23 drugs. […] The clinical improvement was linked to a strong reduction of the Th1 and Th17/Tc17 cellular mucosal infiltrate, suggesting that IL-17-producing T cells play a pivotal role in OLP.

• #2 Oral Lichen Planus Treatment & Management: Medical Care, Diet, Activity

  https://emedicine.medscape.com/article/1078327-treatment

  Platelet-rich plasma (PRP) and platelet-rich fibrin (PRF) have been suggested as possible alternatives to corticosteroids in the treatment of OLP. […] Some evidence suggests that topical curcumin may help palliate pain and promote clinical healing in patients with OLP. […] All OLP patients should be informed of the slightly increased risk of oral squamous cell carcinoma (SCC), the most common of all oral malignancies. […] Erosive and atrophic lesions can be converted into reticular lesions by using topical steroids. […] A 2025 study found that photobiomodulation (PBM; also referred to as low-level laser therapy [LLLT]) using an 810-nm diode was effective for treating OLP, though more so for erosive OLP than for keratotic OLP.

• #2

  https://journals.lww.com/aomr/fulltext/2022/34010/evaluation_of_efficacy_of_three_treatment.5.aspx

  This study is in consistent with Jajarm et al. wherein they concluded that the LLLT could be used as effectively as topical corticosteroid therapy and could be used as a possible substitute in the coming years. […] The current study also corroborates with Mahdavi O. et al. wherein they found out that low-level laser therapy could be used as a replacement in the management of atrophic/erosive OLP; their study also depicted that a significant decrease happens in the disease process as a cumulative effect of various irradiations with LLLT. […] Despite the limited sample size, it appears that 904 nm LLLT was much more effective and better than the topical corticosteroid therapy in the treatment of OLP and even exhibited greater results in long-term follow-up.

• #2 Photodynamic therapy in oral lichen planus: A prospective case-controlled pilot study | Scientific Reports

  https://www.nature.com/articles/s41598-020-58548-9

  Oral lichen planus (OLP) is a common, chronic relapsing inflammatory disorder of the mucous membranes, which causes major discomfort. Current treatment includes topical/systemic glucocorticoids, immune modulators and systemic immunosuppressants, which may lead to considerable side-effects. The aim of this study was to determine the clinical and immunological efficacy of photodynamic therapy (PDT) in OLP as an alternative, easy-to-use, safe and non-invasive treatment. […] PDT led to a statistically significant reduction of clinical parameters (lesion size, ABSIS, Thongprasom-score) and improvement of all evaluated quality-of-life (QOL) items. […] PDT treatment in OLP leads to lesion reduction and improvement of QOL, and induces local and systemic anti-inflammatory effects. The study identifies PDT as a novel therapeutic option in OLP.

• #2 Lichen planus – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/lichen-planus/diagnosis-treatment/drc-20351383

  If you have no pain or discomfort, you may not need any treatment. Lichen planus on the skin often clears up on its own in months to years. […] Medicines and other treatments might help relieve itching, ease pain and speed healing. Talk with your health care provider to weigh the pros and cons of treatment options. You may need more than one approach to control your symptoms. […] If the disease affects your mucous membranes and nails, it tends to be harder to treat. Even if treatment works, the symptoms may return. You’ll likely need to visit your health care provider for follow-up care at least once a year. […] Often, the first choice for treatment of lichen planus of the skin is a prescription corticosteroid cream or ointment. This may help ease pain, swelling and inflammation. […] If a topical corticosteroid doesn’t help and your condition is severe or widespread, your health care provider might suggest corticosteroid pills or injections.

• #2

  https://journals.lww.com/aomr/fulltext/2022/34010/evaluation_of_efficacy_of_three_treatment.5.aspx

  LLLT has a number of advantages over other traditional techniques, such as corticosteroids, including its safety and lack of side effects. […] Although largely palliative, a variety of therapeutic techniques, such as topical therapy and laser therapy, are used. Over the years, topical corticosteroid therapy (TCT) has been the most common treatment for OLP, while low-level laser therapy (LLLT) is a more recent development. […] The aim and objective of the study was to compare different management modalities in oral lichen planus on the basis of pain and percentage of healing using VAS, WHO oral mucositis assessment scale, and global healing index, respectively. […] Group 1 patients received TCT, Group 2 patients received LLLT, and Group 3 patients received both the above therapies. […] Results of this study indicated that a combination of LLLT and TCT was remarkably effective in alleviation of signs and symptoms of OLP. The percentage of healing in Group 3 patients was found to have a significant increase from baseline visit to the fifth visit followed by Group 2 and then Group 1 patients.

• #2 Oral Lichen Planus: Symptoms, Causes & Treatment

  https://my.clevelandclinic.org/health/diseases/17875-oral-lichen-planus

  Use mild, unflavored toothpaste and dental floss (no mint, cinnamon or sodium lauryl sulfate) […] Practice stress management techniques daily […] Stop taking medications that cause flare-ups. […] Most people notice major symptom relief within a month of using topical corticosteroids (the type you rub on the lesions). With a shot, it may take two to three treatments to feel better. With pills, it may take a few weeks. […] If youre experiencing a symptom flare-up, let your provider know. They can start you on treatments that can help you feel better.

• #2 Lichen planus

  https://www.nhs.uk/conditions/lichen-planus/

  Lichen planus on your skin usually gets better on its own in about 9 to 18 months. […] Creams and ointments from a GP can help control the rash and ease itching. […] If creams and ointments do not work, or you have severe lichen planus, steroid tablets or treatment with a special kind of light (light therapy) can help. […] Lichen planus in your mouth can last for several years. Mouthwashes and sprays from a GP can help ease symptoms like burning or sore gums. […] If you have lichen planus in your mouth: avoid salty, spicy and acidic foods, or alcohol, if they make your mouth sore. […] brush your teeth carefully twice a day to keep your gums healthy. […] use a mouthwash that does not contain alcohol, if it makes your mouth sore.

• #2 Oral Lichen Planus: Symptoms, Causes & Treatment | Colgate®

  https://www.colgate.com/en-us/oral-health/mouth-sores-and-infections/oral-lichen-planus-symptoms-causes-treatment

  immune response medications, such as pimecrolimus cream and tacrolimus ointment, applied directly to the affected area […] systemic medications taken internally […] ultraviolet light therapy […] antihistamines to relieve itching […] aloe vera. […] If an allergic reaction is triggering your outbreak, you may be referred to a dermatologist or allergist. […] Good oral health care is essential to managing oral lichen planus. Patients should brush gently twice a day with a soft-bristled toothbrush and a mild toothpaste. They should avoid salty, spicy or acidic foods. Caffeine, alcohol and tobacco should also be avoided, and one should eat soft foods that don’t irritate the mouth tissues. Patients who have the habit of chewing their lips or gums should try to stop because mouth injuries can trigger an attack.

• #2 Get Lichen Planus Treatment Online – TeleMed2U

  https://www.telemed2u.com/dermatology/lichen-planus

  Prescription corticosteroid cream or ointment can help with small outbreaks. A corticosteroid pill or injection may be prescribed if the bumps or sores are widespread. […] Oral lichen planus may be treated with numbing drops to provide temporary relief for painful areas. Corticosteroid, to reduce inflammation, may be prescribed as a mouthwash, ointment or gel that’s applied directly to mucus membranes; or as a pill or injection directly into the sore. […] Self-care measures include: Practice good oral care, (brush twice and floss every day), including regular dentist visits. Keeping the mouth clean helps reduce symptoms, and lowers your infection risk. […] Manage stress, it can worsen symptoms and cause flare-ups.

• #2 Lichen planus: Symptoms, Types, and Treatment with Images — DermNet

  https://dermnetnz.org/topics/lichen-planus

  Oral lichen planus, the mouth is often the only affected area and often involves the inside of the cheeks and the sides of the tongue, but the gums and lips may also be involved. […] In oral lichen planus, limited evidence is found in using apremilast. Successful treatment of oral and cutaneous lichen planus with adalimumab has previously been reported. Tildrakizumab has been shown to demonstrate positive results in erosive oral lichen planus in an isolated case study. […] In cases of oral lichen planus affecting the gums and buccal mucosa with contact allergy to mercury, the lichen planus may resolve on replacing the fillings with composite material. If the lichen planus is not due to mercury allergy, removing amalgam fillings is very unlikely to result in a cure.

• #2 Oral lichen planus – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/oral-lichen-planus/diagnosis-treatment/drc-20350874

  In addition to regular medical and dental treatment, these self-care measures may make your oral lichen planus symptoms better or help prevent episodes of severe symptoms from coming back from time to time: […] See your dentist twice a year for checkups and cleanings, or more often as directed. Because long-term treatment for oral lichen planus is often needed, talk with your healthcare professional about how often you should be seen to track how your treatment is working and to get cancer screening.

• #2 Oral lichen planus | Cleveland Clinic Journal of Medicine

  https://www.ccjm.org/content/90/12/717

  Intralesional injection of triamcinolone acetonide in concentrations of 10 to 20 mg/mL is helpful in persistent oral lichen planus. […] Systemic corticosteroids like methylprednisolone or prednisolone (11.5 mg/kg daily) may be indicated in patients unresponsive to topical steroids. […] Other medications such as topical calcineurin inhibitors, oral retinoids, hydroxychloroquine, mycophenolate mofetil, and oral and topical cyclosporine have also been used in the treatment of oral lichen planus. […] Oral lichen planus, especially the erosive type, is a potentially premalignant disorder with a higher risk of progression to squamous cell carcinoma and necessitates periodic follow-up.

• #2 Oral lichen planus: Management and prognosis – UpToDate

  https://www.uptodate.com/contents/oral-lichen-planus-management-and-prognosis

  Oral lichen planus (LP) is a mucosal subtype of LP that presents with a variety of clinical features. Clinical subtypes include reticular oral LP (white striations, papules, and plaques), erythematous (atrophic) oral LP (mucosal atrophy and red patches), and erosive oral LP (erosions or ulcers) (picture 1A-B). […] The primary goal of treatment is to reduce the pain and morbidity typically associated with erythematous and erosive disease. […] Initial management includes topical corticosteroids, oral hygiene, and trigger avoidance. […] Insufficient response to topical corticosteroids may require patient assessment and selection of subsequent therapy, including topical calcineurin inhibitors and intralesional corticosteroid injections. […] For severe or refractory disease, systemic glucocorticoids may be used, along with additional therapies such as oral metronidazole, hydroxychloroquine, and retinoids.

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