Lichen planus is a chronic inflammatory condition that can affect the skin, mucous membranes, scalp and nails. Characterised by purple-red, flat-topped, itchy papules, this condition can significantly impact quality of life. In this article we examine in detail the current approaches to lichen planus treatment and patient management strategies in 2026.
What Is Lichen Planus?
Lichen planus is an autoimmune process in which T lymphocytes are directed against basal keratinocytes. The condition most commonly occurs between the ages of thirty and sixty and is slightly more prevalent in women than in men. Classic cutaneous lichen planus is defined by five features: purple colour, polygonal shape, flat surface, itching and a papular structure.
The disease has subtypes according to the different areas of involvement:
- Cutaneous lichen planus: Purple papules on the wrists, ankles and trunk
- Oral lichen planus: White reticular lines on the inner cheek mucosa (Wickham's striae)
- Lichen planopilaris: A form causing cicatricial alopecia on the scalp
- Nail lichen planus: Thinning, ridging and pterygium formation of the nail plate
Treatment Approaches in 2026
Topical Treatments
The first-line treatment for localised lichen planus lesions is topical corticosteroids. High-potency corticosteroid creams continue to be effective for cutaneous lesions. New topical calcineurin inhibitors developed in 2026 offer a safe alternative, particularly for mucosal involvement, by reducing steroid-related side effects during long-term use.
For oral lichen planus treatment, topical corticosteroid mouthwashes, adhesive-base oral gels and mucoadhesive tablets are frequently used.
Systemic Treatments
Systemic treatment may be required in widespread or refractory lichen planus cases. Agents used include oral corticosteroids, acitretin, methotrexate and mycophenolate mofetil. In 2026, targeted immunomodulatory therapies have also begun to appear in clinical practice. In particular, studies investigating the efficacy of JAK inhibitors in lichen planus are yielding promising results.
Phototherapy
Narrowband UVB phototherapy is an effective option in the treatment of widespread cutaneous lichen planus. Applied as two to three sessions per week, treatment generally achieves marked improvement over a period of eight to twelve weeks. PUVA therapy may be considered as an alternative in refractory cases.
Laser Treatment
Carbon dioxide laser and Nd:YAG laser are used particularly for hypertrophic lichen planus lesions and the erosive form of oral lichen planus. Fractional laser protocols developed in 2026 minimise post-treatment scar formation, delivering better cosmetic outcomes. Please contact us for pricing information on laser treatments.
Patient Management and Follow-up
- Identifying triggers: Stress, certain medications and dental materials can trigger lichen planus. Identifying and removing possible triggers improves treatment success.
- Oral hygiene: Regular dental check-ups and the use of appropriate oral care products are essential for patients with oral lichen planus.
- Malignancy screening: There is a low risk of malignant transformation, particularly in the erosive form of oral lichen planus. Regular clinical and, where necessary, histopathological follow-up should therefore be carried out.
- Psychological support: Chronic itching and visible lesions can create a psychological burden. Addressing the patient's emotional needs is an integral part of treatment.
At Virtuana Clinic, we are by your side with our multidisciplinary approach to the diagnosis and treatment of lichen planus. You are welcome to visit our clinic for a personalised treatment plan tailored to the type and severity of your condition.