What is the prognosis of lichen planus?

Answer 1

• In general, the outlook is good. Lichen planus of the skin usually goes without leaving any ongoing problems.
• Without treatment, about half of cases of lichen planus affecting the skin clear within 6-9 months. The rest usually clear soon after this. It is unusual for the rash to last longer than 18 months. However, lichen planus persists longer in a small number of people who are severely affected. This is mostly in people who develop lichen planus mouth ulcers, and lichen planus of the vulva or penis.
• Treatment can usually ease skin symptoms until the rash clears.
• For lichen planus of the skin, once the rash has cleared, about 1 in 5 affected people have a recurrence sometime in the future. A small number of people have several recurrences.
• If lichen planus affects nails or hair, any damage such as bald patches or destroyed nails is permanent.
• People with lichen planus have a slightly higher than average chance of developing other 'inflammatory' diseases. For example: ulcerative colitis, alopecia areata, vitiligo, dermatomyositis, morphea, lichen sclerosis, and myasthenia gravis. This is probably due to some people being more prone to 'immune' or 'inflammatory' conditions. However, most people with lichen planus do not develop any of these other conditions.
• If painful ulcers develop in the mouth due to lichen planus, then there is higher than average chance of developing cancer of the mouth. Again, most people do not but regular mouth checks from a dentist are advisable.
• If the vulva is badly affected, there is a slight increased risk of developing cancer of the vulva.

Answer 2

The condition is usually gradually progressive. Sometimes the patches grow rapidly over a short period, and then the condition remains stable for many years.