Lichen planus, a common inflammatory skin condition possibly caused by an autoimmune reaction, affects around 1 to 2 percent of Americans, the American Academy of Dermatology reports. Lichen planus can affect the skin or the oral mucosa in the mouth. The oral form of the disease affects women twice as often as men, according to the AAD. Oral LP appears most often on the cheeks but can also affect the tongue, lips or gums. Oral LP, which appears as white lacy lines and dots in the mouth, lasts longer than the skin version and is harder to treat.
Corticosteroids
Application of topical corticosteroids to severe or painful lesions helps heal the outbreak, lead author Dr. Hilary Johnson of the New York University Department of Dermatology noted in a 2008 article for the "Dermatology Online Journal." Frequent use of topical corticosteroids can lead to oral candidiasis, also known as thrush. Long-term use of topical corticosteroids can also lead to thinning of the skin, adrenal gland suppression and other skin problems, MayoClinic.com warns. Corticosteroids can also be injected directly into the oral LP lesions and can lead to long-term side effects that are similar to the topical application. Taking oral corticosteroids long-term can lead to diabetes, osteoporosis, high blood pressure and elevated cholesterol levels.
Retinoids
Retinoids, or synthetic vitamin A, can also be applied directly to oral LP lesions or taken by mouth. Retinoids can cause birth defects and should not be taken by pregnant women or women planning to get pregnant in the near future, MayoClinic.com warns. Retinoids can irritate the mucous membranes and aren't as effective in treating the oral LP lesions as corticosteroids, Dr. Johnson states.
Calcineurin Inhibitors
Topical application of calcineurin inhibitors, the same medications used to prevent organ rejection after a transplant, can treat an oral outbreak of LP. Calcineurin inhibitors can also cause local skin irritation when applied to oral lesions. These potent medications raise some concern about cancer development in people using them due to their immunosuppressive effects, Dr. Johnson reports.
Phototherapy
Phototherapy with UVA or UVB light can also treat oral LP. Ultraviolet B light penetrates only the top layer of skin, the epidermis, while UVA penetrates deeper into the skin. Drugs that facilitate absorption into the skin may be used in conjunction with UVA treatment. These drugs cause light sensitivity and can result in bad sunburn if a person goes out in the sun without covering in the first few days after treatment, MayoClinic.com explains. Ultraviolet A treatment is effective for severe oral LP but may also increase the risk of cancer development in the mouth, Dr. Johnson reports.
