Lichen planus, particularly in its oral form, is associated with a small increased risk of developing oral cancer.

Lichen planus is a chronic condition that affects the skin and mucous membranes, often causing itchy, purplish bumps or patches. It can appear on various parts of the body, including the mouth, where it’s known as oral lichen planus.

While oral lichen planus itself is not cancerous, having it can increase the risk of developing oral cancer.

Lichen planus in its skin form (cutaneous lichen planus) is generally not linked to an increased risk of cancer. However, when it occurs in the mouth — a condition known as oral lichen planus (OLP) — there’s a higher risk of developing oral cancer.

In a 2021 study of over 3,000 people with OLP, about 2.58% developed oral cancer, often many years after their initial OLP diagnosis. The research highlighted that these individuals frequently had fewer regular checkups, which could’ve played a role in their cancer development.

In addition, the study found that people whose oral cancer had developed from OLP had slightly better survival rates compared to people without OLP. For instance, at 60 months after diagnosis, 82% of OLP patients survived, compared to 77% of non-OLP patients.

A 2022 research review suggested that inflammation in OLP promoted tumor growth, sped up cell division, and helped cells evade natural growth limits. However, more research is needed to confirm how these changes happen and whether they actually lead to cancer.

Is lichen planus linked to autoimmune diseases?

Lichen planus is believed to be an autoimmune disease, although its exact cause remains unknown. It’s thought that exposure to viruses, drugs, or allergens may alter skin cells, prompting an immune response.

In this process, T cells, a type of white blood cell, mistakenly identify healthy skin cells — particularly basal keratinocytes in the outer layer of the skin — as harmful. This leads to an attack on these cells, resulting in inflammation and tissue damage.

Is lichen planus linked to the hepatitis C virus?

Lichen planus is strongly linked to the hepatitis C virus (HCV), as people with lichen planus are 5 times more likely to test positive for HCV.

The exact reason for this connection isn’t fully understood, but it’s believed that the immune system’s response to HCV may trigger the development of lichen planus in some cases.

If lichen planus is left untreated, several issues can arise depending on the type and severity of the condition.

For cutaneous lichen planus, which affects the skin, symptoms like itching and discomfort can persist or worsen, leading to chronic skin changes or scarring. Severe cases may become resistant to treatment and significantly impact quality of life.

For OLP, untreated lesions can lead to ongoing pain, difficulty eating, and an increased risk of developing oral cancer. Persistent inflammation may also cause complications if not monitored and managed regularly.

Treating lichen planus and oral cancer together can be complex, as both conditions require different treatment approaches. The goal is to manage the symptoms of lichen planus while effectively treating the cancer.

Here’s how both conditions might be approached simultaneously:

Oral cancer treatment:

  • Surgery: If the cancer is localized, surgery may be used to remove the tumor.
  • Radiation therapy: Often used after surgery or as the main treatment if surgery is not an option.
  • Chemotherapy: In more advanced cases, chemotherapy may be combined with radiation.

OLP management during cancer treatment:

  • Topical steroids: Mild topical corticosteroids may still be used to control OLP symptoms. This should be done under close supervision to ensure it doesn’t interfere with cancer treatment.
  • Nonsteroid alternatives: If corticosteroids are a concern, other treatments like calcineurin inhibitors might be prescribed.
  • Mouth rinses: Antiseptic or anti-inflammatory mouth rinses can help relieve symptoms of OLP without affecting cancer treatment.
  • Home remedies: Home remedies may include using saltwater rinses to reduce inflammation and discomfort, and applying coconut oil or aloe vera gel to soothe and moisturize affected areas.

Lichen planus, particularly in its oral form, carries a small increased risk of developing oral cancer. Regular checkups and early detection are important for managing this risk effectively.

If you have OLP, staying on top of monitoring can lead to better long-term health outcomes.