Itchy Purple Bumps? Why Your Skin Has Lichen Planus & Medically Approved Next Steps

If you've noticed itchy, purple bumps on your skin, you may be dealing with a condition called lichen planus. The name sounds complicated, but it describes a well‑recognized inflammatory skin disorder that doctors diagnose and treat regularly.

Lichen planus can affect the skin, mouth, nails, scalp, and even genitals. While it is not contagious and often improves over time, it can be uncomfortable and sometimes persistent. Understanding what's happening — and what to do next — can help you feel more in control.

---

What Is Lichen Planus?

Lichen planus is an inflammatory condition believed to be caused by an overactive immune response. In simple terms, your immune system mistakenly attacks healthy skin or mucous membrane cells.

It most commonly appears in adults between ages 30 and 60, though it can occur at any age.

What It Looks Like

Classic skin lichen planus often has:

• Purple or violet-colored bumps
• Flat-topped, shiny surface
• Intense itching
• Fine white lines on the surface (called Wickham striae)
• Clusters on the wrists, ankles, lower back, or legs

When it affects other areas, it looks different:

• Mouth (oral lichen planus): Lacy white patches, redness, or painful sores inside the cheeks
• Nails: Thinning, ridging, splitting, or permanent nail damage
• Scalp (lichen planopilaris): Redness, irritation, and potential hair loss
• Genitals: Painful erosions or white patches

---

What Causes Lichen Planus?

The exact cause isn't fully understood, but research shows it involves immune system dysfunction.

Possible triggers include:

• Viral infections (including hepatitis C in some cases)
• Certain medications (such as some blood pressure drugs, NSAIDs, or antimalarials)
• Dental materials (rarely)
• Stress (may worsen symptoms, but is not the root cause)

Importantly:

• Lichen planus is not contagious
• It is not caused by poor hygiene
• It is not a fungal infection

---

Is Lichen Planus Serious?

For many people, lichen planus is uncomfortable but not dangerous. Skin lesions often clear within 1–2 years, though discoloration may linger longer.

However, some forms require closer monitoring:

• Oral lichen planus carries a small increased risk of oral cancer.
• Scalp involvement can cause permanent hair loss if untreated.
• Nail lichen planus can lead to lasting nail damage.
• Severe genital involvement can cause scarring.

This is why proper diagnosis matters.

If you're experiencing any combination of purple bumps, nail changes, or persistent skin irritation and want to understand whether it might be Lichen Planus (Including Nails), a free AI-powered symptom checker can help you assess your symptoms and determine the right next steps.

---

How Is Lichen Planus Diagnosed?

A doctor — usually a primary care physician or dermatologist — will:

1. Examine your skin, mouth, scalp, or nails
2. Ask about medications and medical history
3. Possibly perform a skin biopsy (a small sample examined under a microscope)

A biopsy confirms the diagnosis and rules out similar conditions like psoriasis, eczema, lupus, or drug reactions.

In some cases, your doctor may also recommend:

• Blood tests (especially to screen for hepatitis C)
• Oral cancer screening if mouth lesions are present

---

Medically Approved Treatments for Lichen Planus

There is no permanent cure, but treatments aim to:

• Reduce itching
• Calm inflammation
• Prevent scarring
• Improve comfort

Your treatment plan depends on where the lichen planus appears and how severe it is.

1. Topical Corticosteroids (First-Line Treatment)

These prescription creams or ointments reduce inflammation.

• High-potency steroid creams for thick skin areas
• Steroid gels for oral lesions
• Steroid injections for stubborn areas

Used correctly under medical supervision, these are safe and effective.

---

2. Oral Medications (For Severe Cases)

If topical treatments aren't enough, your doctor may prescribe:

• Oral corticosteroids
• Retinoids
• Immunosuppressive medications
• Antihistamines to reduce itching

These medications require monitoring due to potential side effects.

---

3. Light Therapy (Phototherapy)

Controlled ultraviolet (UV) light therapy may help widespread skin lichen planus. This treatment is supervised in a medical setting.

---

4. Treatment for Oral Lichen Planus

Management may include:

• Prescription steroid mouth rinses
• Good oral hygiene
• Avoiding spicy, acidic, or irritating foods
• Regular dental checkups

Because oral lichen planus carries a small cancer risk, routine follow-up is essential.

---

What You Can Do at Home

While medical treatment is important, supportive care helps reduce discomfort:

• Use fragrance-free moisturizers
• Avoid scratching (keep nails trimmed)
• Wear loose, breathable clothing
• Use mild, non-soap cleansers
• Apply cool compresses for itching
• Manage stress through exercise, sleep, or relaxation techniques

If itching is severe or sleep-disrupting, speak to your doctor about safe medication options.

---

When Should You See a Doctor?

You should speak to a doctor if:

• You develop persistent purple, itchy bumps
• Mouth sores last more than two weeks
• You notice nail splitting or deformity
• Hair loss occurs with scalp redness
• Lesions are painful, spreading, or worsening
• You have difficulty eating due to oral pain

Seek urgent medical care if:

• You have rapidly worsening symptoms
• You develop signs of infection (fever, pus, spreading redness)
• You experience severe pain or bleeding lesions

While lichen planus itself is usually not life-threatening, certain complications can become serious without treatment. It's always safest to speak to a doctor about anything that could be life threatening or serious.

---

How Long Does Lichen Planus Last?

Skin lichen planus often clears within 12–24 months, though:

• Dark spots may remain temporarily
• Recurrences can happen
• Oral lichen planus may persist longer and fluctuate

Patience is important. Many cases improve significantly with proper treatment.

---

Is Lichen Planus an Autoimmune Disease?

It's considered an immune-mediated inflammatory condition, meaning the immune system plays a central role. It is not the same as classic autoimmune diseases like lupus, but it behaves similarly in that the immune system attacks normal tissue.

Having lichen planus does not automatically mean you will develop other autoimmune disorders.

---

The Bottom Line

If you're seeing itchy purple bumps, lichen planus is a possible cause — especially if the bumps are flat-topped, shiny, and located on your wrists or ankles.

Here's what to remember:

• Lichen planus is not contagious
• It is caused by immune system inflammation
• Most cases improve with treatment
• Oral, nail, and scalp involvement require close monitoring
• Early medical care reduces complications

If you're noticing changes to your skin or nails and want clarity on whether your symptoms align with Lichen Planus (Including Nails), using a free AI-powered symptom checker can help guide you toward the appropriate level of care.

Most importantly, don't ignore persistent or worsening symptoms. Even though lichen planus is often manageable, proper diagnosis ensures you receive the right treatment — and rules out more serious conditions.

If anything feels severe, unusual, or potentially serious, speak to a doctor promptly. Your skin is often a signal of what's happening inside your body, and it deserves attention.