When you see a white net pattern in the mouth: a guide to oral lichen planus

Oral lichen planus is a chronic disease of the oral lining in which white lines form a net-like pattern inside the cheek, on the gums or on the tongue, or the lining turns red, raw and stinging. In Korea, Seoul National University Hospital's medical information describes it as a kind of autoimmune disease, and the Asan Medical Center disease encyclopedia advises that with no symptoms a yearly checkup is enough, without special treatment. It rarely progresses to cancer, so confirming the diagnosis by biopsy and keeping watch steadily is important.

Published 2026-11-08 · Updated 2026-11-08 · DentalStatics editorial team

Key facts

What kind of disease is oral lichen planus?

Lichen planus is a chronic inflammatory disease of the skin or lining, and when it occurs in the mouth it is called oral lichen planus. Seoul National University Hospital's medical information explains that it is the same disease as lichen planus of the skin, known as a kind of autoimmune disease, and classifies it as non-infectious stomatitis along with aphthae and pemphigus. It is not a disease that spreads to others.

The Asan Medical Center disease encyclopedia explains that the cause has not been clearly identified and that there are views that psychological factors, viral infection, immunity and drugs are involved. When lichen planus is on the skin, an itchy rash appears and the nails may thicken or split, so along with the symptoms in the mouth, other parts of the body are also examined.

What does oral lichen planus look like?

According to material from the Journal of the Korean Dental Association, the reticular and erosive forms are the typical forms in the mouth. The reticular form is a net-like pattern of white lines tangled like lace, usually appearing on the cheek lining on both sides near the molars. In the erosive form the lining is red, peeled and raw, and a white pattern may also be seen around it.

Seoul National University Hospital's medical information explains that oral lichen planus tends to form on the gums, the inside of the cheeks or lips, and the lining of the tongue, and that although there may be no symptoms, in severe cases a very stinging pain can be felt. The Asan Medical Center disease encyclopedia also advises that generally there are no symptoms but it can cause painful ulcers.

How is oral lichen planus diagnosed?

It can be suspected from the look alone, but a biopsy is sometimes done to tell it apart from other lesions that look similar. Seoul National University Hospital's medical information explains that lichen planus can mostly improve with appropriate treatment but can sometimes progress to cancer, so a biopsy is sometimes done.

In particular, a white patch that cannot be wiped off must be told apart from leukoplakia. The National Cancer Information Center of the National Cancer Center describes leukoplakia, a white lesion on the oral lining that cannot be wiped off, and a red patch that stays, as lesions that may be precancerous. Material from the Journal of the Korean Dental Association also explains that a biopsy should be considered when it needs to be told apart from leukoplakia.

How is oral lichen planus treated?

For a painless reticular form, observation rather than treatment is central. According to the Asan Medical Center disease encyclopedia, no special treatment is needed when there are no symptoms, and it is enough to have a periodic checkup once a year.

If there is pain, removal of causes and drug treatment are done together. Seoul National University Hospital's medical information explains that removing the cause comes first, so if there is a poor prosthesis, it is redone and a new prosthesis fitted, and smokers must quit. It advises that steroid mouthwash is effective for the reticular form.

The Asan Medical Center disease encyclopedia explains that if the lesion is severe or lasts long, oral steroids or injections into the lesion may be needed, and since candidiasis is often present too, an antifungal can help. Which drug to use and how much is decided from the exam results.

What should I be careful about in daily life with oral lichen planus?

During the period when the lining is red and raw, cut back on things that irritate it, such as spicy and hot foods, sour fruit and alcohol, and keep brushing with a low-irritation toothpaste and a soft toothbrush. Smoking is an item for which Seoul National University Hospital's medical information recommends quitting, so it is good to stop.

The Asan Medical Center disease encyclopedia explains that oral hygiene and dental care are important. Even without symptoms, get checked at set intervals, and if the shape of the pattern changes or a raw spot does not heal or becomes firm, get an exam instead of waiting for the regular checkup.

Use the prescribed steroid mouthwash or ointment for the set frequency and period, and do not use it for a long time on your own because it improved, or stop it suddenly. At the next checkup, bringing a summary of the periods when it hurt and the medicines used makes it easier to judge the course of the lichen planus.

Common myths and facts

Frequently asked questions

Related topics

• Mouth sores and oral pain
• Mouth sores and oral pain
• Ulcer that won't heal
• Cheek biting
• Oral candidiasis
• Burning mouth

References

1. Seoul National University Hospital N Medical Information: Stomatitis
2. Asan Medical Center Disease Encyclopedia: Lichen Planus
3. Journal of the Korean Dental Association: White Lesions of the Oral Mucosa
4. National Cancer Information Center, National Cancer Center: Oral Cancer

Korean version →