Skin diseases and mouth: symptoms, causes & treatment

The oral mucosa has striking similarities with the skin on the rest of your body. Both consist of different layers of cells that protect you from the outside world. However, there are also important differences. Your oral mucosa is softer, more moist and lacks the keratinization that your skin has. Because of these specific properties, a skin disease in your mouth can look very different from other parts of your body.

Various conditions can affect both your skin and oral mucosa. This is because the underlying inflammatory processes in your body can affect both tissues. Sometimes the mouth lesions appear even earlier than the rash, causing your mouth to give a warning signal, as it were. Examples of such disorders include lichen planus, pemphigus, and lupus erythematosus, where characteristic changes can occur on both the skin and the mouth.

The oral cavity is particularly susceptible to inflammation. The constant humidity, the presence of bacteria and fungi, and contact with food and drink create a unique environment. For people with certain skin conditions, this may mean that the oral injuries are more persistent or cause more symptoms than the rash itself. Medically, these disorders are often described based on their appearance: the color, shape, texture, and location of the lesions. These visual features help doctors make the right diagnosis and choose the best treatment.

The development of skin diseases in the mouth depends on several factors that together form a complex interaction. In many of these disorders, your immune system plays a central role. Sometimes your immune system reacts too strongly to certain stimuli, causing inflammation in the oral mucosa. In autoimmune disorders such as pemphigus or lichen planus, the immune system turns against the body's own tissues, leading to damage to the oral mucosa.

External factors can strongly influence the development of oral injuries. Prolonged excessive use of tobacco and alcohol is an important risk factor for certain changes in the oral mucosa. These substances continuously irritate the delicate tissue and can lead to permanent changes in the cells over the years. Mechanical stimuli also play a role: contact with dental fillings, ill-fitting dentures or constant friction can aggravate existing conditions. Even your toothpaste or mouthwash can contribute to irritation in some cases.

Viral infections can also play a role in the development of certain oral diseases. Some viruses remain latent in your body after a first infection and can become active again later, for example in the event of stress or a reduced immune system. This explains why some mouth injuries flare up during periods of extra strain. Drug use is another relevant factor, and certain medicines may cause changes in the oral mucosa as a side effect. Stress and hormonal changes can also affect the condition of your oral mucosa.

The symptoms of skin diseases in the mouth vary greatly depending on the specific condition. What many people notice first are visual changes in their mouths. You can see white stripes or spots that cannot be scraped off, such as lichen planus where a characteristic lace-like pattern is created. Sometimes, on the contrary, red, well-defined spots appear that stand out against the normal pink color of your oral mucosa. In some disorders, you see small blisters or imperfections that can burst after a while and leave painful wounds, which is typical of pemphigus.

Physical sensations can vary considerably. Many people experience a burning or stinging sensation in their mouths, especially when in contact with acidic or spicy foods. Others suffer from sensitivity or a rough feeling when they run their tongues around the affected areas. In lichen planus, this burning sensation may be prominent, while in some other conditions, there is little or no pain, which may be surprising given the visible injury.

Pigment changes are another important symptom. Your oral mucosa may darken, ranging from light brown to almost black. These discolorations can be localized or spread over different parts of your mouth. They are usually painless but can be unsettling to see. Some people notice that their symptoms fluctuate, with periods when the injuries are barely noticeable interspersed with times when the symptoms are more evident. This variation may be related to stress, food choices, or the overall state of your health.

The location of oral injuries often follows a characteristic pattern that helps physicians make a diagnosis. The inside of your cheeks is a common place where various disorders manifest themselves, especially lichen planus, which often occurs symmetrically on both cheeks. Your tongue can be involved in various ways, with injuries confined to the sides, upper surface, or bottom. The edge of your tongue, where it contacts your molars, is often a preferred location for certain changes.

The gums also respond to various skin conditions, with redness, swelling or white discoloration. Some conditions specifically affect the gums around your molars or front teeth, which can lead to sensitivity when brushing your teeth. Your palate can also be involved, both the hard and soft parts, where injuries are sometimes harder to see for yourself but can cause symptoms when eating or drinking something hot.

The lips and, in particular, the lower lip may also be affected. Due to the constant exposure to sunlight and weather conditions, the lips are extra vulnerable. Changes here can range from mild redness and scaling to clearly visible lesions with a different color or texture.

The treatment of skin diseases in the mouth is always customized, tailored to your specific situation. The aim is to reduce the symptoms, to allow the injuries to heal where possible, and to prevent serious complications. Many treatments focus on suppressing overactive inflammatory reactions in the oral mucosa.

Local treatments are often the first step. Creams, ointments or mouthwashes with anti-inflammatory action can be applied directly to the affected areas. This local approach has the advantage that the active substances end up directly in the right place, with minimal side effects for the rest of your body. Lichen planus, for example, often uses corticosteroid-containing mouth gels that soothe the inflamed mucous membrane. It is important to use these medicines consistently according to your doctor's instructions.

For more persistent or serious conditions, tablets that affect your entire body can be chosen. This systemic treatment ensures that even hard-to-reach areas in your mouth receive the medication. The choice for this form of treatment depends on the severity of your symptoms and how well you respond to local therapy. Sometimes a surgical procedure is necessary, which can range from removing a small sample of tissue for examination to removing larger injuries that pose a risk.

Supportive measures are at least as important as drug therapy. Optimizing your oral health contributes to the success of each therapy. This means professional dental cleanings, adjustments to your dentures if necessary, and smoothing sharp edges on fillings or crowns. Lifestyle changes can make a big difference: quitting smoking and limiting alcohol consumption are essential steps, especially for certain oral injuries that can degenerate. Avoiding highly spicy or acidic foods can also help reduce irritation during treatment.

The duration of treatment varies considerably. Some conditions respond to therapy within a few weeks, while others require a long-term approach. Regular monitoring by your therapist is important to monitor progress and adjust treatment if necessary.

Unfortunately, there are many misunderstandings about the treatment of oral injuries that are better avoided. The idea that you can “wash away” oral diseases with strong mouthwashes or saline solutions is wrong. On the contrary, too aggressive oral hygiene can further irritate the delicate oral mucosa and worsen the symptoms. Home remedies such as applying vinegar, lemon juice or other acidic substances directly are counterproductive and damage your oral mucosa. Your mouth does not need “purification” but rather gentle, targeted care.

Ignoring oral injuries in the hope that they will disappear on their own is also not a good strategy. Certain changes in your mouth can be a harbinger of serious problems and require professional review. Early diagnosis and treatment not only prevent discomfort but can also prevent worse in some cases. The idea that avoiding dental care will save you from dental injuries is wrong. Poor oral health, in particular, can make existing conditions worse. Tartar, inflamed gums, and caries create an environment where inflammation thrives.

Self-medication with remnants of old drugs or remedies prescribed for someone else is dangerous. Skin diseases in the mouth require a specific diagnosis and treatment that suits your situation. What works for one person may be ineffective or even harmful for you.

Are skin diseases in the mouth contagious?

Most skin diseases that also occur in your mouth are not contagious. They are caused by internal processes in your body, such as overactive immune responses, and cannot be transferred to others. So you can simply have normal contact with family and friends without the risk of infection.

Can oral injuries degenerate into cancer?

Certain changes in the oral mucosa can indeed increase the risk of degeneration, especially when they exist for years and are not treated. That's why regular monitoring by a doctor is so important. With good follow-up, risky injuries can be recognized and treated in time.

How long does it take for oral injuries to heal?

This varies enormously by condition and person. Some acute inflammations heal within weeks with appropriate treatment, while chronic conditions require a long-term approach. In some cases, it is more about control than complete healing, with the aim of keeping the symptoms manageable.

Can I continue to use my mouth normally during treatment?

In most cases, you can continue to eat, drink and speak during treatment. However, it may be wise to avoid very hot, spicy or acidic foods if they cause additional irritation. Your therapist can advise you on any temporary adjustments to your daily routine.

Is there a connection with my overall health?

Yes, often. Some oral injuries may indicate underlying autoimmune disorders or other systemic disorders. That's why your doctor not only looks at your mouth, but also at your general health. This holistic perspective helps to find the best treatment and discover any other health problems.

Do the injuries come back after treatment?

The risk of recurrence depends on the underlying cause. For some disorders, treatment is definitive, while others are chronic with periods of rest and flare-ups. Good aftercare, the avoidance of triggering factors and regular monitoring help to prevent recurrence or to treat it quickly.

1. Skindr dermatologists
2. Health and Science: Skin Diseases and Mouth
3. EBPNet: Evidence-based guidelines for GPs