ADJUNCTIVE vitamin D supplementation may improve short-term clinical outcomes in patients with oral lichen planus (OLP), according to a new systematic review and meta-analysis. However, benefits appear to diminish over time, highlighting the need for further high-quality trials.
OLP is a chronic immune-mediated inflammatory disorder of the oral mucosa that often causes pain, burning, and impaired quality of life. Standard management typically involves topical or systemic corticosteroids, but incomplete responses and frequent relapses remain common. Vitamin D has immunomodulatory and anti-inflammatory properties, prompting interest in its potential role as an adjuvant therapy.
The researchers analysed data from four randomised controlled trials involving 137 adults with symptomatic OLP. All studies compared standard therapy alone with standard therapy plus vitamin D supplementation. Outcomes included pain severity, clinical lesion scores, mucosal healing, and inflammatory biomarkers.
Short-Term Benefits of Vitamin D in Oral Lichen Planus
Meta-analysis showed that adjunctive vitamin D significantly reduced pain scores at early time points. Pain improvement was observed at 2 weeks (mean difference [MD] −0.85), 4 weeks (MD −1.64), and 6 weeks (MD −1.64), with statistically significant effects across all three intervals. However, heterogeneity was substantial at later assessments, particularly at 4 and 6 weeks.
Clinical severity scores demonstrated significant improvement only at 6 weeks (standardised mean difference −0.58), with no consistent benefit at earlier or later time points. Importantly, patients receiving vitamin D were more than four times as likely to achieve mucosal healing compared with controls (risk ratio 4.04), suggesting a meaningful impact on lesion resolution.
Biochemical analysis further supported an anti-inflammatory effect. Salivary tumour necrosis factor-alpha (TNF-α), a key pro-inflammatory cytokine implicated in OLP pathogenesis, was significantly reduced in the vitamin D groups.
Despite these encouraging findings, the authors noted that by 8 weeks, differences between treatment groups were no longer statistically significant. Limitations included small sample sizes, variable dosing regimens, and short follow-up durations.
Implications for Clinical Practice in Oral Lichen Planus
Overall, the study suggests that vitamin D supplementation may accelerate early symptom relief, promote mucosal healing, and reduce inflammatory activity in OLP when used alongside standard therapy. The authors emphasised the need for larger, well-designed trials to determine optimal dosing strategies and to assess long-term clinical benefits.
Reference
Altamimi I et al. Vitamin D as an adjuvant therapy in oral lichen planus: a systematic review and meta-analysis of randomized controlled trials. Arch Dermatol Res. 2026;318:45.
