In patients with oral lichen planus, Hyaluronic acid, Corticosteroids, and Tacrolimus have comparable effectiveness in terms of reductions in pain scores, lesion size, degree of erythema, and sign scores.

The purpose of a systematic review and meta-analysis was to evaluate the efficacy of Hyaluronic acid in the treatment of symptomatic oral lichen planus, a chronic inflammatory immune-mediated condition.

For randomized controlled trials (RCTs), manual searches were done and online electronic databases were explored. At baseline and after follow-up, the effectiveness of Hyaluronic acid and other interventional therapy were compared in RCTs. The quality of incorporated studies was determined utilizing Cochrane Risk of Bias tool.

Visual Analog Scale (VAS) scores, Disease severity, clinical severity, degree of erythema, lesion size, and Thongprasom sign scores were both quantitatively and qualitatively evaluated. A total of 7 studies were investigated.

While the remaining two studies indicated an uncertain risk of bias, the rest five studies reported a high risk of bias. In comparison to the control group, the overall quantitative evaluation of sign score, degree of erythema, symptoms, and size of oral lichen planus lesions treated with Hyaluronic acid was not clinically meaningful. Additionally, a subgroup analysis contrasting Hyaluronic acid with corticosteroids or placebo failed to provide clinically meaningful outcomes.

Both Tacrolimus and Hyaluronic acid effectively reduced the signs and symptoms, qualitatively. Clinical/illness severity scores/index varied widely. There was a significant amount of heterogeneity across the incorporated studies. The side effects of Hyaluronic acid were not mentioned in any of the incorporated studies. In the management of oral lichen planus, Hyaluronic acid, placebo, Tacrolimus, and Corticosteroids appeared to be similarly beneficial. The score reduction or illness/clinical severity index could not be determined with certainty.

Owing to the anti-inflammatory effect and lack of adverse effects, Hyaluronic acid can be used as an alternate treatment option for oral lichen planus.