A study published in the journal Contemporary Clinical Dentistry comprised of 49 patients suffering from oral lichen planus (OLP). Of these, 63% of the patients associated stress with the onset and the waxing/waning of OLP lesions. Extreme stress may lead to fatigue or tiredness.In cases of severe lichen planus, immune modulators may be prescribed. They work with the body's immune system to help fight the damage caused to the skin. However, they can come with side-effects such as skin irritation, headache, nausea and tiredness.