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Background: The study aimed to compare the effectiveness of photodynamic therapy (PDT) and topical clobetasol therapy in treating oral lichen planus (OLP). To address the absence of commercially available drug carriers, innovative proprietary solutions were developed. These carriers were designed to enhance the therapies: one for the photosensitizer to reduce its contact time with the mucosa, and another for the steroid to prolong its contact duration. Methods: A randomized, single-blind clinical trial lasting three months was conducted on 29 patients with bilateral oral lichen planus using a full contralateral split-mouth design. The authors utilized proprietary carriers containing 5% methylene blue and 0.025%. Lesion size, as well as scores on the Thongprasom, Abisis, and VASs, were assessed during the study. Results: Relatively low rates of complete remission of lichen were demonstrated immediately after treatment, 10.3% after PDT and 3.4% after clobetasol, but after 3 months, 79% after PDT, and 62% after CLO. After 3 months of treatment, a reduction of 79.88% for PDT and 56.3% for CLO in the area of the evaluated lesions was achieved. Conclusions: PDT emerges as an equally effective method for treating OLP in terms of clinical outcomes, with the added advantage of avoiding many complications associated with conventional therapy.