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Objectives: The use of autologous platelet concentrates has shown growing evidence as a promising therapy. We conducted a split‐mouth study to evaluate the effectiveness of injectable platelet‐rich fibrin (PRF) compared with triamcinolone acetonide (TA) in the treatment of oral lichen planus (OLP). Materials and methods: This split‐mouth randomized trial included 12 patients with symptomatic, bilateral OLP lesions. The participants were randomly allocated to receive a 1‐ml intralesional PRF injection on one side of the buccal mucosa and a 0.5‐ml TA injection on the counterpart side. The application was performed once a week for 4 weeks. The outcomes were measured using a visual analog scale score, REU score, and lesion areas. Results: Both injectable TA and PRF were effective in the management of oral lichen planus. After 4 weeks of treatment, there was an average reduction in the VAS score (68.5% i‐PRF, 91% TA) and an average reduction in the REU score (74% i‐PRF, 91% TA). There were no statistically significant differences between the two treatment methods (p > 0.05). Conclusions: Intralesional injection with TA showed more effectiveness than i‐PRF in the management of OPL lesions. Although, i‐PRF cannot be considered a first‐line treatment option, it showed promising alternative therapy choice with no side effects. [ABSTRACT FROM AUTHOR]