Objectives: To compare the effectiveness of topical sesame oil in the formulation of a gel and topical triamcinolone acetonide 0.1% in dealing with the signs and symptoms of OLP. Patients and Methods: This randomized, controlled trial had thirty four patients who were randomly allocated to receive either sesame oil gel or triamcinolone acetonide 0.1% gel thrice daily for 4 weeks.  We assessed pain using the visual analogue scale and erythema and ulceration using the Thongprasom score and salivary MDA by ELISA.  Results: Patients improved significantly in both groups, however change in the triamcinolone group occurred significantly faster than the sesame oil group. The Thongprasom score differed significantly between both groups (p< 0.001) favoring the triamcinolone group. The MDA level was statistically insignificant between both groups. Conclusion:  Sesame oil can relieve pain but not as quickly as triamcinolone acetonide, additionally, it has no detectable effect on improving the clinical picture of OLP.