Lichen Planopilaris (LPP) – Causes, Symptoms & Treatment
Patients experiencing scarring hair loss can benefit from evaluation by a dermatologist familiar with inflammatory scalp disorders. Dr. Dina M. Strachan, MD, a board-certified dermatologist at Aglow Dermatology in New York City, provides dermatologic diagnosis and treatment for conditions such as lichen planopilaris.
What is Lichen Planopilaris (LPP)?
Lichen planopilaris (LPP) is a scarring type of hair loss that results from an inflammatory condition affecting the scalp. It is a variant of lichen planus, an autoimmune disorder that targets the hair follicles, leading to permanent hair loss due to follicle destruction. Early diagnosis and treatment are essential to slowing its progression.
Who is Most Commonly Affected?
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Middle-Aged Women: LPP is more common in women aged 30–60.
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People with Autoimmune Conditions: Those with lichen planus or other autoimmune disorders may be at higher risk.
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Individuals with Genetic Susceptibility: Family history may play a role.
What are the Symptoms?
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Patchy hair loss with scarring, often on the scalp’s frontal or vertex region.
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Scalp redness, scaling, and inflammation.
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Burning, itching, or tenderness in the affected areas.
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Follicular hyperkeratosis, where small, rough, scaly bumps form around hair follicles.
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Permanent hair loss in affected regions as follicles are destroyed.
What Causes LPP?
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Autoimmune Reaction: The immune system mistakenly attacks hair follicles, leading to inflammation and scarring.
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Genetics: Some individuals may have a hereditary predisposition.
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Triggers: Potential triggers include viral infections, stress, or medications, although the exact cause remains unclear.
How is it Diagnosed?
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Anti-Inflammatory Medications:
Topical or Intralesional Corticosteroids: Reduce inflammation and slow disease progression.
Oral Hydroxychloroquine: May help modulate immune response.
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Topical and Systemic Treatments:
Calcineurin Inhibitors (Tacrolimus, Pimecrolimus): Help reduce scalp inflammation.
Oral Tetracycline Antibiotics: Used to control inflammation.
Immunosuppressive Drugs (Methotrexate, Cyclosporine): Reserved for severe cases.
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Scalp Care & Gentle Hair Practices:
Avoiding harsh chemical treatments and excessive heat styling.
Using mild shampoos and scalp moisturizers to reduce irritation.
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Hair Restoration (For Advanced Cases):
Hair Transplant Surgery: Can be an option once the disease is inactive.
Non-surgical Hair Restoration: Alma TED or PRP involves using growth factors on viable hair follicles.
Can LPP Be Reversed or Prevented?
LPP is not reversible once scarring occurs, but early intervention can prevent further hair loss and restore where there is damage. Avoiding triggers, maintaining scalp health, and following prescribed treatments can help slow the disease’s progression.
Frequently Asked Questions (FAQs)
Hair loss due to LPP is permanent if scarring has developed, but treatment can help prevent further damage.
Stress, infections, and certain medications may contribute.
There is no cure, but effective treatments exist to manage the condition and preserve remaining hair.
When to See a Dermatologist
If you experience patchy hair loss, scalp discomfort, or persistent inflammation, seek medical attention promptly. Early treatment is essential to slow disease progression and protect existing hair.
Next Steps & How to Get Treatment
If you suspect you have LPP, schedule a consultation with our hair loss dermatologist for a thorough evaluation and personalized treatment plan. Learn more about Learn about our virtual visits for hair loss services!