What Is Lichen Planopilaris and How Does It Affect the Scalp?

 

Lichen Planopilaris (LPP) is a rare inflammatory scalp condition that can lead to permanent hair loss if not treated early. It affects the hair follicles and is considered a type of scarring alopecia (also called cicatricial alopecia).

In this article, you'll learn what causes LPP, how to recognize it, and the best ways to manage it. Let’s break it down in simple terms.

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💡 What Exactly Is Lichen Planopilaris?

Lichen Planopilaris is a type of autoimmune disease that affects the skin, especially the scalp. The body’s immune system, which normally protects against infections, starts attacking its own hair follicles. This causes inflammation, leading to scalp redness, irritation, and ultimately hair loss.

There are three main types of LPP:

• Classic LPP – Involves patchy hair loss with redness and scaling.

• Frontal Fibrosing Alopecia (FFA) – Causes hairline recession, especially in women.

• Graham-Little-Piccardi-Lassueur Syndrome – Rare; affects scalp, armpits, and groin.

According to Cleveland Clinic, LPP can lead to irreversible hair loss if left untreated.

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🧠 What Causes Lichen Planopilaris?

The exact cause of LPP is not fully understood, but doctors believe it’s an autoimmune reaction. Some common triggers include:

• Genetics (family history of autoimmune diseases)

• Hormonal changes (especially in women after menopause)

• Stress

• Infections or trauma to the scalp

• Certain medications

In many cases, no clear cause is found.

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🧪 Signs and Symptoms of Lichen Planopilaris

Here are the most common symptoms to look out for:

• Itching or burning sensation on the scalp

• Red or purple patches on the scalp

• Scalp pain or tenderness

• Hair thinning in patches

• Scaling or flaking skin

• Follicular hyperkeratosis (rough, bumpy texture around follicles)

• Scarring and permanent bald spots

LPP typically begins with small patches and may spread over time. Unlike other types of hair loss, the skin in affected areas may look shiny or smooth due to scarring.

You can see example images and explanations on Healthline.

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🔬 How Is Lichen Planopilaris Diagnosed?

To diagnose LPP, a dermatologist will:

1. Examine your scalp visually.

2. Use a dermoscope to check the follicles.

3. Conduct a scalp biopsy – a small piece of scalp is removed and tested under a microscope.

4. Run blood tests to check for autoimmune conditions.

Early diagnosis is crucial. Once hair follicles are destroyed, regrowth is not possible.

At clinics like Pretty Skin Clinic, dermatologists use advanced diagnostic tools for early and accurate detection.

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🎯 How Does It Affect the Scalp?

LPP damages the hair follicles, causing inflammation and scarring. Here's how the disease progresses on the scalp:

1. Inflammation phase: The immune system attacks the hair follicle.

2. Scarring phase: The follicle gets damaged and replaced by scar tissue.

3. Permanent hair loss: Hair cannot grow back from scarred follicles.

Affected areas become smooth, with no visible pores. The scalp may feel tight, itchy, or burning.

Over time, the condition can cause large bald patches, especially if untreated.

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🧴 Available Treatments for Lichen Planopilaris

While there is no cure for LPP, several treatments can slow down the progression and relieve symptoms.

1. Topical Treatments

• Corticosteroid creams or ointments – Reduce inflammation.

• Calcineurin inhibitors (like tacrolimus) – Help control immune activity.

2. Oral Medications

• Antimalarial drugs like hydroxychloroquine.

• Immunosuppressants such as methotrexate or mycophenolate mofetil.

• Oral steroids (short-term use for flares).

• Antibiotics like doxycycline (for anti-inflammatory effect).

3. Injections

• Corticosteroid injections directly into the scalp for active inflammation.

4. Other Therapies

• Light therapy (phototherapy)

• Platelet-rich plasma (PRP) therapy (experimental in some clinics)

• Hair transplant (in selected cases where the disease is inactive)

Dr. Pretty Singla, Dermatologist, often suggests a personalized treatment plan based on the severity of the condition and the patient’s history. Visit her site PrettySkin.in for more insights on scalp disorders.

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🍎 Self-Care Tips to Manage LPP at Home

Here are some steps to reduce symptoms and protect your scalp:

• Avoid harsh hair products like sulfates or alcohol-based gels.

• Don’t scratch your scalp, even if it's itchy.

• Use gentle, pH-balanced shampoos.

• Protect your scalp from sun exposure.

• Manage stress through yoga or meditation.

• Avoid tight hairstyles that pull on the scalp.

• Stay consistent with medications and follow-up visits.

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📊 Who Is Most At Risk?

Lichen Planopilaris can affect anyone, but it is more common in:

• Women aged 40–60 years

• Postmenopausal women

• People with other autoimmune diseases (like lupus or thyroid disorders)

Though less common in men, it can still occur and should not be overlooked.

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💬 Patient Experience

Many patients notice hair shedding, irritation, or flaking and mistake it for dandruff or regular hair loss. But when symptoms worsen, they seek help. Early treatment can prevent scarring and save hair.

As shared on Cleveland Clinic, delays in diagnosis often lead to irreversible hair loss.

At Pretty Skin Clinic, patients report visible relief and reduced hair loss when treated consistently and monitored closely by a dermatologist.

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📅 How Often Should You Visit a Dermatologist?

If you’re diagnosed with LPP, regular checkups are crucial. In the early stages, you may need monthly visits. Once the condition is under control, follow-up every 3–6 months is common.

Always track your symptoms and take photos to compare progress. Let your doctor know if you notice:

• New bald patches

• Increased itching or pain

• Flaking or bumps

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❓Frequently Asked Questions (FAQs)

Q: Is Lichen Planopilaris contagious?

No. LPP is not contagious and cannot be spread from person to person.

Q: Will my hair grow back?

If scarring has not occurred yet, hair may regrow. But once follicles are scarred, hair regrowth is unlikely.

Q: Can diet affect LPP?

There’s no proven diet for LPP, but anti-inflammatory foods (like fruits, leafy greens, omega-3s) may help reduce inflammation.

Q: Is stress a trigger?

Yes, high stress levels can worsen autoimmune responses, including LPP.

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✅ Key Takeaways

• Lichen Planopilaris (LPP) is a rare scalp condition that leads to scarring hair loss.

• It is believed to be caused by autoimmune reactions.

• Early treatment can slow down or stop hair loss.

• Affected individuals should see a qualified dermatologist for evaluation.

• Pretty Skin Clinic, under the guidance of Dr. Pretty Singla, offers advanced diagnostic and treatment options for scalp conditions like LPP.

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⚠️ Disclaimer:

The information provided is for informational purposes only and does not constitute medical advice. Readers should consult with a qualified healthcare professional for diagnosis and treatment.