What is lichen planopilaris?

What is Lichen Planopilaris?

Lichen Planopilaris (LPP) is a rare type of autoimmune disorder that affects the hair follicles, leading to hair loss.

Key Characteristics:

• Inflammation of Hair Follicles: LPP causes inflammation around hair follicles, which can lead to hair loss, thinning, and scarring.

• Scarring Alopecia (Hair Loss): Over time, the inflammation can result in scarring (fibrosis) of the affected areas, leading to permanent hair loss.

• Symptoms: The condition is often characterized by:

• Itching or burning sensation in the scalp.

• Hair thinning or bald patches that can gradually spread.

• Red or purple bumps on the scalp, sometimes with white scales.

• Dry, flaky patches of skin on the scalp, similar to dandruff.

• Commonly Affects the Scalp: LPP primarily affects the scalp but can sometimes involve other areas of the body where hair is present, such as the eyebrows, eyelashes, and body hair.

Causes and Risk Factors:

The exact cause of Lichen Planopilaris is not fully understood, but it is believed to be related to an abnormal immune response. In autoimmune conditions like LPP, the immune system mistakenly attacks the body’s own tissues—in this case, the hair follicles. Factors that may contribute include:

• Genetics: A family history of lichen planus or other autoimmune diseases may increase the risk.

• Hormonal changes: Some women experience flare-ups of LPP around menopause, suggesting hormonal influences.

• Infections: Certain infections or illnesses may trigger or exacerbate LPP.

• Medications: Some drugs, particularly those that affect the immune system, may contribute to the development of LPP.

Diagnosis:

To diagnose Lichen Planopilaris, a dermatologist typically performs the following:

• Physical Examination: To observe the symptoms, such as hair thinning, scarring, and the presence of red or purple bumps on the scalp.

• Biopsy: If the diagnosis is not clear, a biopsy may be taken to confirm the diagnosis.

Treatment Options for Lichen Planopilaris:

While there is no cure for Lichen Planopilaris, several treatment options can help manage the condition, reduce symptoms, and prevent further hair loss. Treatment aims to reduce inflammation, stop the progression of hair loss, and promote hair regrowth in non-scarred areas.

1. Topical Treatments:

• Corticosteroids

• Topical Calcineurin Inhibitors

2. Oral Medications: immune suppressive drugs, hydroxychloroquine, 5a-reductase inhibitors

3. Hair Restoration Treatments: Minoxidil

Prognosis and Outlook:

The prognosis for Lichen Planopilaris varies from person to person. In some individuals, the condition stabilizes after a period of time, and hair loss may not progress further. However, in others, it may continue to cause hair thinning and scarring. Early diagnosis and treatment are critical to managing the condition and minimizing the risk of permanent hair loss.

In cases where the scalp is significantly affected by scarring, regrowing hair may not be possible. However, treatment can help manage inflammation, alleviate symptoms, and prevent further damage.

Conclusion:

Lichen Planopilaris is a challenging condition that can lead to permanent hair loss if not properly managed. Early diagnosis and a tailored treatment plan are essential for controlling symptoms and preventing further progression of the disease. If you suspect you may have LPP, it’s important to consult a dermatologist for a proper diagnosis and treatment recommendations tailored to your specific needs.

*Note: this is not medical advice.