Lichen Planopilaris
Lichen planopilaris is a form of scarring alopecia that causes inflammation and permanent hair loss on the scalp.
It typically presents as patchy hair loss with associated redness, scaling and irritation around hair follicles.
As a scarring condition, affected hair follicles can be permanently destroyed, making early diagnosis important.
At The London Skin and Hair Clinic, Consultant Dermatologists assess lichen planopilaris and related scalp conditions to confirm the diagnosis and guide appropriate management. Patients seeking a hair loss dermatologist in London can access specialist evaluation and care.
Lichen planopilaris is one of the scarring alopecias and usually presents as patchy hair loss on the scalp.
Lichen planopilaris encompasses central centrifugal cicatricial alopecia (CCCA), lichen planopilaris, cicatricial alopecia and frontal fibrosing alopecia
Lichen planopilaris usually presents as red, inflamed, scaly patches of hair loss on the scalp
Treatments can include topical steroids or topical calcineurin inhibitors or intralesional steroid injections to the affected areas or Systemic treatment such as hydroxychloroquine
What causes Lichen Planopilaris?
The exact cause of lichen planopilaris is not fully understood, but it is believed to be an autoimmune inflammatory condition.
In this process:
- the immune system targets hair follicles
- inflammation develops around the follicle
- permanent damage and scarring can occur
Unlike some scalp conditions, lichen planopilaris is not caused by infection.
Who is at risk of Lichen Planopilaris?
Lichen planopilaris is more commonly seen in:
- women than men
- adults over the age of 40
- individuals with other inflammatory or autoimmune conditions
It may also occur alongside related forms of scarring alopecia, such as frontal fibrosing alopecia.
What are the symptoms of Lichen Planopilaris?
The condition most commonly presents as patchy hair loss on the scalp.
Symptoms may include:
- areas of hair loss with redness and inflammation
- scaling around individual hair follicles
- smooth, shiny skin where hair has been lost
- loss of follicular openings in affected areas
Some patients may also experience:
- itching
- burning
- tenderness or discomfort
In some cases, eyebrows or body hair may also be affected.
Images of Lichen Planopilaris
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How is Lichen Planopilaris diagnosed?
A dermatologist will diagnose lichen planopilaris through clinical assessment of the scalp.
Diagnosis may include:
- dermatoscopic examination
- hair-pull test
- review of medical history
In many cases, a scalp biopsy is required to confirm the diagnosis and distinguish it from other types of hair loss.
Samples are examined by a specialist pathologist with expertise in hair and scalp disorders.
How is Lichen Planopilaris managed?
As lichen planopilaris is a scarring condition, treatment focuses on slowing progression and preserving existing hair.
Management options may include:
- topical anti-inflammatory treatments
- steroid injections into affected areas
- systemic medications to control inflammation
Response to treatment can vary, and not all patients achieve disease control.
Close monitoring by a dermatologist is important to manage symptoms and reduce further hair loss.