Devastating Hair Loss Due To Lichen Planopilaris

Devasting Hair Loss Due To Lichen Planopilaris

The Best Hair Systems for Trichotillomania

Lichen Planopilaris, a rare but serious skin condition that affects hair follicles, can be a source of distress for those affected by it. It is important to understand what causes this condition and how it can be treated. In this blog, we take a deep dive into understanding Lichen Planopilaris- its definition, prevalence, symptoms, and diagnosis process. We will also discuss the potential triggers and risk factors associated with the condition. Additionally, we will cover the course of treatment available to manage Lichen Planopilaris - both pharmacological and non-pharmacological measures. Lastly, we will talk about living with this condition and its prognosis. Read on to gain comprehensive insights into Lichen Planopilaris and how you can manage it effectively.

Lichen planopilaris is a scarring hair loss condition characterized by inflammation and damage to the hair follicles. If left untreated, it can lead to permanent hair loss. Dermatologists diagnose lichen planopilaris through a biopsy. Treatment options for this condition focus on reducing inflammation and promoting hair regrowth. By using topical corticosteroids, dermatologists aim to improve the efficacy of treatment. Lichen planopilaris presents with symptoms of an itchy rash and may be associated with conditions like rheumatoid arthritis. (

Lichen planopilaris, a form of lichen planus that primarily affects the scalp, is an autoimmune disease where the immune system mistakenly targets the hair follicles. This condition can lead to hair loss and scarring on the scalp. Common symptoms include redness, itching, and irritation in the affected areas. Early diagnosis and treatment are key to effectively managing lichen planopilaris. It is essential to understand the characteristics of this condition for proper identification and timely intervention. Dermatology research and the Journal of the American Academy of Dermatology (JAAD) often provide insights into the efficacy of topical corticosteroids and other treatment options. Recognizing the symptoms of lichen planus and understanding its follicular variant, known as follicular lichen planus or lPP, can facilitate appropriate diagnosis and management. Additionally, it's important to note that individuals with lichen planopilaris may have an increased risk of developing rheumatoid arthritis.

Lichen planopilaris, a rare condition, affects both men and women, with a higher prevalence in middle-aged individuals. Factors like family history and autoimmune disorders can increase the risk. While the exact prevalence is unknown, it is estimated to affect less than 1% of the population. The impact on quality of life and self-esteem can be significant due to its symptoms and clinical features. Dermatology professionals often use topical corticosteroids for treatment, which have shown efficacy in managing this itchy rash.

The exact cause of lichen planopilaris remains unknown, but it is believed to be an autoimmune condition. Triggers such as stress, hormonal changes, and infections may contribute to its development. Those with a family history of lichen planopilaris or other autoimmune disorders may be at a higher risk. Genetic factors are also thought to play a role, although further research is needed for a full understanding of the causes and risk factors of this condition.

Stress and emotional trauma have been associated with triggering flare-ups of lichen planopilaris. Hormonal changes, such as those experienced during menopause, can also contribute to the development of this condition. Infections caused by certain bacteria or viruses have also been linked to lichen planopilaris. Additionally, exposure to certain medications or chemicals can sometimes trigger the condition in susceptible individuals. It is important to identify and avoid potential triggers in order to effectively manage lichen planopilaris.

Lichen planopilaris, a dermatological condition, is characterized by specific symptoms and clinical features. Individuals with this condition often experience itching, redness, and irritation on their scalp. Hair loss is a prominent feature, leading to the development of bald patches. In severe cases, lichen planopilaris can cause scarring and permanent hair loss. Recognizing these symptoms is crucial as early diagnosis and treatment are essential. Seeking medical attention promptly can help manage the condition effectively. 

Recognizing the Symptoms of Lichen Planopilaris can help in early diagnosis and treatment. Common symptoms include itching, burning, and tenderness on the scalp. Red or purple-colored bumps may appear, leading to hair loss. The affected areas may have a rough texture and scaly appearance, with swollen and inflamed hair follicles. If you experience these symptoms, it is recommended to consult with a dermatologist for proper evaluation and treatment.

Understanding the clinical features of lichen planopilaris is crucial for accurate diagnosis and appropriate treatment. In the early stages of the condition, individuals may experience redness, scaling, and small areas of hair loss on the scalp. As lichen planopilaris progresses, it can lead to larger bald patches and scarring. It's important to note that in some cases, lichen planopilaris may extend beyond the scalp, affecting other parts of the body. Recognizing these clinical features can help healthcare professionals provide effective management and care for patients with lichen planopilaris.

Diagnosing lichen planopilaris involves a combination of clinical evaluation, medical history review, and specialized tests. A dermatologist may perform a scalp biopsy to examine the affected tissue under a microscope. Other tests, such as blood tests or patch testing, may be recommended to rule out other possible causes and triggers. It is essential to consult with a dermatologist experienced in diagnosing and treating lichen planopilaris for accurate results. Early and accurate diagnosis is crucial for implementing an effective treatment plan and managing lichen planopilaris symptoms.

Lichen planopilaris should be distinguished from other causes of scarring hair loss, such as frontal fibrosing alopecia. Non-scarring alopecia areata may resemble early-stage lichen planopilaris but require different treatments. Trichoscopy aids in distinguishing lichen planopilaris from other non-scarring alopecias. Dermatologists may perform blood tests to exclude underlying autoimmune diseases. Examination of the nails and mucous membranes can help differentiate lichen planopilaris from other forms of lichen planus.

Corticosteroids, both oral and topical, are commonly used in the dermatology field to address lichen planopilaris (LPP), a condition characterized by a scarring rash on the scalp. For more severe cases, immunosuppressive agents like mycophenolate mofetil may be prescribed. Additionally, antibiotics can help control any secondary infections associated with LPP. Topical minoxidil has shown efficacy in promoting the regrowth of hair in small affected areas. In cases of permanent hair loss caused by LPP, hair transplantation can be considered.

To treat lichen planopilaris, dermatologists often prescribe corticosteroids such as topical clobetasol propionate to reduce inflammation. Another medication, hydroxychloroquine, can modulate the immune system and help manage this condition. Topical calcineurin inhibitors like tacrolimus can also be used to alleviate inflammation on the scalp. In refractory cases, methotrexate, a systemic immunosuppressive agent, may be recommended. Retinoids like acitretin can normalize the abnormal growth cycle of hair follicles affected by lichen planopilaris. These pharmacological measures have shown efficacy in managing the symptoms of lichen planopilaris.

Protecting the scalp from sun exposure, either by wearing hats or using sunscreen, is an important measure for managing lichen planopilaris. It's also advisable to avoid harsh hair treatments and styling products to minimize scalp irritation. Using gentle shampoos and conditioners can help maintain scalp health in individuals with lichen planopilaris. If bald patches are a concern, wearing wigs or other hairpieces can provide cosmetic coverage. 

Since I have worked with many with Lichen Planopilaris, it is my recommendation that you wear a clip-on system instead of an attached hair topper. It is essential to treat your irritated scalp, therefore, an attached hair system may not be advisable. A scalp with Lichen can become crusty, and needs consistent cleaning, and massage. A wig may be too heavy, and uncomfortable. Therefore, a clip-on hair system may work best.  

Once your hair loss is under control, see the below video on how we can help on an aesthetic level. All the while giving you access to treating your scalp. At Noelle Salon, you will be working with a team of expert hair loss stylists who understand LLP and will offer our best advice as to how to restore your hair.


Depending on where you are experiencing hair loss, we may use hair extensions which also allows you or your physician to treat your scalp. Soothing creams should be avoided directly on the hair extension attachment.

Living with lichen planopilaris requires long-term management as it is a chronic condition. Regular follow-up appointments with a dermatologist are necessary to monitor the progress of the disease. Support groups and online communities can provide valuable emotional support for individuals dealing with lichen planopilaris. Adhering to the prescribed treatment plan and maintaining scalp hygiene are essential in effectively managing the condition. It is important to maintain a positive outlook and seek professional help when needed to cope with the challenges that arise.

We treat your lichen planopilaris with the utmost compassion, we will also help to soothe your scalp with scalp treatments, and massage prior to applying hair toppers or wigs.  Meet us at a free and private consultation. It is never a good idea to glue a hair system onto your head when experiencing hair loss due to Lichen Planopilaris.

Hair Loss background

With Alopecia Areata, fungal infections, other autoimmune diseases, thinning hair by Trichotillomania which removes hair follicles by physical means. At Noelle Salon, we cover the various approaches to hair solutions to treat hair loss, female pattern baldness, balding spots, and other conditions to which you lose hair. At Noelle Salon, we focus on hair growth techniques. Hair systems and hair extension maintenance is part of the journey while wearing them. For Trichotillomania, as our hair grows they both will loosen, and service is required. The difference between a hair system and hair extensions for Trichotillomania clients varies based on the location of hair loss. 


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