What Is Lichen Planopilaris?

Lichen planopilaris (LPP) is a rare condition that affects the hair and scalp and is part of the lichen planus family. Lichen planus is an inflammatory condition that affects the mucous membranes and skin.

TYPES

LPP develops in one of three distinct forms depending on the location and pattern of symptoms.

Classic LPP

Also known as follicular lichen planus, this type is far more common in women than in men and can develop at any age. Some people who have this type of LPP on their scalp also have it on their nails, mucosa, and skin. You will notice smooth areas of hair loss on your scalp that appear white. Scales around hair follicles and redness on the scalp are also common. When small patches of hair fall out, they can grow together to form an irregular shape. Hair loss progresses gradually over time and is most common on the front, sides, and lower back of your scalp.

Lassueur Graham-Little Piccardi Syndrome

Women between the ages of 30 and 70 are most likely to develop this rare form of LPP that causes scarring hair loss. Post-menopausal women in their 50s develop it more often than older and younger women.

Frontal Fibrosing Alopecia

This type of LPP primarily affects women over age 50 who have gone through menopause. Hair loss and scarring occur on your scalp’s frontal region.

CAUSES

Dermatologists suspect that LPP stems from an autoimmune disorder that causes white blood cells to attack hair and skin cells, eventually destroying them. However, the precise cause remains unknown. Dermatologists are uniquely suited to diagnose and treat LPP compared to family doctors because they specialize in skin disorders.

SYMPTOMS

The most common symptoms associated with LPP include bald patches on the scalp, itching, burning, pain, and scaly skin that develops around hair follicles. You may notice small red bumps called papules around clusters of hair. LPP causes scarring in some people that can result in permanent hair loss.

Treatment

If you think you have one of the three forms of LPP described above, your first step is to schedule an exam with Anne Arundel Dermatology. One of our dermatologists will examine your skin and scalp under a microscope and may extract a small portion of scalp skin to conduct a punch biopsy. Diagnosing LPP can sometimes be challenging, but our dermatologists have the experience and tools to distinguish its symptoms from other skin diseases.

 

Our primary goal when treating LPP is to stop the condition from spreading and manage your symptoms so you feel comfortable. Typical treatments include antibiotics, corticosteroids, antibiotics, or antimalaria drugs. Light therapy can also be useful to stimulate your hair follicles to produce hair again.

Man with a bald head
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