Understanding Lichen planopilaris: Causes, Symptoms, and Management

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Lichen planopilaris

by Alike Medical Team ∙ Updated on June 13, 2023

General

A rare inflammatory condition that can cause permanent hair loss is lichen planopilaris. It is considered a form of lichen planus that affects the hair follicles. It causes patchy, progressive, permanent hair loss, primarily on the scalp, but it can also affect the eyebrows, pubic region, and body.

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Signs & symptoms

Lichen planopilaris typically appears as smooth white patches of hair loss on the scalp. In areas of hair loss, no hair follicle openings can be seen. Each hair follicle is surrounded by scale and redness at the edges of these patches, which may be spiny when touched. The hair can be easily pulled out. Multiple areas may merge into larger irregular areas owing to its multifocal nature. Affected areas of the scalp include the sides and front, as well as the lower back. It is common for symptoms to be absent, but they may include: An itchy feeling Feeling of pain Sensitivity Feelings of discomfort A burning sensation. The progression of lichen planopilaris is usually slow. It is rare to experience diffuse hair loss.

Diagnosis

On the basis of the clinical presentation and careful examination of the teeth, nails, and skin, lichen planopilaris is suspected. A scalp biopsy may confirm the diagnosis if it includes hairs with surrounding redness and scale near the edge of the hair loss area. Despite this, biopsy cannot always provide a definitive diagnosis. It may not be possible to confirm the diagnosis in cases with only patchy scarring and hair loss.

Treatment

A treatment should be sought and provided as soon as possible, as no treatment can restore hair that has already been lost and replaced by scarring. Treatment aims to slow the progression of the disease and relieve symptoms. Loss of hair may continue, but at a slower pace. Inflammatory agents and corticostreids are used as treatment.

Note

☝ We provide information on prescription and over-the-counter medicines, diagnosis, procedures and lab tests. This material is provided for educational purposes only and is not medical advice, diagnosis or treatment.

National Institutes of Health ∙ World Health Organization ∙ MedlinePluse ∙ Centers for Disease Control and Prevention

☝ All information has been reviewed by certified physicians from Alike

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