Lichen planopilaris (LPP) is a rare inflammatory condition that presents leads to patchy, progressive, permanent hair loss on the scalp. LPP mostly affects young adult females but can affect all ages and males. LPP often develops in association with lichen planus. Smooth white patches of scalp hair loss are noted with LPP, and hair follicle openings do not appear in the areas of hair loss. Instead, redness and scaling surround each hair follicle at the edges of the patches. LPP patches appear in discrete small areas that can merge to form larger irregular areas mostly on the sides, front, and lower back of the scalp. Most patients with LPP do not experience symptoms, but some can experience itch, pain, tenderness, discomfort, and burning. LPP is usually slowly progressive. A diagnosis of LPP can be confirmed with a scalp skin biopsy if deemed necessary by your dermatologist, but your dermatologist will usually be able to diagnose the condition based on clinical presentation.
What is the treatment?
The goal of treatment for LPP is to slow the progression of the disease and to minimize symptoms.
Topical medications: Steroid ointments, creams, or gels such as clobetasol or fluocinonide can be used to reduce inflammation and promote healing of the skin. A class of topical creams called calcineurin inhibitors, such as tacrolimus, can be prescribed as a non-steroid option to help reduce inflammation.
Oral medications: Oral medications, such as oral steroids, can be prescribed to help reduce inflammation. Oral antibiotics and immunosuppressants can also be prescribed to help reduce inflammation.
LPP is a difficult to treat condition, but there are options to manage the progression of the condition. Work with our dermatologists to determine the best treatment plan for you.
