Lichen Planopilaris (LPP): Scalp Symptoms: none to severe

Scalp symptoms: none to severe

Lichen planopilaris (LPP) is a scarring alopecia that has the potential to cause progressive and permanent hair loss.

Affected individuals typically first notice increased daily hair shedding and this is often accompanied by scalp symptoms such as itching, burning, tingling, tenderness or pain. Some patients, however, do not have symptoms.

This photo shows the scalp of a patient with LPP who has marked scalp symptoms. Repeated itching of the area has triggered skin excoriations and localized bleeding. This is one indication that the disease is active.

There are several treatments that can help slow it down or stop it but regrowth does not happen to a significant degree for most. Treatments include topical steroids, steroid injections and a range of oral medications such as doxycycline, hydroxychloroquine, methotrexate, mycophenolate, cyclosporine and low level laser. Options like low dose naltrexone, and tofacitinib may also be options.