Single Hairs in Lichen Planopilaris: A Reflection of the Destructive Process

Three-Haired and Two-Haired Follicular Units Become Single Haired Units

Lichen planopilaris (“LPP”) is a type of scarring alopecia. It is thought to be autoimmune in ethology meaning that the body’s own immune system is triggered to attack and destroy hairs. LPP is a destructive process.

Hairs normally emerge from the scalp in ‘bundles’ of one, two or three hairs (sometimes four). We call these follicular units. Many people expect that hairs emerge from the scalp all by themselves - but that’s not the case. They emerge normally from a single follicular opening or ‘Ostia’ in groups of 1, 2 or three hairs. Most common they come out in bundles of two and three in the middle, crown and back. The temples of humans normally has a lot higher proportion of single haired follicular units (only one hair emerges from the pore).

Single hairs in lichen planopilaris (LPP). Lichen planopilaris is an autoimmune disease whereby the immune system attacks hair follicles. The result is a conversion slowly over time of three and two haired ‘follicular unit' bundles into single haired follicular units. As the disease progresses, the single haired follicular units are also destroy and replaced by scar tissue.

LPP is a destructive process and destroys the normal architecture of follicular units.

LPP is a destructive process and destroys the normal architecture of follicular units. Where there were three hairs in a follicular unit before, slowly there becomes two hairs as one hair decides it not survive the immune attack and the changes the hairs incurs on account of the immune attack (loss of oil glands, death of cells in the follicle and permanent scar tissue developing). Where there were two hairs before, slowly there becomes one as one hair decides it not survive the immune attack and the changes the hairs incurs on account of the immune attack (loss of oil glands, death of cells in the follicle and permanent scar tissue developing. Where there was one hair in an area before, slowly there becomes none as the one hair decides it not survive the immune attack and the changes the hairs incurs on account of the immune attack (loss of oil glands, death of cells in the follicle and permanent scar tissue developing. The findings of advanced LPP are scattered single hairs over the scalp.