Lichen Planopilaris: Itching, Burning, Tenderness, Shedding

Itching, Burning, Tenderness, Shedding

Lichen planopilaris (LPP) is a scarring hair loss condition that leads to permanent hair loss in affected areas without treatment.

Individuals with the condition may initially develop itching, burning or pain. For some, increased amounts of shedding may be the only symptom.

Examination of LPP via up close (“dermatoscopic”) examination is shown here. The scalp is red and scaly. In particular, some of the scale is located around hair follicles (called perifollicular scale). There are distinct whitish areas seen which represent permanently scarred areas of the scalp.

Treatment of LPP includes topical steroids, topical calcineurin inhibitors, steroid injections and a variety of oral immunosuppressive medications such as doxycycline, hydroxychloroquine, mycophenolate, cyclosporine, methotrexate, isotretinoin, tofacitinib and pioglitazone. Low level laser and excimer laser could to be studied and appear to offer benefit for some.