How fast does Lichen planopilaris progress?

How Fast Does Lichen Planopilaris (LPP) Progress?

I’ve selected this question below for this week’s question of the week. It allows us to review some concepts in the speed of LPP progression.

QUESTION

I was diagnosed with lichen planopilaris and am wondering a few things. How fast does LPP progress? I’m trying to decide if I should go look for a wig or shave my head? I can’t seem to get anyone to give me a straight answer on how this condition exactly behaves. I'm confused !

ANSWER

Thanks for the question. The speed varies greatly between people. Some people have very very very very very mild and slowly slowly slowly progressive  LPP.  In fact, there are thousands and thousands and thousand of people walking in the world around with very mild form of LPP who don't even know they have the disease and probably never ever will because of how slow it changes. That means that the hair density is the same year after year - and if any hair loss does occur in that patient’s it’s not due to the scarring alopecia but due to other issues like androgenetic alopecia. (SEE FORMER ARTICLE: HOW FAST DOES HAIR LOSS PROGRESS?)

Typically a patient with mildly active, UNTREATED, scarring alopecia will have changes in their hair density that can be captured by a camera every 6 months. In most patients, the hair loss does not change week by week (but of course can in more active cases).

Treatment can stop the disease process for many patients, and some can even get a bit of hair back depending on the individual treatment responsiveness of the patient, the treatment used and the amount of hair loss the patient experienced so far.

There are some forms of LPP that do progressive quite fast. Aggressive treatments are needed to stop it. Aggressive forms that cause rapid hair loss are not common but may affected 2-3 % of patients. Most patients have either a moderately slow process or slow process. Of course, it may seem fast to the patient.

So, the answer to your question is that it's a spectrum. There is no one story of LPP. There are many different stories you’ll hear when you ask 100 patients “how fast did your hair loss occur?”