WHAT IS LICHEN PLANOPILARIS?
Lichen planopilaris (LPP) is a chronic inflammatory autoimmune disorder of the scalp in which the immune system targets hair follicles, leading to their destruction and replacement with scar tissue. This process results in permanent, irreversible hair loss in affected areas.
LPP is one of the most common causes of scarring alopecia. The exact trigger remains unknown. The condition can affect adults of all ethnicities, however, women are 2 times more likely to be diagnosed than males.
Onset usually occurs in middle-aged adults, but it can appear earlier or later.
Patients often experience itching of the scalp, burning pain or tenderness. Redness and perifollicular scale (small white flakes around the follicles). Increased hair shedding before bald patches develop, and eventually smooth bald patches without visible follicles, often with a shiny appearance due to scarring.
HOW IS LICHEN PLANOPILARIS DIAGNOSED?
Our expert trichologist Donia Maria Messeh, will perform a thorough evaluation and clinical examination. A detailed scalp analysis using trichoscopy will also be carried out. The diagnosis of lichen planopilaris (LPP) is supported by several features, including areas of scarring hair loss, along with redness and scaling around the hair follicles. In some cases, a scalp biopsy may be performed to confirm the diagnosis. Biopsy findings typically show inflammation, loss of sebaceous (oil) glands, and scarring around the hair follicles.
Early LPP is often misdiagnosed as androgenetic alopecia (female pattern hair loss), sometimes accompanied by seborrheic dermatitis. The key difference is that LPP presents with inflammation, tenderness, and perifollicular scaling, which not all are features of androgenetic alopecia. An expert will be able to accurately distinguish between these conditions through careful clinical examination and by taking a detailed medical history.
WHAT TREATMENT OPTIONS ARE AVAILABLE FOR LICHEN PLANOPILARIS
The main goal of the treatment is to stop the disease from progressing. Several treatments may help slow the progression of LPP and reduce symptoms, these include:
- Oral medications such as finasteride, dutasteride, doxycycline, hydroxychloroquine (Plaquenil), isotretinoin (Accutane), or mycophenolate mofetil
- Steroid injections into the scalp to calm inflammation
- Topical medicines applied at home, such as clobetasol, fluocinonide, tacrolimus (Protopic), pimecrolimus (Elidel), or clobetasol shampoo (Clobex)
- In some cases, hair transplantation may be considered if the disease has remained inactive for a long period
HOW LONG WILL I BE ON TREATMENT?
Lichen planopilaris is a chronic condition that requires careful monitoring. If the condition is stable and is no longer spreading, medication doses may be gradually reduced or possibly stopped. However, if there are signs of new activity, treatment may need to be adjusted, with higher doses or different medications prescribed.
WHY VISIT DONIA MARIA CLINIC TO TREAT YOUR LICHEN PLANOPILARIS?
Expert trichologist Donia Maria Messeh is a highly respected trichologist and scalp specialist with over 15 years of clinical experience. Specialising in a wide variety of hair loss conditions, our expert Donia Maria Messeh works closely with each patient to truly understand your hair concerns, current hair care routines, and the emotional and physical impact it has on your daily life. Following a detailed assessment, she develops a personalised treatment plan designed to deliver lasting results.
At Donia Maria Clinic, we recognise that LPP is more than a dermatological diagnosis, it is a deeply personal experience that can affect your confidence, identity, and may also affect your daily life. Our approach combines medical expertise with a deep commitment to personalised care.
At the clinic, each treatment plan is meticulously tailored based on the extent of hair loss, age, medical history, and personal goals. Advanced diagnostic tools are used to identify potential contributing factors.
DNA testing may also be included, offering valuable insights into each individual’s unique genetic profile and allowing for the creation of truly bespoke, highly effective treatment strategies.
Every consultation begins with a thorough evaluation of the hair, scalp analysis by trichoscopy, lifestyle, medical history, current routines, and emotional wellbeing. We take the time to listen and we take time to identify underlying triggers, whether it being genetic, hormonal, nutritional, environmental, before designing a tailored treatment plan that may include advanced therapies, topical or systemic treatments, and supportive care.
WHAT ARE MY NEXT STEPS?
Book a consultation with trichologist Donia Maria Messeh, who will evaluate your condition and offer treatment options going forward. Click the link below to start the process.