Lichen Planopilaris Treatment in Indore

About LPP

Lichen planopilaris is a rare inflammatory scalp disorder that results in permanent hair loss because of the destruction of hair follicles. It is in the category of scarring alopecia.

Key features:

Red, inflamed patches on the scalp

Scaling or shiny skin where hair is lost

Itching, burning, or tenderness

Gradual thinning of hair, followed by permanent baldness

Cause:

Autoimmune reaction → body attacks hair follicles

Exact triggers unknown

Can be associated with lichen planus elsewhere (skin, nails, mouth)

⚠️ Diagnosis

Clinical examination: patchy hair loss with perifollicular erythema

Trichoscopy-scalp dermoscopy: white dots, perifollicular scaling

Scalp biopsy: confirms inflammation around follicles and scarring

Blood tests, if necessary, to rule out autoimmune conditions

Treatment

Goal: Reduce inflammation, prevent further hair loss. Hair regrowth into scarred areas is usually not possible.

1. Topical Treatments

Corticosteroids (high potency): reduce inflammation

Clobetasol propionate 0.05% lotion/foam/shampoo

Calcineurin inhibitors: tacrolimus or pimecrolimus cream

It is useful if steroids cause side effects or are to be used for a long time.

2. Oral Medications

Corticosteroids (short-term, systemic)

Prednisone may be used in severe flares

Hydroxychloroquine (antimalarial)

Common first-line systemic treatment for long-term control

Immunosuppressants:

Methotrexate, mycophenolate mofetil, cyclosporine (reserved for resistant cases)

Tetracycline antibiotics: doxycycline or minocycline

Anti-inflammatory effect; sometimes used in mild cases

3. Procedural / Supportive Care

Intralesional steroid injections for localized inflammation

Scalp care: mild shampooing; avoid irritation

Sunscreen or scalp protection if scalp is exposed

Prevention & Maintenance

Early diagnosis and treatment can help prevent permanent hair loss.

Avoid trauma to affected scalp areas: scratching, tight hairstyles

Regular follow-up with a dermatologist regarding disease activity

Minimize the triggers if known, such as stress, infections, or medications

What Not to Do

Don't ignore symptoms early on because scarring is permanent.

❌ Avoid using harsh chemicals or dyes on your scalp.

❌ Don’t scratch or pick inflamed patches

❌ Do not self-administer over-the-counter antifungals or steroids for long periods of time