Can You Give Me More Information on Lichen Planopilaris?'

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Name: Lowri

Question: I was diagnosed with lichen planopilaris and I would like to know what is usually a duration of LPP (the active period of LPP) and can it occur again later like after a few years. Can the patches get bigger months or years later? And I would also like to ask how much time you usually eat antimalarials, if they are prescribed.

Answer: Hi, Lowri. Lichen Planopilaris is an autoimmune condition and its triggers are still not well understood.

Examples of hair loss from Lichen Planopilaris - cicatricial alopecia

It can be quite unpredictable and, therefore, I cannot give you the typical duration of the condition, although what is known is that once it damages the hair follicles, it leaves permanent scarring.

There are patients who suddenly notice a tiny patch on the scalp which never worsens and remains stable. There are also patients who struggle with LPP for years as it gradually spreads across the scalp.

It is possible for Lichen planopilaris to recur. Sometimes LPP burns itself out or it is stabilised with treatment and, for many patients, it may never worsen. However, it should still be monitored because this does not prevent it from recurring at any point in the future. It’s different with every patient so, again, unfortunately I cannot provide you with a definitive answer as to whether you will experience a relapse or not.

When the condition is still active, the patches can get bigger later down the line. Your LPP should, therefore, be monitored with regular photos taken of the patches so that you can compare the hair loss and condition of the affected and surrounding areas. This will ensure that any signs of activity can be noticed early and appropriate treatment can be started. As mentioned previously, for some patients the patches never change.

There are various treatment approaches a dermatologist may recommend to Lichen planopilaris patients, depending upon the patient’s severity of hair loss, symptoms and medical history.

With regards to the antimalarial drug Hydroxychloroquine, The British Association of Dermatologists recommends a minimum trial of 4-to-6 months to see whether this is effective.

If it is found to be helpful, the patient may be advised to continue this treatment for longer, until the condition goes into remission. However, such an approach should be thoroughly discussed with the patient’s doctor - ideally dermatologist.

We cannot treat Lichen Planopilaris at Belgravia but we hope this information is helpful and answers your queries fully.

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