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Lichen Planus and The Link to Hair Loss

As many as 4 in 10 scarring alopecia cases that a dermatologist will see are due to lichen planopilaris, according to some sources. It’s a variation of lichen planus, a condition that causes an itchy skin rash but sometimes affects other parts of the body, such as the mouth, genitals, nails and hair. In cases where lichen planus does affect the scalp it can lead to redness, irritation and permanent hair loss.

What is Lichen Planus?

Lichen Planus on the WristLichen planus is not an inherited disease. It is not an infection. It is not related to nutrition. It is not contagious and it is not a form of cancer. Lichen planus is a type of inflammation that develops in the skin but the cause of the inflammation is not known. Most dermatologists believe it is an autoimmune disease, triggered by a virus or other environmental factor which makes the immune system attack the cells on the skin.

Lichen planus commonly appears around the wrists and ankles but it can affect any area of the body. The onset of the rash is usually gradual and it looks like reddish-purple, flat-topped bumps, or sometimes it can have an irregular white lacy appearance called Wickham’s Striae.

What is Lichen Planopilaris?

Lichen planopilaris, also known as lichen planus follicularis, is the specific name given to lichen planus of the scalp. It looks like patches of baldness that may expand and join together over time. The condition develops slowly, but if left untreated, eventually the inflammation will destroy the hair follicles and result in permanent hair loss.

Inflammation is not always present with lichen planopilaris, however, which sometimes makes it hard to distinguish from other forms of scarring hair loss, such as systemic lupus erythematosus and frontal fibrosing alopecia. In these cases a skin biopsy may be required to diagnose the condition.

Who Gets Lichen Planus?

About 1 in 50 people develop lichen planus. It can happen at any age, although more than two-thirds of cases occur in people aged 30 to 60 and it seems to affect women more than men.

People with lichen planus have a slightly higher than average chance of developing other inflammatory diseases, such as alopecia areata, vitiligo and lichen sclerosis. However, most people do not develop any of these conditions. 

Treatment for Lichen Planus and Lichen Planopilaris

Lichen Planus of the scalp can cause permanent hair lossThere is no cure for hair loss as a result of lichen planopilaris and treatment usually involves similar methods used in the treatment of alopecia areata. The most popular treatment methods involve use of corticosteroids. However, their effectiveness varies considerably from person to person. The clinically proven hair growth stimulant minoxidil could possibly help prevent permanent damage to the scalp. It is sometimes used when treating alopecia areata and might help reduce the risk of permanent hair loss by working to stimulate and maintain hair growth.

Similarly, there is no cure for lichen planus. However, about half of all cases affecting the skin clear within six to nine months, and the rest typically last no longer than two years. There is however treatments that can help relieve the itching and improve the appearance of the rash, until it goes away.

  • Steroid cream of ointment: work to ease the itch but may not clear the rash
  • Steroid pastes or mouth washes: help ease the pain of mouth ulcers
  • Steroid tablets: a course of these may clear or greatly reduce the rash but are generally not advised due to possible side-effects. Also, the rash may reappear after the tablets are finished
  • Immune suppressant medication: work to reduce inflammation for a variety of conditions but are not usually advised due to potential serious side-effects
  • PUVA: light therapy treatment can provide relief but may induce nausea and increase the risk of skin cancer
  • Antihistamine medicines: may help ease the itch and help you sleep at night if it is keeping you awake

For information about hair loss and the available treatments, contact The Belgravia Centre on 020 7730 6666. If you would like to arrange a free consultation with a medically-trained specialist at the UK’s leading hair loss clinic, simply call the number mentioned or send an email instead.

More Information:
Hair Loss in Men
Hair Loss in Women
Treatments for Hair Loss

Interesting Articles:
Michael Jackson’s Hair Loss – What Happened to His Bald Spot?
Frontal Fibrosing Alopecia – Women’s Receding Hairline
New Lupus Treatment May Help With Hair Loss

10 Comments

30th April, 2015 at 6:05 pm

jill

I would like to know what can be done for loosing hair and thinning of hair, I have Lichen Planus, also Lichen Scoliosis. thank you. jill

6th May, 2015 at 2:37 pm

Sarah Belgravia

Hi Jill, You can find the full answer to your question here in our hairloss ANSWERS section where one of our specialists has responded

24th August, 2015 at 1:04 pm

sohaila

Is there a cure for hair growth in patients with lichen planus Is Kvrvynks solution is effective for treatment or offer you another drug

24th August, 2015 at 2:29 pm

Sarah Belgravia

Hi Sohaila, There is no truly effective treatment for Lichen Planus hair loss. There is research underway at the moment which is trying to develop a treatment for scarring alopecia but, as of yet, this is still in its early stages.

22nd June, 2016 at 6:32 pm

Carlos

Hello, I was diagnosed will LPP 1 month ago but have been dealing with the symptoms for about 4 months. I've experienced dramatic hair shedding. I am wondering if this hair shed is a result of permanent damage to my follicle or if the scarring takes more time to develop. Also, my hair thinning has been diffused rather than patchy, is this normal? May I be experiencing telogen effluvium as well? Thank you

24th June, 2016 at 9:31 am

Sarah Belgravia

Hi Carlos, One of Belgravia's senior hair loss specialists has answered this question for you. We hope you find this information useful.

27th June, 2016 at 4:32 pm

Carlos

Thank you so much for the response. I would like to set up a consultation. The diagnosis was done after a scalp biopsy, is it likely that there was a misdiagnosis? I know it is possible but how likely may it be? Can Lichen Planopilars cause diffuse thinning or is it always patchy? Also, does telogen effluvium cause any pain? I've been experiencing constant, intense burning and itching throughout my scalp. Thank you

28th June, 2016 at 9:55 am

Sarah Belgravia

Hi Carlos, we have sent appointment times and information to your email address. I hope this helps.

30th September, 2017 at 10:55 am

akash verma

I m having hair lichen. Can it be treated or at least my inching and hair lose can be stopped. Or if anyone can suggest any type of tablets or cream from which i can be relieved

2nd October, 2017 at 11:35 am

Sarah Belgravia

Hi Akash, you will need to speak to your doctor about this. Lichen Planus is an autoimmune disorder which causes patchy hair loss and scarring. Because scarring hair loss cannot be treated, this is not something we are able to help you with unfortunately.

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