What is lichen planopilaris?

Lichen planopilaris is a primary scarring alopecia in the lichen planus family. Classic LPP often shows irregular or patchy loss on the crown or elsewhere, with redness and scale around hair shafts (perifollicular inflammation), and symptoms of itch, pain, or burning — or, sometimes, surprisingly little discomfort. Destroyed follicles leave smooth, shiny skin. The American Academy of Dermatology’s scarring-alopecia teaching is that once a follicle is scarred, full return is not the realistic goal; the job is to quiet inflammation and protect what is left. Frontal fibrosing alopecia is widely treated as a patterned variant that prefers the front hairline and eyebrows. HairBase already has a frontal-fibrosing-alopecia page for that map. This Q&A is LPP as the inflammatory scarring disease itself — not a second copy of the FFA hairline story. This is not medical advice.

Diagnosis is clinic plus trichoscopy; a scalp biopsy is common when the pattern is mixed with androgenetic thinning or traction. Treatments dermatologists use are anti-inflammatory, not a drugstore minoxidil-as-cure protocol. Topical minoxidil (Rogaine) may help remaining non-scarred hairs look thicker; it does not replace corticosteroids, other anti-inflammatories, or the specialist’s plan, and it will not unscrew a white scar. Do not transplant into active LPP expecting a reliable take — disease can attack grafts. Do not start or stop prescription immune medicines from a forum.

LPP is not ordinary male- or female-pattern miniaturization, not alopecia areata’s usual non-scarring patches, and not CCCA’s typical crown-outward map in women of African descent — though more than one alopecia can exist in one scalp. Photograph the same light. If there is scale around hairs, pain, or shine, book dermatology rather than another bottle of foam. Related pages: FFA, CCCA, telogen after shock.

Quellen: AGA review (CCID) ↗

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