- Lichen planus – follicular lichen planus
- Lichen planopilaris
- Frontal fibrosing alopecia (FFA)
- Lassueur Graham-Little Piccardi syndrome
- Lichen planopilaris
- 6 Lichen Planopilaris Natural Treatments
- Causes and symptoms
- Conventional Treatments
- 1. Castor oil
- 2. Herbal teas
- 3. Virgin coconut oil
- 4. Blackstrap molasses
- 5. Essential oils
- 6. Turmeric
- Lichen Planopilaris – Symptoms, Causes, Treatment & Prevention
- What is Lichen Planopilaris?
- Who gets Lichen Planopilaris and why?
- Clinical features of Lichen Planopilaris
- What are the symptoms of Lichen Planopilaris?
- Causes of Lichen Planopilaris
- How is Lichen Planopilaris diagnosed?
- Treatment of Lichen Planopilaris
- Complications of Lichen Planopilaris
- What does Lichen Planopilaris look ?
- Risk factors of Lichen Planopilaris
- What is the outcome of Lichen Planopilaris?
- Lichen Planopilaris
- Frontal fibrosing alopecia
- Graham Little syndrome
- Follicular lichen planus
- Lichen Planopilaris Symptoms
- Lichen Planopilaris Causes
- Lichen Planopilaris Treatment
- Potent corticosteroids
- Topical tacrolimus
- Mycophenolate mofetil
- Lichen Planopilaris Pictures
- Natural Treatment
Lichen planus – follicular lichen planus
Created: 8th December 2012 | Last Updated: 27th March 2020
|Initially described by Pringle in 1895, lichen planopilaris (LPP) is a cutaneous disorder selectively involving hair follicles with a lymphocytic inﬂammatory process that eventually destroys the follicles leading to expanding areas of scarring alopecia (cicatricial alopecia). Together with frontal ﬁbrosing alopecia (FFA) and the Lassueur Graham-Little Piccardi syndrome, lichen planopilaris is a form of follicular lichen planus. This chapter is set out as follows:|
Frontal fibrosing alopecia (FFA)
Lassueur Graham-Little Piccardi syndrome
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6 Lichen Planopilaris Natural Treatments
Lichen planopilaris is one of a larger group of conditions that is known as scarring alopecia. It is an uncommon inflammatory skin complaint that results in inflammation and the development of irreversible and permanent loss of hair on the scalp.
The hair loss experienced is patchy and also results in scarring as well as scaled skin around any remaining hairs. other forms of scarring alopecia, it is characterized by the hair follicles being permanently destroyed and replaced by scar tissue.
It is possible for adults of both genders to contract lichen planopilaris but it tends to be more common in younger adult females. While it is not always the case, this condition can develop along with a skin condition called lichen planus which affects skin, nails and mucous membranes.
Causes and symptoms
The precise cause of the condition is not known Apart from hair loss, other potential symptoms of lichen planopilaris include
Because the hair loss experienced is permanent and there is no known remedy for reversing the hair loss and scarring, treatment tends to be focused on slowing the progression of the condition and relieving any of the symptoms such as itching or inflammation.
Once diagnosed, the common treatment options are anti-inflammatory medications topical or oral corticosteroids and oral hydroxychloroquine. Even with medical treatment, responses are varied and studies into a variety of medications have proven to be contradictory.
Topical Corticosteroids: Powerful steroid preparations in the form of gels, lotions or mousses may help treat localized areas.
It is important to apply the right amount of the treatment only to the affected areas leaving unaffected areas untouched.
If they are used incorrectly, these steroid preparations can cause the skin to thin and can cause damage to sensitive areas. They can be especially effective in treating rashes and relieving itching.
Steroid injections: Intralesional steroids as they are otherwise known can be injected into the affected areas. They may be more effective in treating smaller areas but are uncomfortable and often times painful. They also carry the risk of unwanted side effects atrophy or dimpling in the skin.
Steroid tablets: May be prescribed for a short time and can effectively reduce inflammation and itching. Unfortunately, a long course of this medication can can bring with it some very nasty side effects including elevated blood pressure, osteoporosis, weight gain and diabetes.
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Hydroxychloroquine is a useful drug for treating the condition though it requires a minimum of 4 months treatment to note its effectiveness. When it works, it can be continued until remission. When used long term, retinal damage is a possibility but the risk is reduced by keeping dosage low.
Immunosuppressive drugs: Drugs to suppress the immune system are sometimes used but with degrees of success being varied. They are considered safer than steroid treatment but can still produce unwanted side effects.
Many home treatment options contain anti-fungal and antibacterial options that can ease inflammation and itching. As always there are no guarantees, but the treatments we will look at are safe and natural and may well bring some relief anecdotal evidence and the way in which they help with other inflammatory skin complaints.
1. Castor oil
Castor oil has a number of medicinal properties and is often used for its laxative abilities but it is also traditionally used to treat the hair and for scalp complaints. The oil is derived from the beans or the seeds of the castor oil plant and contains omega 6 fatty acids and vitamin E as well as many nourishing minerals important for healthy hair and scalp maintenance.
It has antifungal and antibacterial actions which make it an excellent and natural home remedy. It has many applications for the hair including stimulating growth, treating dryness of the scalp and dandruff and moisturizing. There are many anecdotal testimonials around the internet from people with lichen planopilaris that have had some degree of success with castor oil
To apply castor oil to your hair, follow these simple steps:
2. Herbal teas
Many people suffering from lichen planopilaris recommend drinking herbal teas to improve their symptoms. Those teas with the best recommendations are nettle tea and horsetail tea both of which have numerous health benefits and can be easily found at most supermarkets. Try drinking one or both of these teas at least 3 times daily.
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3. Virgin coconut oil
Virgin coconut oil has any number of therapeutic benefits and is used for a variety of skin complaints as well as to nourish the hair and scalp. Rich in vitamins and important minerals coconut oil has anti-inflammatory and natural antiviral and antifungal properties and possesses the ability to easily penetrate the scalp and work from within.
It is used these days to treat a variety of hair complaints from simply improving the quality of appearance to promoting hair growth. It is also used to treat fungal scalp conditions dandruff and is one of the very best natural remedies known.
Of course, not all coconut oil is of the same quality and you should make sure that you buy the best quality virgin coconut oil that you can afford.
To apply coconut oil to your hair and scalp;
4. Blackstrap molasses
This is a remedy that keeps popping up when it comes to hair loss complaints including lichen planopilaris. It tastes great and is packed with nutrients that can help the hair and scalp. To help your condition, you should take a tablespoon twice each day.
5. Essential oils
These incredible oils have countless uses on a huge variety of conditions and certain essential oils have proven very effective for use on the hair. Most essential oil contain antifungal and antibacterial properties as well as anti-inflammatory abilities that can improve the appearance of your hair and ease any inflammation or infection of the scalp.
While it is not guaranteed, some essential oils can even reduce the appearance of scarring and some can even promote hair growth. You can see a detailed article about essential oils for a variety of hair conditions here.
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Among the best essential oils to use for lichen planopilaris are:
An alternative is to dilute your essential oil with a suitable vegetable oil known as a carrier oil. There are many possible carrier oils and some of the best for your hair and scalp would be coconut oil, jojoba oil. Massage the blended mixture into your hair.
Do not apply your essential oil without diluting it first because they are extremely strong and may cause more irritation and inflammation of the scalp.
The important compound contained in turmeric when it comes to treating lichen planopilaris is curcumin.
Curcumin possesses anti-inflammatory properties and numerous biological activities that may help prevent scarring on the scalp.
It has already demonstrated the ability to reduce and eliminate inflammation caused by damaged lipids and is also a natural antioxidant which helps repair cellular damage.
To apply turmeric powder to your hair:
Lichen Planopilaris – Symptoms, Causes, Treatment & Prevention
Lichen Planopilaris is a chronic inflammatory condition that affects the scalp. It results in patches of hair loss on the scalp that may cause itching and burning. Lichen Planopilaris is a form of lichen planus that mostly affects women in young adulthood.
Lichen Planopilaris may cause permanent hair loss and scarring due to primary Cicatricial Alopecia. The distinct feature of this disease is hair loss in patches that occur in many different patterns.
This article explains the causes, symptoms and treatment options for Lichen Planopilaris.
What is Lichen Planopilaris?
Lichen Planopilaris is an inflammatory scalp disease that results in permanent hair loss. This disorder is said to be a variant of Lichen Planus, a common skin disorder causing distinct reddish purple rashes on the body.
When Lichen Planus affects the scalp and causes bald patches, it is called Lichen Planopilaris. It damages the hair follicles by causing inflammation and leading to hair loss and scarring. The hair follicles are often observed to be reddish and scaly due to inflammation.
Individuals sometimes experience pain and itching or are altogether asymptomatic. Lichen Planopilaris is generally said to have three subtypes: Classic Lichen Planopilaris, Frontal Fibrosing Alopecia, and Graham Little Syndrome.
Graham Little Syndrome represents Cicatricial Alopecia on the scalp causing permanent hair loss, and non-scarring alopecia on other regions of the body. The cause of the disease is not clearly understood but the primary mechanism remains the same, where the hair follicle gets inflamed causing hair loss due to scarring of follicle.
Who gets Lichen Planopilaris and why?
Lichen Planopilaris affects individuals across all ages; young men and women are ly to be affected as compared to children and elderly. However, women in the age group of 40 to 60 years of age are predominantly affected. This disorder often occurs in association with Lichen Planus, which affects the skin, nails and different mucosal membranes of the body.
About 50% of individuals with Lichen Planopilaris show development of Lichen Planus. The exact cause of the disease is not known but there have been hypotheses that indicate autoimmunity as the probable cause. It is the most common reason of scarring alopecia.
This disorder is not hereditary but there are certain genes that predispose an individual to the development of this disease.
Clinical features of Lichen Planopilaris
The key clinical features of Lichen Planopilaris are the presence of lesions with perifollicular erythema and perifollicular scale on the scalp. The lesions are reddish and show a scaly or crusty appearance mostly towards the periphery. The hair follicle is affected and shows inflammation.
There are bald patches observed on the scalp that range from few to many anywhere on the scalp. These bald patches are often smooth and whitish in color and the pattern of hair loss is greatly varied. The small patches often fuse to form larger region of hair loss. Other hair bearing regions are seldom affected.
In Graham Little Syndrome patchy loss of hair with scarring is observed on the scalp along with loss of hair on other body parts.
What are the symptoms of Lichen Planopilaris?
The symptoms of Lichen Planopilaris differ from individual to individual. Mainly the vertex and crown region is affected. A very evident symptom is hair loss and occurrence of bald patches. The lesions also show scaling towards the periphery.
The primary symptoms exhibited by patients include pain and itching accompanied by redness and certain discomfort. Patients suffering from this disease often show presence of Lichen Planus, which affects the skin, and mucous membranes of the body.
Causes of Lichen Planopilaris
The precise cause of Lichen Planopilaris is not known and thus this makes the treatment a challenge. There are certain suspicions that point to autoimmunity as the cause of this disease.
The immune system of the body reacts in an abnormal manner and mistakenly attacks the healthy tissues of the body. In this case the cells of the immune system called lymphocytes attack the hair follicles and destroy the stem cells.
This type of hair loss is usually irreversible and permanent and there is not much scope for re-growing the hair. Presence of certain genes put a person at a risk of developing this disease.
How is Lichen Planopilaris diagnosed?
The diagnosis of Lichen Planopilaris requires a careful dermatologic examination of the scalp. All the clinical, histological and pathological observations together give a conclusive diagnosis. A biopsy is very crucial in this diagnosis.
The biopsy specimen must be taken from an active lesion that displays perifollicular erythema and perifollicular scaling. Anagen Pull test is also done to confirm the diagnosis. In addition to this examination of nails, skin and various mucus membranes are done to look for underlying Lichen Planus.
Trichoscopy, a recent non-invasive diagnostic method is also employed to investigate the scalp for the various clinical presentations of the disease.
Treatment of Lichen Planopilaris
There is no specific cure for Lichen Planopilaris, but there are treatments that help to relieve the symptoms to an extent and slow down the progression of the disease. An early diagnosis provides better scope of treatment. Any hair loss due to scarring alopecia cannot be revived and is permanent.
The basic aim is to slow the pace of the disease. The usual course of treatment includes oral, topical and intralesional medications. Corticosteroids are often administered orally, topically through an intralesional injection. Hydrochloroquine is an antimalarial medication which helps reduce inflammation.
Immunosuppressants Methotrexate are also prescribed. Pioglitazone is an antidiabetic, which is also used in the treatment of this disease. The efficacy of these treatments is observed differently in different persons. When the disease has reached its burnt-out stage, cosmetic surgery and hair transplantation can be considered.
Scope of recovery is very little and relapse is a common occurrence.
Complications of Lichen Planopilaris
Complications of Lichen Planopilaris include development of Cicatricial alopecia that causes scarring and irreversible hair loss. Many times Lichen Planopilaris is accompanied by Lichen Planus.
Lichen Planus affects the skin, nails and various mucous membranes. It causes characteristic reddish purple flat rashes on the body.
Skin pigmentation and disfiguration is also associated with Lichen Planopilaris.
What does Lichen Planopilaris look ?
Lichen Planopilaris shows presence of smooth bald patches that have a shine. These bald patches go on to fuse and form bigger patches of bald regions. The hair follicles are inflamed and show a red and scaly appearance. These patches appear anywhere on the scalp.
Perifollicular erythema and perifollicular scales are commonly observed in Lichen Planopilaris. Perifollicular scale is a distinct feature of this disease. Development of Cicatricial alopecia resulting in hair loss and scarring is also observed.
Frontal Fibrosing alopecia shows scarring and hair loss in the frontal hair line where as Graham Little syndrome shows bald patches all over the scalp with itchy rash. These different patterns help diagnose the disorders.
Risk factors of Lichen Planopilaris
The risk factors of Lichen Planopilaris includes age, mostly middle-aged women are prone to developing this disease. Certain genes predispose a person to Lichen Planopilaris.
Caucasian adults are reported to have a higher incidence of this disease as compared to other populations. Individuals with a Hepatitis C infection go on to develop this disease.
Environmental factors certain medicines and toxins can also trigger the development of this disease. It is also observed that a certain scalp trauma can cause this disease.
What is the outcome of Lichen Planopilaris?
Lichen Planopilaris spontaneously resolves, however the hair loss is permanent. Relapse is commonly observed and the disease can return even after years of being in remission. This disease has a slow course of progression and is erratic making it highly unpredictable.
This is an inflammatory condition that is rare and can result in having progressive patchy hair loss that occurs most of the time on your scalp that is permanent but can also affect other parts of your body that is hairy. Although it is a rare medical condition it is also one of the most common causes of scarring hair loss of your scalp.
There are three forms of lichen planopilaris that are recognized which are:
Frontal fibrosing alopecia
This is scarring and hair loss in the frontal region of your scalp and usually affect post-menopausal women over the age of fifty.
Graham Little syndrome
This is a rare variant of lichen planopilaris and is an inflammatory form of scarring hair loss. It usually affects women in the age range of thirty to seventy with it particularly affecting the post-menopausal middle-age group.
Follicular lichen planus
This is the another name for the classic lichen planopilaris.
It is a medical condition that usually will affect women of all ages and it can also affect men. Many times with a person having lichen planopilaris it will be in connection with lichen planus that affects the nails, skin, and mucosa.
When a person has lichen planopilaris it will usually present itself as smooth areas hair loss from your scalp that is white. In the spots where you have the hair loss you cannot see any hair follicle openings. At the outside on the edges of the spots there could be redness and scales around each of your hair follicle.
The hairs in these areas can be pulled out easily and it is also multifocal. The small patches where hair loss has occurred can come together to make bigger shapes that are irregular. The sites where hair loss is commonly found are usually on the front, lower back, and sides of your scalp and usually progress slowly.
Lichen Planopilaris Symptoms
There may be no symptoms at all but if there are they can include:
Lichen Planopilaris Causes
The reason that a person gets lichen planopilaris is not known but it is thought it could be the result of an allergic reaction to certain things penicillin, gold, anti-malarial agents and more.
The reason that some think these could be the cause of lichen planopilaris is that this inflammatory condition appears after some period of time which could be weeks or years after being exposed to these various things.
Some even think that it has some hereditary or genetic characteristics which mean if you are related to someone who has had it there is a chance you will get it.
If you are visiting your dermatologist or physician because you are noticing hair loss that is permanent and is causing any of the above symptoms they will carefully examine your skin, nails, and mouth for lichen planus evidence.
An accurate diagnosis can be confirmed by having a biopsy from your scalp done which includes collecting hairs with scale and redness surrounding the sample at the bottom or top edge of the hair loss area. If the biopsy is taken from an already scarred area of hair loss it will not help make an accurate diagnosis.
They may not even be able to make an accurate diagnosis is the biopsy is taken from an area where there is no evidence of inflammation and there is just scarring hair loss that is patchy.
Lichen Planopilaris Treatment
You should seek treatment immediately after getting an accurate diagnosis for lichen planopilaris because there is no treatment that will be able to recover the hairs that are already gone and scarring has taken the hairs place.
The reason that you should treat this medical condition is to make sure the progression has been slowed and to help to relieve any symptoms that you might be experiencing.
You may still notice continual hair loss but at a rate that is slower.
Some of the treatments that used include:
Topical which are effective anti-inflammatory preparations and applied directly to the skin, intralesional which is a steroid injection that is injected immediately below your skin, or oral which are synthetic derivatives of the natural steroids and taken by mouth.
It has immunosuppressant activity and is given by injection or orally. It works directly on skin cells and your immune system
This is an oral antibiotic used to treat skin diseases
This is an oral retinoid which is a vitamin A derivative that is taken after eating.
This is an anti-malarial medication and occasionally used in inflammatory skin conditions
It is the salt form of mycophenolic acid which is an immunosuppressive medication. It works by inhibiting antibody production.
This is a medication that is used to treat ringworm and stops fungal cells from dividing.
This is a strong immunosuppressant medication.
There have even been some cases where lichen planopilaris has cleared up on its own but most of the time it does need to be treated. For the moderate itching you can take over-the-counter antihistamines for relief.
Lichen Planopilaris Pictures
Collection of Pics, Images and Pictures of Lichen Planopilaris…
To treat lichen planopilaris you can use anti-inflammatory herbs that can inhibit your immune response that can trigger inflammation. You can also take over-the-counter analgesics to help reduce the pain.
You can also use oats in your bath to help relieve the itchiness or make a paste of it and apply it to the itchy spots. Valerian is considered a calming herb so you can take it to help prevent and relieve the symptoms if there are any.
There is no natural treatment that will cure or prevent permanent hair loss scarring from lichen planopilaris