Lichen Planopilaris - Symptoms, Causes & Treatment
Medically reviewed by Dr. Anand S. Urhekar, MD, MD Pathology, Clinical Advisor · Last updated July 2026
An inflammatory scarring alopecia in which the immune system attacks hair follicle stem cells, destroying follicles permanently. It causes patchy hair loss with smooth shiny scarred scalp, redness and scale around remaining hairs, and symptoms of burning, itching or tenderness.
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Quick Answer
Lichen planopilaris is a scarring alopecia in which inflammation permanently destroys hair follicles. Signs are patchy hair loss with a smooth shiny scalp lacking follicle openings, redness and scale around the hairs at the edge, plus burning, itching or tenderness. Hair already lost cannot regrow, so urgent dermatology referral and treatment to halt progression is the priority.
Symptoms
- Patchy hair loss with smooth, shiny scarred areas
- Loss of visible follicular openings
- Redness and fine scale around hairs at the active edge
- Burning, itching or tenderness of the scalp
- Hairs at the margin pull out easily during active disease
Causes & Risk Factors
- Autoimmune attack on follicular stem cells
- Associated with lichen planus of skin, nails or mucosa
- More common in women aged 40–60
- Frontal fibrosing alopecia is a related variant affecting the hairline
Treatment & Management
- Potent topical or intralesional corticosteroids
- Topical calcineurin inhibitors
- Oral hydroxychloroquine, doxycycline or mycophenolate
- Oral 5-alpha reductase inhibitors in frontal fibrosing alopecia
- Gentle hair care; hair transplantation only after prolonged inactivity
When to See a Doctor
See a dermatologist urgently for hair loss with scalp burning, tenderness, redness or scale around the hairs. Every week of active inflammation destroys follicles that cannot be recovered.
Frequently Asked Questions
Will my hair grow back?
Hair lost to scarring does not regrow, because the follicle stem cells are destroyed. Treatment aims to stop further loss and relieve symptoms, so early diagnosis is critical.
How is it different from alopecia areata?
Alopecia areata produces smooth bald patches with visible follicle openings and no symptoms, and it can fully regrow. Lichen planopilaris causes symptoms, scale and redness, loses follicle openings, and is permanent.
Related Conditions
Medical References
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Medical Disclaimer: This information is for educational purposes only and is not intended as medical advice. The content on this page should not be used to diagnose or treat any health problem. Always consult with a qualified healthcare professional for proper medical evaluation, diagnosis, and treatment of your condition.