Can lichen planopilaris cause scarring alopecia?

Lichen planopilaris is an inflammatory scalp disorder that targets the area around hair follicles. Scarring alopecia is the hair loss that can follow when follicles are damaged. The affected scalp may show patchy thinning, redness, scale, burning, tenderness, or itch. Some people notice short broken hairs or loss of the tiny openings where hairs emerge.

The condition can be active at the edge of a patch while the centre looks smoother. Hair cannot reliably regrow from a follicle that has been destroyed, so identifying inflammation early matters. Hair loss alone does not prove lichen planopilaris; infection, alopecia areata, traction, and other disorders can look similar.

Book a dermatology assessment for progressive or patchy scalp loss, especially when there is itch, pain, scale, or redness. Examination may include scalp magnification and, when the diagnosis is uncertain, a small biopsy. Treatment aims to calm active inflammation and protect remaining follicles; a dermatologist may discuss topical or injected medicines and treatments taken by mouth.

Use gentle shampoo, avoid tight hairstyles and chemical irritation, and try not to scratch active areas. Take clear photographs in consistent lighting so changes can be discussed at appointments. Do not wait for extensive loss before seeking evaluation.

Seek an appointment soon if a bald patch is enlarging, new patches appear, or scalp symptoms persist. Prompt review is especially appropriate for pus, crusting, marked swelling, fever, or severe pain, which may indicate infection or another problem needing different care. Sudden extensive shedding also warrants assessment rather than assuming it is scarring disease.

Ask whether the follicles look inflamed or scarred, whether a biopsy would clarify the diagnosis, what signs show that treatment is working, and how scalp health will be monitored. Discuss possible side effects, hair-care adjustments, and whether camouflage or hair restoration should wait until inflammation is controlled.