What causes lichen planopilaris?

The immune system becomes active around the upper part of a hair follicle. Ongoing inflammation can cause redness, scale, burning, tenderness or itch around individual hairs. With time, the follicle may be replaced by scar tissue, leaving smooth areas where hair does not readily regrow. The condition is not caused by poor hygiene, and a diagnosis cannot be made from hair shedding alone. A clinician may examine the scalp closely and sometimes sample skin to distinguish it from other causes of hair loss.

Book a dermatology review when scalp discomfort, perifollicular scale or expanding hair loss persists. Use gentle hair care, avoid tight styles and reduce scratching or chemical irritation while the scalp is inflamed. Treatment aims to calm inflammation and protect remaining follicles; options can include Steroid Injection Into The Skin or Oral Corticosteroid Treatment, depending on the pattern and severity. Do not start prescription steroids without an individual assessment.

Seek an appointment promptly if hair loss is enlarging, the scalp is painful or burning, or you see redness and scale around follicles. Urgent assessment is sensible for sudden extensive loss, marked swelling, pus, fever or severe pain, because infection or another active scalp disorder may need different treatment. Earlier control may help limit further follicle damage, but only an examination can clarify the cause.

Ask whether your pattern suggests scarring hair loss, whether a scalp biopsy is useful, which treatment target is most urgent, and how response will be tracked with scalp photographs or examinations.