Hair loss due to lichen planus: what to know

Lichen planus is an inflammatory skin condition. When it affects the scalp, follicle inflammation may cause tenderness, itching, redness, scaling, or small bumps before hairs become thinner. Hair loss may appear in patches or as a widening area, and active inflammation can damage follicles. Scarring forms when a follicle is replaced by scar tissue, so early assessment matters. Scalp symptoms can resemble other causes of hair loss, including alopecia areata or infection; appearance alone cannot confirm the diagnosis.

Arrange an appointment with a dermatologist for an examination of the scalp and hair pattern. The clinician may check for signs of active inflammation and may recommend a close scalp inspection or a small biopsy when the diagnosis is uncertain. Treatment aims to calm inflammation and protect remaining follicles; options can include prescribed topical corticosteroids or, for more extensive disease, oral corticosteroid treatment. Avoid scratching, picking scales, tight hairstyles, harsh chemical processing, and vigorous brushing. Keep a simple record of new patches, discomfort, and changes in shedding.

Seek dermatology care promptly if hair loss is advancing, the scalp is painful, crusted, bleeding, or very itchy, or smooth shiny areas are appearing. Arrange earlier review if eyebrows or other hair-bearing areas are involved. Sudden, sharply defined bald patches, pus, fever, or marked swelling need timely assessment because infection and other inflammatory conditions require different treatment.

Could the scalp changes represent lichen planus or another condition? Are there signs of scarring or active follicle inflammation? Would a biopsy help? Which treatment should be applied, where, and for how long? How should side effects be monitored, and what hair practices should I pause?