Lichen planus hair loss treatment: what to know

When lichen planus affects the scalp, inflammation may cause itching, redness, scaling, tenderness or areas of reduced hair density. Scratching and ongoing inflammation can injure follicles; some hair loss may become difficult to reverse once follicles scar. A dermatologist may examine the scalp with magnification and may recommend a biopsy when the pattern is unclear. See [Lichen Planus](/conditions/lichen-planus/), [Itchy Skin](/symptoms/itchy-skin/) and [Skin Bumps](/symptoms/skin-bumps/) for related information.

Treatment may include a prescribed [Topical Corticosteroid](/treatments/medical-dermatology/topical-corticosteroids/) applied to active scalp areas, or another anti-inflammatory medicine selected by the clinician. More extensive inflammation may prompt discussion of [Oral Corticosteroid Treatment](/treatments/medical-dermatology/oral-corticosteroid-therapy/). Handle hair gently, avoid tight styles, harsh chemicals and vigorous scratching, and use the prescribed application method rather than increasing it yourself. Take photographs in consistent lighting so changes in density, scale or redness are easier to discuss.

Arrange dermatology care for a widening patch of hair loss, scalp pain, burning, heavy scale, pustules or persistent itch. Seek prompt assessment if hair loss is progressing quickly, the scalp is very tender, or there is drainage, spreading redness or fever. Early review matters because treatment is directed at active inflammation and cannot reliably restore follicles that have scarred.

Ask whether the follicles show active inflammation or scarring, whether a biopsy is useful, and exactly where and how often to apply treatment. Discuss gentle styling, monitoring photographs, expected follow-up, and whether other body sites or medicines could be relevant to the diagnosis.