Lichen planus on the head and scalp

On the scalp, lichen planus may produce redness that is difficult to see, violet or brown bumps, scale, burning or tenderness. Inflammation around follicles can be associated with broken hairs or areas that look thinner. Similar symptoms can come from psoriasis, infection, eczema or traction, so a dermatologist may need to inspect the scalp closely and sometimes test a small sample.

Avoid scratching, tight hairstyles, harsh chemical treatments and vigorous brushing over sore areas. Follow the prescribed scalp treatment carefully; a topical corticosteroid may be selected for accessible inflamed patches, while extensive disease may prompt discussion of oral corticosteroid treatment or another specialist approach. Do not put a body cream into the eyes or use a scalp prescription on the face without instructions. See [Lichen Planus](/conditions/lichen-planus/) and [Topical Corticosteroids](/treatments/medical-dermatology/topical-corticosteroids/).

Arrange assessment for ongoing scale, tenderness, itching, widening part lines, broken hairs or smooth areas of hair loss. Seek prompt care if the scalp becomes very painful, crusted, swollen or draining, or if eye or mouth symptoms occur as well. A [Skin Bumps](/symptoms/skin-bumps/) symptom page can offer context, but it cannot identify the cause of a scalp lesion.

Is the hair change coming from active inflammation or breakage? Which scalp areas need treatment? How should I wash and style my hair during a flare? Could a medicine, product or hairstyle be contributing? Do I need follow-up to monitor the follicles?