What should you know about lichen planus planopilaris?

Inflammation develops around hair follicles. You may notice small rough or scaly bumps around hairs, redness, burning, tenderness, or [Itchy Skin](/symptoms/itchy-skin/). Hair can become thinner in patches, and affected follicles may eventually leave smooth areas where regrowth is difficult. This pattern is different from ordinary shedding, so a close scalp examination matters. It sits within the wider [Lichen Planus](/conditions/lichen-planus/) family and can occur with skin changes elsewhere.

Arrange a dermatology appointment when scalp redness, scale, soreness, or patchy loss persists. Take clear photographs in the same lighting to show change over time, and use a gentle shampoo while avoiding scratching, tight hairstyles, harsh chemical treatments, and vigorous brushing. A clinician may use magnification and sometimes a scalp biopsy to assess follicle inflammation. Treatment may include [Topical Corticosteroids](/treatments/medical-dermatology/topical-corticosteroids/) or, when inflammation is more active, [Oral Corticosteroid Treatment](/treatments/medical-dermatology/oral-corticosteroid-therapy/).

Seek prompt review for fast-moving hair loss, painful scalp areas, pus, crusting, bleeding, or marked swelling. Urgent care is appropriate for facial swelling with breathing trouble or a widespread blistering reaction. Do not wait for hair loss to become extensive before arranging an assessment, because treatment decisions focus on controlling active follicle inflammation.

Is the hair loss scarring or non-scarring? Do you see active inflammation around follicles? Would a biopsy help? Which scalp treatments fit my symptoms, and how will we judge whether inflammation is settling?