Lichen planus scalp hair loss: what to know

Scalp involvement may cause itchy or tender patches, redness, scaling, small bumps, and reduced hair density. When inflammation damages a follicle, hair may not grow back from that follicle; this is called scarring hair loss. Hair shedding can also have other causes, so a scalp examination is needed before connecting every change to lichen planus. Read more about [Lichen Planus](/conditions/lichen-planus/) and [Itchy Skin](/symptoms/itchy-skin/).

Arrange a dermatology appointment, especially if a patch is expanding, painful, or leaving a smooth-looking area. The clinician may examine the follicles and sometimes recommend a small skin sample. Treatment aims to calm inflammation and protect remaining follicles. Options can include [Topical Corticosteroids](/treatments/medical-dermatology/topical-corticosteroids/) or, for more active disease, [Oral Corticosteroid Treatment](/treatments/medical-dermatology/oral-corticosteroid-therapy/). Avoid scratching, tight hairstyles, harsh chemical processing, and vigorous brushing while the scalp is irritated.

Seek prompt medical care for rapidly increasing hair loss, marked scalp pain, pus, crusting, bleeding, or a new smooth shiny patch. Urgent assessment is also sensible when inflammation reaches the eyebrows or eyelashes, or when mouth or genital sores occur. These features do not identify one diagnosis by themselves, but they can signal active or wider disease.

Ask whether the follicles show scarring, whether a biopsy is useful, how long treatment should be continued, and which hair products or styling practices should be paused. Ask how to monitor new symptoms and what changes should trigger an earlier review.