When is steroid injection recommended for lichen planopilaris?

Lichen planopilaris is an inflammatory condition that can affect the scalp and lead to scarring around follicles. An intralesional steroid is placed into selected inflamed areas rather than taken throughout the body. The aim is to reduce local inflammation, tenderness, redness, scaling, or burning and help limit further follicle injury. It does not restore follicles that have already been permanently scarred.

A dermatologist may examine the scalp closely and consider symptoms, visible activity, hair changes, and the pattern of inflammation before recommending injections. The treatment plan can be adjusted when the scalp is widespread, infection is suspected, or another diagnosis needs checking.

Tell the clinician about scalp infections, medicines, allergies, previous steroid reactions, and areas of hair loss that are changing. Keep the scalp clean as advised and avoid scratching or picking at tender sites. After treatment, follow the clinic’s instructions and watch for increasing pain, spreading redness, drainage, or marked skin thinning at an injection site. Follow-up helps the dermatologist judge whether inflammation is settling and whether another treatment is needed.

Arrange a dermatology review for ongoing scalp burning, pain, redness, scaling, or expanding hair loss. Seek prompt medical care if an area becomes rapidly swollen, hot, very painful, or starts draining, because these changes can suggest infection or another active problem. New eyebrow loss, extensive scalp tenderness, or sudden changes in the pattern of hair loss also deserve assessment rather than self-treatment.

Ask which scalp areas appear active, what benefit the injections are intended to provide, how the injection sites will be chosen, and what local effects to report. You can also ask how treatment will be combined with scalp care or other anti-inflammatory options, and how progress will be monitored.