Lichen Planopilaris (LPP)

Last updated: 6 February 2026. Next review: 6 February 2027

What is lichen planopilaris?

Lichen planopilaris (LPP) is a type of scarring alopecia that primarily affects the scalp, most commonly in middle-aged women, although it also occurs in men, young adults, and, rarely, in children.

Some people with LPP may also have lichen planus, a related condition affecting the skin, mucosa, and nails.

What does lichen planopilaris look like?

Lichen planopilaris causes smooth, shiny patches of hair loss where hair follicles are no longer visible. Common features include:

Redness or scaling at the edges of hair loss patches
Hair that can be easily pulled out
Hair loss often occurs in multiple areas of the scalp, which can merge over time
The most commonly affected areas are the sides, front, and lower back of the scalp
Diffuse hair loss is uncommon

Not everyone experiences physical discomfort, but some may notice:

Itching
Pain or tenderness
Burning or discomfort

Early diagnosis can help slow progression and protect remaining hair.

How is lichen planopilaris diagnosed?

Diagnosis usually involves:

Trichoscopy – using a tool to look at the hair and scalp up close.
Scalp biopsy – taking a small piece of skin to be analysed in the lab, to confirm scarring and inflammation.

Is lichen planopilaris permanent?

It is unlikely that hair will be able to regrow once the hair follicles have been destroyed. However, treatment may slow or halt further hair loss, helping to preserve the remaining hair.

What causes lichen planopilaris?

The cause of LPP is unknown. We do know that in affected skin of people with LPP, increased numbers of immune cells can be seen around the hair follicle. It is believed their attack on the hair follicle ultimately destroys it, and scars are formed in the areas surrounding hair follicles. However, it is not fully understood why this happens.

Can lichen planopilaris be treated?

Currently, there is no treatment that can reverse hair loss from LPP. Treatments focus on slowing progression by reducing immune system activity and protecting remaining hair follicles:

Topical, intralesional and systemic corticosteroids
Immunosuppressants
Antibiotics
Hydroxychloroquine
Topical calcineurin inhibitors

Additional Information:

The British Association of Dermatologists have produced a patient information leaflet about Lichen Planopilaris:

READ THE BAD PATIENT INFORMATION LEAFLET ON LICHEN PLANOPILARIS

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