National Center for Advancing and Translational Sciences Genetic and Rare Diseases Information Center, a program of the National Center for Advancing and Translational Sciences

Lichen planopilaris

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Other Names:
Follicular lichen planus; Frontal fibrosing alopecia (subtype); Kossard disease; Follicular lichen planus; Frontal fibrosing alopecia (subtype); Kossard disease; Lichen planopilaris classic type; LPP; Lichen planus follicularis; Lichen follicularis See More
Categories:
Subtypes:
Lichen planopilaris (LPP) affects the scalp and hair. It is a form of lichen planus, an inflammatory condition affecting the skin and mucous membranes. Symptoms may include scaly skin and redness around hair follicles, bald patches, and pain, burning, or itching on the scalp. Tiny, red bumps (papules) may appear around hair clusters. LLP can cause scarring which leads to permanent hair loss (cicatricial alopecia). There are 3 forms of LPP which differ by the pattern and location of symptoms: classic LPP, frontal fibrosing alopecia, and Lassueur Graham-Little Piccardi syndrome. The cause of LPP is unknown. It is thought to be an auto-immune disorder of the hair follicles. A diagnosis of LPP is made based on a clinical exam and microscopic examination of a piece of tissue from the affected area. Treatment options may include different oral and topical medications and light therapy.[1][2][3]
Last updated: 6/9/2020
The following list includes the most common signs and symptoms in people with lichen planopilaris (LPP). These features may be different from person to person. Some people may have more symptoms than others and symptoms can range from mild to severe. This list does not include every symptom or feature that has been described in this condition.

Symptoms may include:[2][3]
  • Patches of hair loss
  • Scalp redness
  • Scalp pain or burning
  • Scalp itching
Lichen planopilaris usually occurs in adulthood between the ages of 30-60. It affects females more than males. It may occur gradually or suddenly, and it gets worse over time. LPP results in scarred patches on the scalp and permanent hair loss.[1]
Last updated: 6/9/2020

This table lists symptoms that people with this disease may have. For most diseases, symptoms will vary from person to person. People with the same disease may not have all the symptoms listed. This information comes from a database called the Human Phenotype Ontology (HPO) . The HPO collects information on symptoms that have been described in medical resources. The HPO is updated regularly. Use the HPO ID to access more in-depth information about a symptom.

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Medical Terms Other Names
Learn More:
HPO ID
80%-99% of people have these symptoms
Alopecia
Hair loss
0001596
Hyperkeratosis 0000962
Lichenification 0100725
Papule 0200034
30%-79% of people have these symptoms
Abnormal fingernail morphology
Abnormal fingernails
Abnormality of the fingernails
[ more ] 		0001231
Dermal atrophy
Skin degeneration
0004334
Pruritus
Itching
Itchy skin
Skin itching
[ more ] 		0000989
Skin ulcer
Open skin sore
0200042
5%-29% of people have these symptoms
Abnormal blistering of the skin
Blistering, generalized
Blisters
[ more ] 		0008066
Abnormal intestine morphology
Abnormality of the intestine
0002242
Hepatitis
Liver inflammation
0012115
Hypopigmented skin patches
Patchy loss of skin color
0001053
Neoplasm of the oral cavity 0100649
Onycholysis
Detachment of nail
0001806
Pterygium 0001059
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Last updated: 7/1/2020
The cause of lichen planopilaris is unknown. It is thought to be an autoimmune disorder in which white blood cells attack and destroy skin and hair cells.[1][3]
Last updated: 6/9/2020
The diagnosis of lichen planopilaris (LPP) is made through a clinical exam and a microscopic examination of a piece of the affected skin.[2] A punch biopsy is usually done to get the piece of skin. LPP may be difficult to diagnose because its symptoms look like other more common conditions.[3]
Last updated: 6/9/2020
Treatment for lichen planopilaris (LPP) focuses on managing the symptoms and stopping the condition from spreading and getting worse. Different medications are used, including corticosteroids, anti-malarial drugs, antibiotics, and retinoids.[2][4] These can be taken by mouth, injected, or put on the skin. Light therapy is another treatment option. People with LPP often have to try several different treatment methods before the symptoms improve.[5]

One specialist who may be involved in the care of someone with lichen planopilaris is a dermatologist.
Last updated: 6/9/2020
The exact incidence of lichen planopilaris (LPP) is unknown. It has been estimated that LPP may be the cause of baldness in about 1.25% of cases.[6]  
Last updated: 6/9/2020

If you need medical advice, you can look for doctors or other healthcare professionals who have experience with this disease. You may find these specialists through advocacy organizations, clinical trials, or articles published in medical journals. You may also want to contact a university or tertiary medical center in your area, because these centers tend to see more complex cases and have the latest technology and treatments.

If you can’t find a specialist in your local area, try contacting national or international specialists. They may be able to refer you to someone they know through conferences or research efforts. Some specialists may be willing to consult with you or your local doctors over the phone or by email if you can't travel to them for care.

You can find more tips in our guide, How to Find a Disease Specialist. We also encourage you to explore the rest of this page to find resources that can help you find specialists.

Healthcare Resources

  • A dermatologist is a doctor whose training is in treating conditions that involve the skin, hair, and nails. This condition may be treated by a dermatologist. To find a dermatologist near you, you can search the American Academy of Dermatology online directory by clicking on the link above.

Related diseases are conditions that have similar signs and symptoms. A health care provider may consider these conditions in the table below when making a diagnosis. Please note that the table may not include all the possible conditions related to this disease.

Conditions with similar signs and symptoms from Orphanet
Differential diagnosis includes discoid lupus erythematosus (DLE), folliculitis decalvans, mucous membrane pemphigoid (see these terms), seborrheic dermatitis, alopecia areata, and central centrifugal cicatricial alopecia (CCCA).
Visit the Orphanet disease page for more information.

Research helps us better understand diseases and can lead to advances in diagnosis and treatment. This section provides resources to help you learn about medical research and ways to get involved.

Clinical Research Resources

  • ClinicalTrials.gov lists trials that are related to Lichen planopilaris. Click on the link to go to ClinicalTrials.gov to read descriptions of these studies.

    Please note: Studies listed on the ClinicalTrials.gov website are listed for informational purposes only; being listed does not reflect an endorsement by GARD or the NIH. We strongly recommend that you talk with a trusted healthcare provider before choosing to participate in any clinical study.

Support and advocacy groups can help you connect with other patients and families, and they can provide valuable services. Many develop patient-centered information and are the driving force behind research for better treatments and possible cures. They can direct you to research, resources, and services. Many organizations also have experts who serve as medical advisors or provide lists of doctors/clinics. Visit the group’s website or contact them to learn about the services they offer. Inclusion on this list is not an endorsement by GARD.

Organizations Supporting this Disease

Social Networking Websites

Organizations Providing General Support

These resources provide more information about this condition or associated symptoms. The in-depth resources contain medical and scientific language that may be hard to understand. You may want to review these resources with a medical professional.

Where to Start

  • DermNet NZ is an online resource about skin diseases developed by the New Zealand Dermatological Society Incorporated. DermNet NZ provides information about this condition.
  • The American Osteopathic College of Dermatology (AOCD) has developed an information page on this condition. Click on the link to read more.

In-Depth Information

  • Medscape Reference provides information on this topic. You may need to register to view the medical textbook, but registration is free.
  • The Monarch Initiative brings together data about this condition from humans and other species to help physicians and biomedical researchers. Monarch’s tools are designed to make it easier to compare the signs and symptoms (phenotypes) of different diseases and discover common features. This initiative is a collaboration between several academic institutions across the world and is funded by the National Institutes of Health. Visit the website to explore the biology of this condition.
  • Orphanet is a European reference portal for information on rare diseases and orphan drugs. Access to this database is free of charge.
  • PubMed is a searchable database of medical literature and lists journal articles that discuss Lichen planopilaris. Click on the link to view a sample search on this topic.

Questions sent to GARD may be posted here if the information could be helpful to others. We remove all identifying information when posting a question to protect your privacy. If you do not want your question posted, please let us know.

  1. Lepe K, Salazar FJ. Lichen Planopilaris. In: StatPearls. Jan 2020; https://pubmed.ncbi.nlm.nih.gov/29262050.
  2. Babahosseini H, Tavakolpour S, Mahmoudi H, et al. Lichen planopilaris: retrospective study on the characteristics and treatment of 291 patients. J Dermatolog Treat.. 2019; 30(6):598-604. https://pubmed.ncbi.nlm.nih.gov/30411987.
  3. Kerkemeyer KL, Green J. Lichen planopilaris: A retrospective study of 32 cases in an Australian tertiary referral hair clinic. Australas J Dermatol. 2018; 59(4):297-301. https://pubmed.ncbi.nlm.nih.gov/29297588.
  4. Errichetti E, Figini M, Croatto M, Stinco G. Therapeutic management of classic lichen planopilaris: a systematic review. Clin Cosmet Investig Dermatol. 2018; 11:91-102. https://pubmed.ncbi.nlm.nih.gov/29520159.
  5. Randolph MJ, Salhi WA, Tosti A. Lichen Planopilaris and Low-Level Light Therapy: Four Case Reports and Review of the Literature About Low-Level Light Therapy and Lichenoid Dermatosis. Dermatol Ther (Heidelb). 2020; 10(2):311-319. https://pubmed.ncbi.nlm.nih.gov/32060796.
  6. Meinhard J, Stroux A, Lünnemann L, Vogt A, Blume-Peytavi U. Lichen planopilaris: Epidemiology and prevalence of subtypes - a retrospective analysis in 104 patients. J Dtsch Dermatol Ges. 2014 Mar; 12(3):229-35, 229-36. http://www.ncbi.nlm.nih.gov/pubmed/24533855.