7 Things I Wish I Knew Before My LPP Diagnosis
Quick answer: Lichen planopilaris (LPP) is an autoimmune condition where your immune system attacks hair follicles, causing inflammation, scarring, and permanent hair loss if untreated. It is not the same as traction alopecia or postpartum shedding. Early diagnosis from a dermatologist is the single most important step you can take.
Why I Am Writing This (and Why It Matters for You)
A few years ago I noticed my scalp was itching in a way that felt different. Not dry scalp itching. More like burning, right at my hairline and crown. My edges were thinning, and I assumed it was from years of protective styles. I tried everything. Oils. Massages. Growth serums. Nothing worked. Eventually a dermatologist looked at my scalp under a dermatoscope and said two words I had never heard before: lichen planopilaris.
I went home and searched for hours. Most of what I found was written for doctors, not for me. So here are the seven things I genuinely wish someone had told me from the start.
1. What Exactly Is Lichen Planopilaris?
LPP is a form of scarring alopecia, meaning it destroys hair follicles and replaces them with scar tissue. Your immune system, for reasons researchers are still working to fully understand, targets the follicle itself as if it were a threat. Once a follicle scars over, hair cannot grow from it again. That is why catching it early is everything.
It is considered rare, but dermatologists believe it is underdiagnosed, especially in women with textured hair whose scalp is not always examined closely during routine visits.
2. How Is LPP Different From Traction Alopecia or Postpartum Shedding?
This is the question I asked my dermatologist three times because I needed it to sink in. Here is a simple comparison:
| Condition | Cause | Follicle Status | Reversible? |
|---|---|---|---|
| Traction Alopecia | Physical tension from styles | Damaged but alive (if caught early) | Often yes, with early intervention |
| Postpartum Shedding | Hormonal shift after birth | Intact and healthy | Yes, usually resolves on its own |
| Lichen Planopilaris | Autoimmune attack on follicles | Inflamed, then scarred | No, but progression can be slowed |
The tricky part is that LPP can look like traction alopecia, especially at the temples and nape. Both cause thinning edges. But LPP comes with specific scalp symptoms traction alopecia does not.
3. What Are the Actual Symptoms of LPP?
The symptoms that should send you straight to a dermatologist include:
- Burning or itching on the scalp, often before visible loss appears
- Redness or violet-tinged skin around individual hair follicles
- Scalp that looks shiny or smooth in areas of loss (a sign of scarring)
- Hair that comes out with a white sheath around the root
- Loss that spreads in an irregular or patchy pattern, not just at the edges
Dry scalp does not burn like this. If your scalp feels inflamed and your hair is falling out, do not wait to see if it improves on its own.
4. Who Gets LPP?
LPP can affect anyone, but it is most commonly diagnosed in women, often between their 40s and 60s, though younger women get it too. The American Academy of Dermatology notes that scarring alopecias as a group are more frequently seen in women with skin of color, though the reasons are not fully understood and are an active area of research.
There is no single confirmed cause. Genetics, environmental triggers, and immune dysfunction all appear to play a role. Some people with LPP also have lichen planus on their skin or nails, which is the same autoimmune process showing up elsewhere in the body.
5. How Is It Diagnosed?
A scalp biopsy is the gold standard. Your dermatologist will take a small tissue sample from an active area of inflammation and examine it under a microscope. Under a dermatoscope (a handheld magnifying tool used in-office), a trained eye can see the classic signs: perifollicular scale and loss of follicular openings.
This is why a board-certified dermatologist, ideally one who specializes in hair loss, is non-negotiable. A general practitioner or even a trichologist cannot diagnose LPP without biopsy confirmation.
6. What Are the Treatment Options?
There is no cure for LPP. The goal of treatment is to stop or slow the inflammation before more follicles scar. Common approaches include:
- Topical or injected corticosteroids to reduce inflammation directly at the scalp
- Hydroxychloroquine (Plaquenil), an antimalarial drug used off-label for autoimmune conditions, often prescribed by dermatologists for LPP
- Oral retinoids like isotretinoin in some cases
- JAK inhibitors, a newer class of drugs showing early promise in research settings
Your dermatologist will decide based on how active your disease is and how you respond. Treatment takes months. Progress is slow and sometimes frustrating.
On the self-care side, keeping your scalp clean, avoiding anything that could add irritation, and being gentle with any remaining hair all matter. Gentle scalp massage with a non-irritating oil-based product may support circulation to follicles that are not yet scarred. If that is something you want to try, the Follicle Enhancer uses peppermint, argan, jojoba, and coconut to support scalp health without harsh ingredients. But to be real with you: no topical product stops an autoimmune process. Your dermatologist is doing the heavy lifting here.
7. LPP Does Not Mean You Are Out of Options
This was the hardest thing for me to accept and also the most freeing. LPP caught early, treated consistently, can be managed. Many women reach a stable state where active inflammation stops and further loss is minimal. Some explore hairpieces, scalp micropigmentation, or hair transplants (though transplants into scarred areas are complex and not always successful, so that conversation needs to happen with a specialist).
What I know now is that the worst thing I did was assume my hair loss was just about my protective styles and try to fix it myself for too long. Getting in front of a dermatologist changed everything, even if the news was hard to hear.
Frequently Asked Questions
Is lichen planopilaris contagious?
No. LPP is an autoimmune condition, not an infection. You cannot catch it from someone else and you cannot pass it on.
Can traction alopecia turn into lichen planopilaris?
They are separate conditions, but repeated trauma to the scalp may lower the threshold for inflammation in people who are already genetically predisposed to autoimmune responses. The two conditions can also exist at the same time, which makes diagnosis more complicated. A biopsy is the only way to know for sure.
Will my hair grow back with LPP?
In areas where scarring has already occurred, hair does not grow back because the follicle is gone. In areas where follicles are still active and inflamed but not yet scarred, stopping the inflammation may help preserve those follicles. This is why early treatment matters so much.
Should I stop wearing braids or protective styles if I have LPP?
Talk to your dermatologist about this specifically. In general, reducing any source of scalp tension or irritation during active inflammation is a reasonable step. Tight styles may worsen symptoms even if they did not cause the condition.
What does LPP look like on a dark scalp?
On deeper skin tones, the classic violet or purple tinge around follicles can be harder to see and may look more like dark discoloration or subtle redness. Shininess or smoothness in areas of loss is often a more visible sign. This is one reason LPP is frequently missed or misdiagnosed in Black women, which makes finding a dermatologist with experience examining textured hair and melanin-rich skin especially important.
How long does it take to see results from LPP treatment?
Most dermatologists assess response after three to six months of treatment. LPP is a slow-moving condition in both directions, meaning it progresses slowly and it responds slowly. Patience is genuinely part of managing it.
This article is for education and is not medical advice. If you are worried about hair loss, see a board-certified dermatologist. These statements have not been evaluated by the FDA. Edge Naturale products are not intended to diagnose, treat, cure, or prevent any disease.