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How Can Inflammation And Hair Loss Be Treated When Diagnosed With Lichen Planopilaris?

Posted on Wed, 24 May 2023

Question: Good morning. I'm having serious issues in regards to my hair. Back in December 2013 a biopsy of my scalp was performed and the diagnosis was Lichen planopilaris. I did my own research to educate myself on this condition. In my case I noticed it has it dormant stage and progressive stage. Now it's in a progressive stage once again because I'm losing my hair. Any suggestions on how to treat the inflammation/hair loss. I'm using various hair products and vitamins hoping it will assist in my treatments. In addition here are other factors I'm dealing with that doesn't help with my situation.

Diabetes/medication - metformin - side effect hair loss
High blood pressure/medication - amlodipine- side effect small percentage hair loss
Vertigo/medication - meclizine-side effect hair loss
Peri-menopause - hormone imbalance - side effect hair loss

I'm working on alternatives to work with my conditions but it would help if I can get some input on this Liche planopilaris if can be reverse or become dormant again.

Thank you

Answered by Dr. Dr. Kakkar (1 hour later)

Brief Answer:
Regarding lichen planopilaris

Detailed Answer:

Hello,

Potent topical steroid lotions like Clobetasol Propionate, twice daily, along with oral Betamethasone 0.1mg/kg on 2 consecutive days of a week (Oral Mini Pulse) e.g every Saturday's and Sunday's, offers an effective and safe option for arresting disease activity in lichen planopilaris(LPP). Unlike daily oral steroids or injectable steroids, Oral Mini pulse is far less likely to raise blood sugar levels or raise blood pressure.

An alternative to oral steroids is of course, oral Cyclosporine which has proved to be an effective yet non steroid alternative option in arresting active lichen planopilaris. However, Cyclosporine can raise blood pressure and therefore you may require an adjustment in the dose of Amlodipine.

Hope I have answered your query. Let me know if I can assist you further.

Thank you.

Regards,
Dr. Kakkar S.
Dermatologist

Above answer was peer-reviewed by : Dr. Prasad

Follow up: Dr. Dr. Kakkar (2 hours later)

I don't want to overwhelm my scalp or my system with these different products. I'm currently using DHT blocker hair products. I stop using the rogaine because I needed further clarification on using both of these products at the same time. You recommended clobetasol propionate and the oral XXXXXXX plus. Would I be able to use these products at the same time for example use the steroid lotion and DHT products in the morning and the rogaine at night. Just trying to find a regimen that is safe and effective.

thanks

Answered by Dr. Dr. Kakkar (9 hours later)

Brief Answer:
Regarding lichen planopilaris

Detailed Answer:

Hello,

You may take an oral DHT blocker e.g Finasteride 2.5mg - 5mg once daily. In addition you may use Clobetasol Propionate 0.05% lotion in morning and Rogaine (Minoxidil) for night application. Oral mini pulse has to be taken only on 2 consecutive days, morning (after breakfast). This regimen is safe and effective for lichen planopilaris.

Hope I have answered your query.

Thank you.

Regards,
Dr. Kakkar S.
Dermatologist

Note: Hope the answers resolves your concerns, however for further guidance of skin related queries consult our Dermatologist.Click here to book a consultation

Above answer was peer-reviewed by : Dr. Vaishalee Punj