Can a Hair Transplant Help With Lichen Planopilaris?

Lichen planopilaris, shortened to LPP, is a hair loss condition that often causes scarring, localised hair loss, and skin irritation. [1] While hair restoration surgery should always be performed on a case-by-case basis, there is the potential to use a transplant to correct hair loss, provided the condition is dormant.

This makes a big difference because a hair transplant procedure performed when the client has active signs of LPP might make it very likely that the grafts will fail. The positive is that most researchers believe LPP calms down after a period of time (a year), at which point a hair transplant would be a far more viable solution.

In this guide from the hair restoration specialists at KSL Clinic, we’ll explain lichen planopilaris, how it affects the health and appearance of your scalp, and some of the many considerations when deciding whether a hair transplant is the solution for you.

Understanding Lichen Planopilaris and Hair Loss

Lichen planopilaris, also known as scarring alopecia [2], is caused when a skin condition called lichen planus affects areas of the scalp or skin where hair grows. The outcome is that hair follicles can become permanently damaged and replaced with scar tissue.

While relatively rare, adults from a Caucasian ethnicity and from age 45 and upward are more likely to develop the condition, while women are between two and five times more likely to have an LPP diagnosis than men. [3]

Although LPP is one of the most diagnosed causes of scarring alopecia, hence the association between the conditions, it is only responsible for about 1% of all cases of hair loss. Other issues, like androgenetic alopecia, are far more common and also easier to correct through a permanent hair transplant.

Types of Lichen Planopilaris

A further complication is that LPP doesn’t necessarily affect every client in exactly the same way.

Dr Matee, Director of Surgical Services at KSL Clinic, notes, ‘There are three primary forms of lichen planopilaris we see, and getting to the underlying cause of hair loss is paramount to making relevant recommendations.

Classic lichen planopilaris causes bald patches of hair loss and scarring, usually to the scalp. Frontal fibrosing alopecia affects hair growth around the front of the head and the temples and can also be linked to hair loss around the eyebrows and eyelashes.

Finally, a more complex strain is called Graham-Little-Piccardi-Lassueur syndrome, which results in hair loss and scarring to the scalp, thinning or hair loss to areas of body hair, and often changes to the skin texture wherever there are follicles.

Addressing hair loss correctly is essential, and if you’ve experienced sustained hair loss and suspect this is down to lichen planopilaris, it may be important to gain a formal diagnosis first to ensure you have the right treatment to get the symptoms under control before we can focus on hair restoration.’

Signs That Your Hair Loss is Due to Lichen Planopilaris

LPP differs from more common types of hair loss because alongside thinning or hair loss to your scalp and facial hair, you’ll often notice redness, roughness, and thicker skin forming in the same areas where you’ve seen a reduction in the density or thickness of your hair.

The condition also causes burning, itching, and pain, whereas other forms of hair loss, such as pattern hair loss, are not linked with any discomfort and simply mean follicles stop producing new hair.

Understanding the causes isn’t always straightforward because some people believe that it is an autoimmune condition in which the immune system attacks healthy follicles and tissue. 

Still, in every case, lichen planopilaris is not contagious, cannot be spread to or caught from other people, and can often be well managed with a combination of therapies, medications and potentially a hair transplant when the condition is stable and dormant.

Can I Have a Hair Transplant to Correct Lichen Planopilaris-Related Hair Loss?

As we’ve indicated, the right time for a hair transplant will always depend on your symptoms, and if there has been at least one year and ideally two to five years since you most recently experienced irritation and visible hair loss, a transplant could be a great way forward. [4]

Our surgical teams will need to verify whether there are enough donor hairs to replenish the hair loss at the target areas. We’ll also evaluate the scarring to ensure there is a reasonable chance that your tissue can support ongoing hair regrowth following a transplant. [5]

Please contact your nearest KSL Clinic for more information about lichen planopilaris and hair loss, to understand the nature of your alopecia, or to discuss the suitability of a hair transplant and other treatment strategies to restore and maintain your hair.