Evidence checked, 25 October 2026. General information, not individual medical advice.
What is lichen planopilaris, and can the hair grow back?
Lichen planopilaris, often shortened to LPP, is an inflammatory condition that can damage hair follicles and cause permanent scarring hair loss. Treatment aims to control inflammation, reduce symptoms and protect follicles that remain. It cannot reliably restore hair where follicles have already been replaced by scar tissue. Suspected LPP needs timely medical assessment, not a hair-growth package selected before the diagnosis is clear. [1]
That distinction can sound unsettling, but it also explains why getting the right assessment matters. The useful goal is to understand whether disease is active and what can be protected now. A promise of universal regrowth is not a substitute for that plan.
Ask about a diagnosis-led scalp assessment
What signs can lichen planopilaris cause?
LPP may cause irregular patches of hair loss with scale and redness around follicles at the edges. Areas of established scarring can look smooth and pale, with fewer visible follicular openings. Itch, tenderness, pain or burning can occur, but some people have few symptoms. [1]
Do not try to diagnose scarring solely from a mirror or a magnified phone photograph. Normal scalp features, lighting and other hair disorders can be confusing. A clinician examines the pattern, follicular openings and the skin around individual hairs, often using trichoscopy.
Tell the clinician if the area is expanding, if symptoms come and go or if eyebrows and other hair-bearing areas are changing. LPP is not simply a more severe name for ordinary pattern thinning. Different conditions can coexist, so a complete assessment is important.
How is it different from other forms of hair loss?
Pattern hair loss involves progressive miniaturisation and has a different treatment pathway. Telogen effluvium usually presents with increased shedding. Alopecia areata can cause patches without the same scarring process. Other inflammatory disorders, including central centrifugal cicatricial alopecia and discoid lupus, can also scar. [1,2]
A similar-looking patch does not make those diagnoses interchangeable. The location, symptoms, scalp findings and sometimes a biopsy help distinguish them. Frontal fibrosing alopecia is related to the LPP spectrum, but its typical presentation and management discussion should still be assessed specifically. [1]
If you have already been told you have LPP, bring the clinic letter or biopsy report. It is better to review the actual diagnosis than to reconstruct it from memory or a product recommendation.
What happens during the diagnostic assessment?
A clinician asks about onset, progression, symptoms, treatments and your medical history, then examines the scalp. They may also look for signs of lichen planus elsewhere, including the skin, mouth and nails. Trichoscopy can show features that support the diagnosis and help identify an active area. [1]
A scalp biopsy may be recommended when confirmation is needed. The site matters: an active edge can provide more useful information than an area of old, complete scarring. The clinician should explain why the biopsy is proposed, what it involves and how the result will change the plan. [1]
Not every hair-loss consultation includes a biopsy, and a cosmetic service price should not be assumed to cover it. If another clinician needs to perform it, ask about the referral route, cost and follow-up. You should know who will interpret the result and discuss it with you.
Why is early treatment discussed?
Once a follicle has been replaced by scar tissue, regrowth is not a realistic routine treatment promise. The aim is to reduce ongoing inflammation and prevent or slow further loss. Treatment response varies, and progression can sometimes continue despite care. [1]
That does not mean a person should panic about every itchy scalp. It means that progressive patches, persistent perifollicular inflammation or a concern about scarring deserve assessment rather than months of trial-and-error products.
Photographs can help monitor change, but they need consistency. Use similar lighting, hair position and distance, and follow the clinician's advice about intervals. Daily photographs in changing light may increase worry without showing whether the condition is truly progressing.
What treatments are used?
Specialist treatment may involve topical, injected or systemic anti-inflammatory medicines. Choice depends on disease activity, extent, symptoms, medical history and the balance of benefits and risks. Some options need blood tests or other monitoring. [1]
There is no single treatment that works for everyone. Published studies vary in quality and sometimes disagree. A systematic review and network meta-analysis published in Dermatology in 2024 included seven studies and 251 people with LPP. The authors described the evidence for medical interventions as weak. Small case series and early reports should not be read as proof that a new treatment will restore every person's hair. A useful specialist discussion covers the strength of evidence, expected goal, monitoring and what happens if the first approach is not enough. [1,5]
Do not start, stop or change a prescription based on an online article. Ask how progress will be judged and which side effects need prompt advice. Controlling symptoms and slowing loss can be worthwhile outcomes even when an already scarred area does not regrow.
Discuss a scalp change before choosing treatment | Call 020 3951 3429
Can PRP treat lichen planopilaris?
PRP has been reported among possible treatments, but that is not the same as an established, reliably effective treatment for LPP. DermNet notes variable responses and conflicting evidence across treatment approaches. A specialist should lead the discussion if an adjunctive procedure is being considered. [1]
The better-known PRP hair studies mainly concern androgenetic alopecia. A 2024 review of five randomised trials of PRP added to topical treatment found potential density benefits, with low to very low certainty of evidence. Those findings cannot be assumed to apply to an inflammatory scarring alopecia. [3]
Do not book PRP expecting it to recreate follicles in scarred skin or replace anti-inflammatory treatment. If there is coexisting pattern thinning, a later discussion can separate that problem from active LPP. The diagnosis, current activity and specialist plan should determine whether any additional procedure is appropriate.
How is follow-up different from a cosmetic progress check?
Follow-up assesses disease activity as well as appearance. The clinician may review symptoms, inflammation, photographs, the distribution of loss and how treatment is tolerated. The interval should be agreed for your situation. [1]
Ask what counts as improvement or stability. Less itch alone may not answer every question about progression, and a disappointing photograph does not automatically mean treatment has failed. A consistent clinical record helps distinguish a true change from differences in styling or lighting.
If the area expands, symptoms worsen or treatment causes problems, contact the treating team rather than waiting until the next planned cosmetic appointment. Keep a record of changes and bring it to the review.
What should I do if I am worried about scarring hair loss?
Arrange an assessment and explain why you are concerned: new patches, burning, tenderness, scaling around hairs or an area that seems to be enlarging. If you have an existing dermatologist, contact them about a change in activity. A rapidly worsening painful scalp problem or feeling unwell may need more urgent advice.
The London PRP Clinic describes a doctor-led hair and scalp assessment on its service page. Ask the team whether that is the appropriate first step or whether direct dermatology care is more suitable. A service enquiry is not a diagnosis or confirmation that PRP is indicated. [4]
For a London appointment, bring previous reports and your treatment list, and confirm fees before booking. Ask how any specialist referral or biopsy would be arranged. The right plan should protect your remaining hair and give you an honest account of what treatment can achieve.
Enquire about the right assessment and next step | Email the team