Scarring Alopecia and CCCA: Lichen Planopilarus, the most common form seen in our center

Scarring Alopecia & CCCA at SBLHairloss

Lichen Planopilaris (LPP): The Most Common Scarring Alopecia Seen in Our Center

At SBLHairloss, one of the most frequently diagnosed forms of scarring alopecia we encounter is Lichen Planopilaris (LPP)—a rare but serious inflammatory condition that leads to permanent hair loss if not addressed early and appropriately.

What Is Lichen Planopilaris (LPP)?

Lichen Planopilaris is a form of cicatricial (scarring) alopecia in which the body’s immune system mistakenly attacks the hair follicle—specifically the follicular stem cells responsible for hair regeneration. Over time, this inflammatory assault destroys the follicle and replaces it with scar tissue, preventing future hair growth.

LPP primarily affects the scalp but may also involve the eyebrows, underarms, or pubic hair. A commonly associated variant is Frontal Fibrosing Alopecia (FFA), which typically presents as progressive hairline recession and eyebrow loss.

Key Characteristics of LPP

• Inflammatory Condition
  Immune cells target the hair follicle, triggering chronic inflammation.

• Scarring Alopecia
  Once follicles are destroyed, hair loss is permanent in those areas.

• Common Symptoms

  • Redness and scaling around follicles

  • Itching, burning, tenderness

  • Flaky patches

  • Smooth or shiny bald areas on the scalp

• Primary Location
  Scalp (with possible involvement of eyebrows and body hair)

  

Common Forms (Variants)

• Classic Lichen Planopilaris
  Patchy areas of hair loss with perifollicular redness and scale.

• Frontal Fibrosing Alopecia (FFA)
  A subtype marked by scarring hair loss along the frontal hairline and temples, often accompanied by eyebrow thinning or loss.

  

Causes & Triggers

The exact cause of LPP remains unknown, but it is widely considered an autoimmune-mediated condition, where T-cells attack hair follicle stem cells.

Potential contributing factors may include:

• Chronic immune dysregulation

• Infections

• Medications

• Chemical or environmental exposures

• Gut inflammation and food intolerances

Diagnosis

Accurate diagnosis is critical and typically includes:

• Comprehensive scalp and follicular examination

• Scalp biopsy (gold standard)

• Supporting blood work when indicated

SBLHairloss Trichologist-Guided Management Approach

While medical treatment focuses on suppressing inflammation, our trichology-based model emphasizes identifying and reducing inflammatory triggers from the inside out.

1. Identify Inflammatory Triggers

We recommend beginning with a food intolerance test to uncover dietary contributors to immune activation. Tap here to schedule a virtual scan with an (FSA/HSA) intolerance test here: https://link.hairlosscenternj.com/widget/bookings/sbl2/virtuallinkconsult

Once identified, strict elimination of the foods and consistency are key.

2. Support Gut & Colon Health

Chronic inflammation often originates in the gut. Supporting regular waste elimination may help reduce systemic immune burden.

Suggested options include:

• Colon-support formulations designed to promote gentle cleansing regularly once per season with- https://store.hairlosscenternj.com/products/biotics-research-colon-cleanse-tabs?utm_source=copyToPasteBoard&utm_medium=product-links&utm_content=web

• Aloe-based gut-soothing supplements to support intestinal lining health

(Product recommendations may be provided during consultation based on individual needs.)

3. Reduce Systemic Inflammation

Reduce sugars to 50 grams and under per day and processed foods as this increases pain, stiffness and increases the inflammatory response.

Incorporate anti-inflammatory nutrients such as:

• Turmeric & Curcumin-https://www.isotonix.com/product/curcumin-extreme/?id=10107&idType=product

• Ginger (supports pain reduction and inflammation modulation)

• Essential fatty acids that are good for your blood type (e.g., full-fat coconut oil)

• Natural aloe for digestive and inflammatory support-https://www.isotonix.com/product/ultimate-aloe/?id=2232&idType=product

• OPC's & Red wine products These supplements blend extracts from grape seed, pine bark (Pycnogenol®), red wine, bilberry, and citrus to combat free radicals, support cardiovascular and joint health, promote circulation, and aid vision, often in an easily absorbed isotonic formula. https://www.isotonix.com/product/isotonix-opc-3/?id=2217&idType=product

4. Restore Microbial Balance

Add prebiotic and probiotic fiber such as -https://store.hairlosscenternj.com/products/organic-india-psyllium-pre-pro-biotic-fiber?utm_source=copyToPasteBoard&utm_medium=product-links&utm_content=web to support gut microbiome balance, which plays a role in immune regulation and inflammatory control.

Medical Management (Under Physician Care)

The goal of medical treatment is to control inflammation, slow disease progression, and preserve remaining hair and follicles that haven't been subject to the immune system disturbance..

Common treatments may include:

• Topical or oral corticosteroids

• Hydroxychloroquine (antimalarial therapy)

• Tacrolimus

• JAK inhibitors

• Other immune-modulating medications

Scalp & Hair Care Recommendations

• Use gentle, pH-balanced, hypoallergenic shampoos

• Avoid harsh detergents and irritants

• Incorporate anti-inflammatory botanical oils to help soothe burning and tenderness-https://store.hairlosscenternj.com/products/itchy-calm-scalp-shampoo-and-conditioner-with-free-scalp-mask?utm_source=copyToPasteBoard&utm_medium=product-links&utm_content=web

• If yeast or fungal activity is present, a ketoconazole-based cleanser may be recommended

• Salicylic acid–based products can help reduce scaling and scalp pruritus

Prognosis

Lichen Planopilaris is a long-term condition, but with early detection and consistent management, it often becomes inactive or stabilized.
However, hair loss in scarred areas is typically permanent, which makes early intervention essential.

Final Thoughts from SBLHairloss

At SBLHairloss, we believe managing scarring alopecia requires more than symptom suppression—it requires understanding why inflammation exists in the first place. By combining medical collaboration, scalp-focused trichology care, and gut–immune support strategies, we aim to protect remaining follicles and improve quality of life for our clients.

If you are experiencing unexplained scalp symptoms, tenderness, or progressive hair loss, early evaluation is critical.

More information may be found here: https://hairlosscenternj.com/post/scarring-alopecia-and-ccca-lichen-planopilarus

Connect with us today! https://HairLossCenterNj.com