Atypical Presentation of Lichen Planopilaris: Presentation of Two Cases and Review

Lichen Planopilaris (LPP) is an autoimmune condition causing permanent hair loss and fibrosis, often misdiagnosed. Treatments include pioglitazone, topical corticosteroids, anti-inflammatory medication, and Jak inhibitors.

Excess sebum rich in cholesterol and triglycerides can lead to hair loss through inflammation, with treatments like Ciclopirox shampoo, Benzoyl Peroxide shampoo, and Clindamycin gel recommended for managing conditions like seborrheic dermatitis and folliculitis. Pioglitazone is suggested for Lichen Planopilaris, while Omega-3s and reducing processed foods may improve sebum quality, though genetic factors play a significant role.

A user experienced severe scalp itching with MPB and found Nizoral ineffective. A doctor diagnosed seborrheic eczema and prescribed Betacap, which relieved the itching.

Men with hair loss might have lichen planopilaris (LPP), which can mimic androgenetic alopecia, leading to misdiagnosis and ineffective treatment with finasteride or dutasteride. Proper diagnosis, including biopsies, is crucial to distinguish between androgenetic alopecia and conditions like LPP.

PP405, a topical treatment, shows promise for hair growth by activating inactive follicles, with 66% of participants experiencing positive results. The treatment is well-tolerated and may proceed directly to Phase 3 trials, offering a potential alternative to minoxidil and finasteride.

The user added P5P (vitamin B6) to their shampoo to reduce scalp itch, which improved significantly. They have been using finasteride for hair loss but are exploring additional treatments like topical antiandrogens and prolactin inhibitors.