Isotretinoin for the Treatment of Facial Lichen Planopilaris: A New Indication for an Old Drug, a Case Series Study

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.

The conversation discusses using isotretinoin (Accutane) to reduce scalp oiliness and manage scalp issues like seborrheic dermatitis, inflammation, and chronic itch. A user shares that taking 20mg of Accutane every other day effectively reduces oily hair and skin.

The user is experiencing diffuse thinning and inflammation despite using 2.5mg dutasteride daily, ciclopirox, and ketoconazole shampoos. They are considering treatments like hydroxychloroquine and JAK inhibitors due to suspected scarring alopecia and have faced challenges in obtaining a scalp biopsy.

Topical tretinoin applied to the face may exacerbate hair loss in some individuals, potentially triggering conditions like frontal fibrosing alopecia. Experiences vary, with some users reporting no impact on hair, while others experience significant hair loss.

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.

The conversation discusses using tretinoin for hair loss and whether applying SPF on the scalp is necessary if hair covers the treated areas. The user is considering this treatment despite having no completely bald patches.