Lichen Planopilaris: Mechanisms, Subtypes, and Diagnosis

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.

Hair follicle stem cells remain in bald individuals, but progenitor cells do not, raising questions about hair regrowth claims by Pelage. PP405 is discussed as a potential treatment, with skepticism about its effectiveness compared to existing treatments like Minoxidil and Finasteride.

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.

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.

Pilose antler extracts may promote hair growth in androgenetic alopecia by activating hair follicle stem cells through the AKT and Wnt pathways. However, results in mice may not directly apply to humans due to differences in genetic and biochemical conditions.

PP405 is ineffective for miniaturized, fibrosed hair follicles in androgenetic alopecia. AMP303 may activate hair follicle stem cells, but minoxidil and finasteride are still the main treatments.