It Is Not Invisible! A Case Report of 2 Patients with Scalp Lichen Planopilaris Mimicking Androgenic Alopecia

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.

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 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.

Scalp biopsies are crucial for diagnosing hair loss conditions like Diffuse Unpatterned Alopecia (DUPA) and retrograde hair loss, as treatments like finasteride and dutasteride may not be effective if other conditions are present. Combining PPAR-GAMMA agonists with retinoids could improve treatments for conditions like Lichen Planopilaris.

The user is experiencing progressive hair thinning despite using finasteride and dutasteride. A biopsy confirmed male pattern baldness, and minoxidil was suggested as an additional treatment.

The user noticed small circular hairless spots after a buzz cut and has been using finasteride, dutasteride, and oral minoxidil for hair loss. They are experiencing continuous shedding and thinning, and it is suggested they consult a dermatologist for a scalp examination and possible biopsy to determine if it's alopecia areata or androgenetic alopecia.