Scalp trauma in lichen planopilaris: Case reports of disease progression from fire fighter helmet use

This document presents two case reports of firefighters experiencing progression of lichen planopilaris (LPP), a scarring alopecia, potentially exacerbated by the use of fire helmets. Both patients, aged 47 and 44, had a history of hair transplants and reported worsening symptoms, such as pruritus and scaling, associated with helmet use. The study suggests that the physical trauma from wearing helmets, which weigh 3 to 4 pounds and cause friction, may contribute to LPP progression. The findings highlight the importance of considering occupational factors in LPP management and suggest that patients should avoid scalp trauma. Further research is needed to explore the relationship between hair transplants and LPP development.