Topical Gabapentin for the Treatment of Symptomatic Scalp in Cicatricial Alopecias

In this pilot study, topical 6% gabapentin solution was applied twice daily for 12 weeks to treat neuropathic scalp symptoms in a patient with lymphocytic cicatricial alopecia and scalp pruritus. The patient experienced significant reductions in disease activity (LPPAI 0.33 vs. 1.42) and scalp pruritus (visual analog score 1/10 vs. 6/10), along with notable hair regrowth on the affected scalp. Biopsies showed increased epidermal nerve fiber density and VIP expression post-treatment, with no detectable serum gabapentin levels or adverse effects. These results suggested that topical gabapentin was safe and effective for managing symptomatic scalp in cicatricial alopecias, warranting further studies to confirm these findings.