Oral Gabapentin for Scalp Pruritus in Patients with Lichen Planopilaris: A Case Series

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.

Prostaglandin balance affects hair loss, particularly in conditions like Lichen Planopilaris, where an imbalance can lead to hair follicle damage. Treatments mentioned include prostaglandin analogs and Pioglitazone HCL, with a focus on maintaining prostaglandin equilibrium for potential hair regrowth.

Topical pirfenidone is highlighted as an effective anti-inflammatory and anti-fibrotic treatment for hair loss, particularly in addressing perifollicular fibrosis, which may enhance the effectiveness of standard treatments like finasteride and minoxidil. The user also uses calcipotriol, MCT oil, ciclopirox shampoo, and benzoyl peroxide shampoo as part of their regimen.

The user added P5P (vitamin B6) to their shampoo to reduce scalp itch, which improved significantly. They have been using finasteride for hair loss but are exploring additional treatments like topical antiandrogens and prolactin inhibitors.

Hair loss may be linked to the TRPS1 gene and protein, not just DHT. Amplifica's AMP-303 targets mesenchymal stem cells and shows promise in treating hair loss, unlike Pelage's PP405.

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.