Sometimes a rash is more than just a rash. Lichen Planopilaris is one of those situations.
Lichen planopilaris is a rare disease that appears in adults and seems to be most common in middle-aged women. But it is so rare that it is still being studied to learn more about it. Lichen planopilaris is usually accompanied by lichen planus in other parts of the body.
What we do know is that it is most frequent in women between the ages of 40 to 60 and can cause burning or itching on the scalp. It may look like a harmless rash with the individual bumps centered around a hair follicle.
Is Lichen Planopilaris an Autoimmune Disease?
According to the Cleveland Clinic, “Experts don’t fully understand what causes lichen planopilaris. However, it appears that T-cells, which are part of your immune system, attack your hair follicles. Because T-cells are involved, many experts consider lichen planopilaris an autoimmune disease.”
However, many dermatologists point out that lichen planopilaris is different from other autoimmune conditions in that they believe it is triggered by the body’s response to a toxin.
Dermnetnz.org says lichen planopilaris is “thought to be a cytotoxic autoimmune response to an unknown antigen located in hair follicles. The disease is rarely gene-related. It is also rarely drug-induced, eg, pembrolizumab.”
In layman’s terms, the disease appears to be the body’s reaction to some foreign substance. That foreign substance is not genetic or related to medical treatment the patient has had, but it is different from autoimmune conditions when the body’s aggressive response and attacking of its own cells is not triggered by an outside stimulus.
Can Hair Grow Back After Lichen Planopilaris?”
No, the National Institutes of Health consider lichen planopilaris (LPP) an uncommon scalp disorder, but it does cause scarring alopecia. In fact, it is the most common cause of scarring alopecia. When a person has scarring alopecia, the hair follicles are so damaged that the hair cannot regrow naturally.
However, even though it is the most common form of scarring alopecia, it is very uncommon, accounting for only 1% of all hair loss.
Will Vitamin D Help With Lichen Planus?
Lichen planus and LPP often come together, making it easier for some doctors to diagnose LPP by seeing the rection of the patients mouth and mucus membranes to lichen planus.
Unlike LPP, lichen planus is thought to be related to a reaction to various medications and can sometimes be improved by taking Vitamin D as the vitamin supports the immune system. PubMed indicates more studies are needed, but for oral lichen planus (OLP) Vitamin D is a promising treatment.
“All the included studies demonstrated significant amelioration in the OLP symptoms in patients who were given vitamin D supplements as an adjuvant to the conventional steroid therapy and or placebo. This systematic review signifies the role of vitamin D as adjuvant therapy for OLP.”
This does not mean that Vitamin D is necessarily a good treatment or will eliminate the pain and itching associated with LLP, but it is something doctors are investigating. Neither condition can be cured at this time, though they can be reduced if the allergen causing them is identified.
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