Lichen Planopilaris Dermatologist2019-06-11T09:53:23+00:00

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Lichen planopilaris is a type of scarring hair loss that most commonly affects your scalp, but can also cause hair loss of your eyebrows and at other body sites.

IN THESE VIDEOS, I EXPLAIN THE SYMPTOMS AND CAUSES OF HAIR LOSS – AND HOW TO TREAT IT

In the videos above, I explain things in a simple way that applies to most people who have lichen planopilaris. Of course, no video or website can replace the value of a personalised consultation. At your consultation, you can have your skin carefully examined and get an expert recommendation to help you resolve your condition.

Book a consultation

Treatment helps people of all ages take control of their skin condition and get their life back.

CALL 0118 373 5198

How does lichen planopilaris impact people on a day-by-day basis?

LIKE ANY CONDITION THAT CAUSES HAIR LOSS, LICHEN PLANOPILARIS CAN BE EXTREMELY EMOTIONALLY DISTRESSING

An uncomfortable, patchy hair loss

You may experience an itchy or burning, uncomfortable or painful sensation in affected areas on your scalp. Your hair typically falls out in patches, which can become more extensive as the condition progresses.

Lasting hair loss

You may notice redness and flaking of the skin around hair follicles. When your hairs fall out, they do not grow back, and the scalp looks shiny and smooth in that area (also known as scarring).

Your hair loss might be always in the back of your mind

Extreme self-consciousness is common. Is it obvious? Are people staring? Will people still like you if you lose your hair? A person’s hair can be a part of their identify, and that loss of identify can affect every waking moment.

For some, losing their hair is a seemingly hopeless time

For some, it’s a very emotional time. You may question yourself about what you might have done to cause it. You may have been told not to worry about it and you might even imagine your hair may grow back. You might be wasting money on creams and shampoos that just won’t work.

Is there any hope at all?

As this type of hair loss is scarring, unfortunately, any already lost hair will not grow back. We will, however, focus on switching off disease activity and preventing any further hair loss with the prescribed treatment.

What my patients love about my service

MY PATIENTS ARE MY BEST PROMOTERS

Please pass on my thanks to Dr Pratsou for her assessment on my continued taking of roaccutane.

She was completely right, I didn’t need a new course, I needed to move away from the drug. The creams she gave me and Cetaphil recommendation have meant my skin has been the best it’s ever been (ongoing and since I saw her) ALL SUMMER :))))) I’ve had zero problems…and I’m loving it.

Thank you once again.


Phillip, Acne

“Dear Dr Pratsou,

Following the consultation today I feel it appropriate to say thank you for your help in dealing with my rosacea.

On each occasion, I have visited your department I have noticed the kindness and cheeriness of all the staff I have encountered and particularly wanted to say that you made me feel at ease with your calmness and excellent manner.

All is much appreciated.”


Anne, Rosacea

“Thank you very much!!

You three were (and are) a great team!

I will remember you.

You made me feel comfortable.”


Ellie

“Tania,

Please pass to Dr Pratsou my thanks for her skilled work.

The wound is healing beautifully and now the stitches are out it looks as though it will be almost invisible once fully healed.”


Graham, Skin cancer removal

“Dear Dr Penelope, Rena & the team, (I can’t remember the nurse’s name who helped me during my 2 procedures at the Spire!)

I wanted to thank you for your support and help during a very difficult time. You guys do a wonderful job – and we are eternally grateful for your help.”


Clarissa, Skin cancer

“I would like to put on record how impressed I was with the operation you performed for the removal of the SCC on my neck. I cannot even see where the cut or the stitches were! I am indeed very grateful for the excellent work you do.”


Harry, Squamous Cell Carcinoma

“Dear Dr Pratsou,

I am very grateful to you for your diagnosis, recommended treatment and advice. Your letter to my GP sets out both the course of events, and your own analysis of probable condition and possible cause, clearly summarising our discussion.

I hope there will be no recurrence but I will certainly come back to you if there is.”


Ryan, Skin rash

“Dear Tania,

Please pass on my thanks to Dr Pratsou. I saw her this morning for a mole check. She was so lovely and reassuring. Please also thank the two nurses who assisted her during the mole removal procedure. I was very nervous, but they were very efficient, which meant I did not have too long to think about it, but most of all they were very kind. They kept me distracted and calm, which made a huge difference. Thank you also for your efficiency in both booking me in so quickly.”


James, Mole removal
Dear Ms. Pratsou,

I am writing to thank you for the care you have given me in the past few months. From the moment I walked into your consulting room with a lesion on my cheek, a lesion that I fully expected to be some sort of skin cancer (and it was), you have been thorough, reassuring, respectful and in every way professional.

You recognised that I had some insight into the condition of my skin and the procedures required to treat me. You listened to me. You projected expertise and compassion.

During the procedure to remove the growth you ensured that the atmosphere in the treatment room remained not only calm, but actually pleasant. Had it not been that you were excising a growth and sewing me up, I almost felt as if you, me and the nurse were at some sort of women’s discussion group. The time flew by. I had zero anxieties about the procedure and as we both know now, the wound healed flawlessly.

Thank you for your expertise and your communication skills and all round good nature. I feel very lucky.


Karen Tatom, Skin cancer removal

We have replaced the images and names of real patients who provided these testimonials to protect their privacy.

The first step to feeling in charge of your skin is to book an initial consultation

FIND OUT HOW TO GET THE SKIN YOU WANT

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How it works

FEEL IN CHARGE OF YOUR SKIN IN 3 EASY STEPS

STEP 1 – CALL US
STEP 2 – LET’S MEET
STEP 3 – RESOLUTION
CONTACT MY STAFF

Give us a call on 0118 373 5198 and we’ll help guide you towards a first appointment.

MEET WITH ME

I’ll see you and examine your skin before I recommend treatment. In some cases, I can begin treating your condition on the same day.

FEEL IN CHARGE OF YOUR SKIN

I’ll guide you down the road towards a resolution of your skin condition so that you can get back to normal life.

More information about lichen planopilaris

FOR THOSE WHO WANT THE DETAILS

Lichen planopilaris is a type of scarring hair loss that most commonly affects your scalp, but can also cause hair loss of your eyebrows and at other body sites. It is part of a condition called lichen planus, which can also affect your skin, nails, genital area and mouth.

Lichen planopilaris most commonly affects women in their forties and is 2 to 5 times more frequent in women than in men.

Symptoms include:

  • you may experience an itchy or burning, uncomfortable or painful sensation in affected areas on your scalp
  • your hair typically falls out in patches, which can become more extensive as the condition progresses
  • you notice redness and flaking of the skin around hair follicles
  • when your hairs fall out, they do not grow back, and the scalp looks shiny and smooth in that area (also known as scarring).

Lichen planopilaris is thought to be an autoimmune condition.

T-lymphocytes, which form part of the organism’s immune defence, attack the hair follicles. This results in loss of the hairs and scarring.

I will examine your scalp, the pattern of hair loss and type (that is, scarring versus non-scarring). I will use an instrument known as dermatoscope to look for specific evidence of lichen planopilaris.

I may take a scalp biopsy to confirm the diagnosis and determine the best course of treatment.

Treatments include:

  • an ultrapotent topical steroid application to affected areas. This can often be combined with oral treatments
  • alternatively, topical Tacrolimus (Protopic) ointment can be used to suppress local inflammation
  • I often use certain antibiotics called tetracyclines (for example, Doxycycline) for prolonged courses due to their anti-inflammatory effects
  • Hydroxychloroquine, which is an antimalarial drug, can be very effective in switching off activity in frontal fibrosing alopecia. You may require a 6-month initial course to see whether this is effective
  • I sometimes use immunosuppressive tablets (for example, mycophenolate mofetil) when other treatments have been unsuccessful.

Wigs, hairpieces, extensions, and hair fibres can be particularly helpful in managing this condition.

“Will my hair grow back once I start treatment?”

As this type of hair loss is scarring, unfortunately any already lost hair will not grow back. We will however focus on switching off disease activity and preventing any further hair loss with the prescribed treatment.

“What else can I do for myself?”

Some hairdressers specialise in hair systems for hair loss/alopecia.

You can use extensions in long hair through these specialist hair salons.

If you have extensive hair loss, you may find a weave or wig helpful; there are some extremely realistic choices nowadays.

You can also obtain wigs via an NHS prescription.

Affiliations and memberships

I AM PROUD TO BE ASSOCIATED WITH THE FOLLOWING ORGANISATIONS

Questions and answers

RELEVANT AND INFORMATIVE VIDEOS AND ARTICLES

How can you prevent rosacea?

Dr Penelope Pratsou discusses whether it is possible to prevent rosacea flare-ups and if lifestyle modifications can help to protect your skin. 

About the author

Dr Penelope Pratsou | Consultant Dermatologist

MBChB, MRCP (UK) (Dermatology)

I’m Dr Penelope Pratsou, a skilled independent Consultant Dermatologist based in Berkshire. I have specialist expertise in the diagnosis and management of all skin cancers, and in performing mole checks. I’m a trained skin surgeon and remove skin cancers, moles, skin tags, cysts and warts.

I also have invaluable experience in dealing with all skin conditions, from the common skin complaints of acne, rosacea, eczema and psoriasis, to the rarer and more complex skin problems, having seen it all through years of NHS work.

After I obtained my Membership to the Royal College of Physicians, I undertook rigorous specialist training in dermatology, before being appointed as a Consultant Dermatologist at the Royal Berkshire Hospital, Reading. There, I helped set up and lead a busy clinic for the diagnosis and treatment of suspected skin cancer. I was also actively involved in supervising and training both dermatology and GP trainees.

Alongside my increasingly busy private practice, I have maintained an NHS practice in Oxford in order to continue to engage with challenging cases and to develop my specialist interest in skin allergy.

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