Lichen Planus is a frustrating disease, fortunately rare, especially in men. But for victims it is a thoroughly miserable experience that can cause hair loss. We take a closer look.
It is classified as a chronic inflammatory disease which can affect the skin, scalp, mucous membranes and nails. It takes its name from its similarity in appearance to the sort of lichen you will see growing on trees and old walls. It can present in a range of variants, some extremely unpleasant and uncomfortable… including “ulcerative” which sees painful bulbous weeping lesions on the feet, others can affect the lining of the mouth or vulva, both deeply unpleasant and difficult to live with.
There are several variants but the one we are particularly interested in the category “Cutaneous”. This is the form that affects skin scalp and nails. As can be seen in the picture above the typical lesions are purple and blotchy… though there are variants on this too.
Readers will be relieved to learn that the disease is extremely rare, affecting only 0.1% of men and .3% of women, although you might be rightly concerned that little is understood about the triggers. Sunlight seems to have a precipitating effect, one form is noted to be more common in spring and summer in the Middle East. Of course being told that a condition you are actually suffering from is extremely rare is no comfort at all – especially as it points towards a lack of understanding by the medical professions of exactly what is wrong with you. It is understood to be another form of breakdown of the auto immune system which causes it to attack the cells. Where a specific trigger is recognised to have caused a Lichen reaction this is termed “Lichenoid”, among recognised triggers for lichenoid reactions are beta-blockers and anti-malarials along with other less common products.
As previously mentioned, the cutaneous form can affect the skin anywhere on the body, it can also affect the nails. But it is the variant that attacks the hair and scalp we are studying here. Compared to other forms of the disease it is relatively benign in terms of its impact on your day to day life. Nevertheless it is uncomfortable and itchy, and can progress to scarring alopecia and significant hair loss.
As is so often the case with rare diseases of this type there have been no meaningful clinical trials to prove the efficacy of treatments. Topical steroids are usually applied, usually for extended periods but only known to be partially effective and disappointing. The good news is that after some unpredictable period of time the symptoms can be expected to pass… for which we should all be very grateful – some forms, including the terrible one that affects the lining of the mouth, can linger for years and, having gone, can reappear and start all over again.
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