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Home / Conditions / Autoimmune / Lichen Planus
Autoimmune · condition 04 of 18
Lichen Planus: What It Is and How It Affects Your Hair
An immune condition of skin, nails and mouth that can reach the follicle.
Clinically reviewed by Dr. Nina Ross, NDServing all of Metro Atlanta
Quick answer
Lichen planus is an inflammatory condition where the immune system targets the skin, and sometimes the nails and the lining of the mouth. On the skin it shows up as flat-topped, itchy bumps.
Read the full answer
When the same process reaches the hair follicle on the scalp it is called lichen planopilaris, and that form can scar.
Not everyone with lichen planus develops scalp involvement, but scalp symptoms such as burning, tenderness or scale around individual hairs are worth reading under magnification promptly, because early inflammation is the part we can still influence. At Nina Ross Atlanta in Sandy Springs we look at the scalp at 200x and take into account what your skin, nails and mouth are already showing. Serving all of Metro Atlanta.
- Not everyone gets scalp involvement.
- On the scalp it is called lichen planopilaris, and it can scar.
- Early inflammation is the part we can still influence.
What you might be noticing
Symptoms in your words, and ours
Tap the one that sounds like you to see why it happens and how we figure it out.
01Itchy flat purple bumps on my skin
Violaceous flat-topped papules✋🏾
Why it happens
Flat-topped, itchy bumps are the classic skin sign of lichen planus, from immune activity in the skin. On deeper skin tones they often look dark rather than purple.
How we figure it out
Tell us where they are. Skin involvement tells us to read your scalp closely for early follicular signs.
02White lacy lines inside my mouth
Wickham striae, oral lichen planus✋🏾
Why it happens
Lacy white lines inside the cheeks are commonly linked to oral lichen planus, the same immune process in the lining of the mouth.
How we figure it out
We note it as part of the full picture, alongside what your scalp shows at 200x.
03My nails are ridged or splitting
Longitudinal nail ridging or pterygium✋🏾
Why it happens
Ridging or splitting along the length of the nail is commonly linked to lichen planus reaching the nail.
How we figure it out
We note nail changes with your scalp read, because together they help explain what is happening.
04My scalp burns in one spot
Localized trichodynia✋🏾
Why it happens
Burning in one area is commonly linked to inflammation at the follicle, and it can come before any visible loss.
How we figure it out
We read that exact spot at 200x for redness around the follicle and scale climbing the hair shaft.
05Scale right at the base of the hairs
Perifollicular scale, follicular involvement✋🏾
Why it happens
Scale that grips the base of individual hairs is commonly linked to the follicle itself being involved, which behaves differently from loose, ordinary flaking.
How we figure it out
Magnification shows whether scale travels up the shaft or sits loose on the scalp. That difference points toward lichen planopilaris.
What causes it
What is actually driving it
- 01
Immune-mediated inflammation
Immune cells target the basal layer of the skin. When the follicle is involved, the same process affects the region the follicle needs to rebuild itself.
- 02
Medication and infection associations
Some medications and infections have been described alongside lichen planus reactions. Bring your full medication list, and never stop a prescription on your own.
- 03
Stress as an aggravator
Flares are commonly reported during periods of high stress, which is part of why the systemic picture matters here.
What we see that others miss
Reading follicular involvement before the patch appears
The useful window with lichen planus on the scalp is the period when symptoms exist and visible loss does not.
Finding that early is the difference between protecting follicles and documenting their loss.
How we treat it
What care looks like here
On the scalp our work is calming the inflammation and protecting follicles that are still open, using light-based therapy and a restorative program. We take into account what your skin, nails or mouth are showing, and we track the scalp with photographs.
- 01Read the scalp at 200x
- 02Calm the inflammation
- 03Track the same points with photographs
Restorative Therapy
A structured in-house program that treats the scalp and the systems behind it.
One visit. Real answers.
The $99 Hair & Body Discovery
No prepOne visitYour time, your pickNo judgmentServing all of Metro Atlanta
- One-on-one scalp health session with a certified trichologist
- 200x magnification read of your scalp, on screen, while you watch
- A full-body biofeedback scan
- Your Hair & Body Discovery Report, delivered the next day
Our promiseYou'll leave actually seeing what's happening, your scalp at 200x, the systems behind it, with your report the next day. If you don't, the $99 is on us.
Fully HSA/FSA eligible. 0% financing for qualified applicants.
You are welcome here
We are well-versed in us.
On deeper skin tones lichen planus often heals to dark marks rather than red ones, and that is regularly misread. We assess with magnification and we take seriously what you have been feeling.
Relaxers, braids, locs, weaves and heat. Share your full hair history. It is welcomed, never judged.
10 years of specialized care2,500+ clients seenNo judgment
Related conditions
Often confused with this
Lichen Planopilaris
An inflammatory scarring alopecia that often burns or stings before it shows.
CCCA
Central centrifugal cicatricial alopecia. Starts at the crown and spreads outward, quietly.
Alopecia Areata
Smooth, round patches that appear quickly. The follicle usually survives.
Questions, answered
Honest answers before you commit
Does lichen planus always cause hair loss?
No. Many people have skin, nail or mouth involvement and never develop scalp symptoms. It is the follicular form, lichen planopilaris, that affects hair.
How do I know if it has reached my scalp?
Burning, tenderness or scale gripping the base of individual hairs are the signs to watch. At 200x we look for redness ringing the follicle, which can show up before any visible loss.
Can the hair come back?
Where a follicle has scarred, that hair will not regrow. Where inflammation is caught early and the follicle is still open, protecting it is the goal, which is why early reading matters.
Should I stop a medication that might be linked?
No. Never stop or change a prescription on your own. Medication decisions stay with your prescriber. Our role is reading the scalp and identifying the pattern.
Do you handle this in-house?
Yes. Your scalp read, the look at the systems behind it and your scalp care all happen in-house at our Sandy Springs clinic.
Let's find out what your hair is trying to tell you.
You'll see it, or the $99 is on us. Serving all of Metro Atlanta.
Nina Ross Atlanta, 8735 Dunwoody Place, Suite 290, Sandy Springs, GA 30350. Monday to Saturday, 10:00 AM to 3:30 PM.