Is hair transplant a good option for a female patient with lichen planopilaris?

In general hair transplant surgery is not indicated for Lichen Planopilaris.  Non surgical options may be Scalp Micropigmentation.  You need to be under the care of a doctor for Lichen Planopilaris.

Hair transplants can be a good option for lichen planopilaris - if and only if the disease is quiet. If the disease is active, then it would not be a good idea at all. HOW DO I KNOW MY LICHEN PLANOPILARIS IS QUIET?A dermatologist can guide you if your LPP is quiet. In general, LPP is quiet if ALL THREE OF THESE CRITERIA ARE MET:Your hair looks exactly the same as 2 years agoYou have no itching, burning and pain in your scalpYou take no medications (clobetasol, etc) for your hair loss at present.Far too often, patients with LPP rush the decision to have a transplant and it's not successful. Hair transplants for LPP can be extremely successful in the right patient and at the right time. They do present unique challenges including the absolute need to monitor for disease activity after the transplant (it can activate again) and then need (sometimes) for 2 or 3 transplants to build up appropriate density. I see patients with LPP every 6 months after their transplant for the first 2 years.  If there is any sign of the disease coming back, we restart clobetasol and sometimes oral medications like hydroxychloroquine. Other options for cosmetic improvement of LPP (besides hair transplants) include use of a wig, hairpiece. 

Lichen Planopilaris is an an autoimmune diseases which usually negatively impact a hair transplant and are considered a contraindication for hair transplants. See a good description of the disease on wijkipedia below

Dear Febronia,

A patient with diagnosed Lichen Planopilaris needs to be
under the active care of a dermatologist or physician with experience in the
treatment of this metabolic autoimmune phenomenon. If you have active scalp Lichen planis which
is characterized by thinning and terminalization of existing hair follicles,
itching, burning and pain in the scalp together with some flaking then you have
active LPP and should not consider undergoing hair transplantation or the
affected transplant bulbs can become involved.

Patients with active LPP or Lichen Planopilaris need to be on
Clobetasol or even other stronger anti-immunologic drugs such as Hydroxychlorchortin.

I always advise individuals who have this disease to see a
dermatologist who has experience treating LPP and to ensure that the process is
stable prior to considering engaging in hair transplantation surgery.

Properly managed LPP patients can undergo hair restoration at
the right time in their life and need to be followed very carefully with a
dermatologic expert for 2-3 years to minimize risk of activation during the
growing phases. Remember that there are
other options for the Lichen Planopilaris which can include camouflage
hairpieces and wigs as an option for hair transplantation.

I hope this information has been of some assistance and best
of luck.

For more information, please review the link below.

R. Stephen Mulholland, M.D.

Certified Plastic Surgeon

Yorkville, Toronto

If you have been diagnosed with lichen planopliaris, you need to see a dermatologist and be treated before doing any hair transplant surgery, because of you do hair transplant, there is possibility of graft rejection and not taking if it is active.