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Case of the Month
This 59 year old female was first evaluated in December 2011 for a five year history of progressive hair loss and thinning with occasional soreness of her scalp that continued to worsen despite using topical minoxidil products for a number of years.

At the time of her initial visit, a skin biopsy of the scalp was performed which revealed a diagnosis of Lichen Planopilaris (LPP); which is a rare inflammatory condition of the scalp that can lead to areas of permanent baldness.

She was started on a treatment program consisting of oral doxycycline for anti-inflammatory purposes, a potent topical steroid medication to apply daily to the scalp plus monthly intralesional steroid injections to the scalp. After the first year of therapy, the scalp was noticed to be healthier with less inflammation and less tenderness, but prominent areas of hair thinning remained.

Ongoing treatment was administered to keep the condition under control and to see if the areas of persistent hair loss would improve. From time to time, she noticed some increase in itching or tenderness on occasion and periodic increases in hair shedding from time to time.

While at the office during the summer of 2015 for a visit to receive another treatment session for her scalp she was informed that we were testing Platelet Rich Plasma (PRP) to treat individuals with LPP to see if it would or would not work.

She decided to try Platelet Rich Plasma (PRP) as an alternative approach to treating her hair loss and her first treatment session was done in October 2015. Blood was drawn and centrifuged then mixed with an activator compound before being injected into various areas of the scalp affected by the hair loss.

She returned for follow up every 1-2 months after the treatment and was observed to have progressive increase growth of hair in the middle areas of her scalp which were mostly bald with scar tissue prior to the PRP treatment. She returned for a second treatment 7 months after the first treatment and is currently being followed up to observe how the condition continues to improve.

This case represents an example of Lichen Planopilaris that after 4 years of medical treatment has responding to PRP treatment with new hair growth over a 7 month period in areas of previous scarring. This case illustrates one of the ways we are currently using this approach to treating patients with hair loss at Dr. W Dermatology and the Houston Hair Loss Clinic and creating new hope for improvement. It is also of interest that this individual had experienced hair loss for 5 years before seeking medical attention despite noticing no improvement with over the counter topical minoxidil.
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