Lichen Planopilaris: Beard and Facial Hair

Beard and Facial Hair

Beard hair loss in men can be due to a variety of causes. Alopecia areata is among the more common of these and presents with asymptomatic patches of hair loss. A variety of conditions given hair loss accompanied by redness and even permanent hair loss. Lichen planopilaris, folliculitis decalvans and discoid lupus are three important conditions to consider in males presenting with apparent scarring in the beard region. This photo shows a 68 year old male with beard loss from lichen planopilaris. In my experience, most individials with beard LPP tend to have a more aggressive form of scalp LPP. Treatment of beard LPP is similar to the principles of treating scalp LPP and includes topical steroids, steroid injections, calcineurin inhibitors, and systemic agents such as docycycline, methotrexate, hydroxychloroquine, mycophenolate, cyclosporine and sometimes retinoids.