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Scarring alopecia areata (Lichen planopilaris)
Skin and Hair Disorders
Question #26061
259 days ago
1,368

Scarring alopecia areata (Lichen planopilaris) - #26061

Karthick

Sufferin from auto immune condition called lichen planopilaris for almost a year.tooktreatments but no luck … Patchy hair loss…inflammation on the affected areas.. redness and <link removed>uld you please help

Age: 34
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HELLO KARTHIK,

Lichen Planopilarish is a rare autoimmune condition where your immune system mistakenly attacks the hair follicles , especially in the scalp. The inflammation destroys the hair follicle permanently- leading to scarring and irreversible hair loss.

KEY FEATURES -patchy hair loss with redness, itching, burning or pain - follicular plugging- scalp looks like small dots or bumps -shiny patches of scalp with no hair follicles- sign of permanent scarring

It’s considered a type of scarring alopecia and a variant if Lichen planus, which can also affect the skin or mucous membranes

In Ayurveda, LPP is viewed as a complex disease involving -vitiation of pitta and vata doshas - involvement of Rakta dhatu (blood tissue) and Mamsa dhatu (muscle tissue) -A condition called Khalitya + Raktadushti + Darunaka + Indralupta aspects

It is chronic and Tridoshaja , especially dominated by Pitta (Inflammation) and Vata (Destruction, dryness, degeneration)

SYMPTOMS YOU ARE EXPERIENCING -patchy hair loss on scalp - redness or inflamed areas -burning or painful sensation in scalp - itchy or tender scalp - no regrowth in some areas(scarring

INVESTIGATIONS NEEDED -Scalp biopsy= most important to confirms LPP diagnosis -Trichoscopy(dermoscopy)- magnified look at scalp -Blood test -ANA (anti-nuclear antibodies) -ESR, CRP (inflammation markers) - Thyroid profile (autoimmune thyroiditis) - Vitamin D, B12 - Iron studies

TREATMENT GOAL -stops or slow down progression of scarring -control inflammation-reduce burning, itching, redness - purify blood and reduce autoimmune response - promote regrowth in non scarred areas - rejuvinate and nourish scalp tissues - prevent recurrence

DETOX THERAPY- if feasible go for panchakarma= best results in cases like yours

-VIRECHANA= purgation =clears excess pitta from liver ,blood and skin. very effective for LPP

-BASTI= especially effective for chronic autoimmune conditions. vata- pacifying basis rejuvinate scalp tissues

-RAKTAMOKSHANA(leech therapy)= useful in active, inflamed patches, reduces burning , pain, and promotes healing

INTERNAL MEDICINES= to be taken for at least 3-6 months

1) KAISHOR GUGGULU= 2 tabs twice daily after meals with warm water =reduces inflammation, purifies blood

2) AROGYAVARDHINI VATI= 1 tab twice daily after meals with water = supports liver detox and skin health

3) MAHAMANJISTHADI KASHAYA= 20 ml twice daily with warm water before meals = excellent blood purifier, acts on skin and scalp inflammation

4) GUDUCHI CAPSULES= 1 cap. twice daily after meals =immunomodulatory, helps correct autoimmunity

5) BRINGARAJ CAPSULES= 1 cap twice daily in morning and at night = hair tonic, supports regrowth in early stages

6) TRIPHALA= 1 tsp with warm water at bedtime =gentle detox, and digestive support

7) BRAHMI VATI= 1 tab at bedtime = reduces stress, calms autoimmune flare ups

EXTERNAL APPLICATIONS

-NEELIBRINGADI TAILA= apply warm oil to scalp, leave for 1 hour then wash = 3 times/week= use for long term

-DURVADI TAILA= good for active inflammation, alternate days until redness reduces

-KUMKUMADI TAILA= for pigmentation, inflammation only at night, few drops to patches

HERBAL HAIR WASH

BOIL AND COOL -AMLA+ REETHA+SHIKAKAI powder(1 tsp each in 1-2 cups water) -strian and use as a mild cleanser

ALSO= ALOEVERA GEL + NEEM WATER RINSE

LEPA -Manjistha+ neem + sandalwood with cow milk or rose water =leave for 45 min then wash use 2-3 times/week

-JATYADI LEPA= for inflamed skin, ulcerated patches

-SIDDHA TAILA + RASOTHAMADI LEPA= once in 10 days

DIET TO BE FOLLOWED -fresh fruits=pomegranate , sweet grapes, amla - Vegetables= bottle gourd, ridge gourd, ash gourd, leafy greens - mung dal -light and etoxifying - rice, whole wheat - cow ghee-small amount, especially medicated ghee - coconut water - turmeric, coriander, fennel, cumin in cooking

AVOID -spicy, sour, fermented foods- pickles , vinegar - deep fired, oily, heavy-to-digest food - over consumption of salt - tea, coffee, alcohol, smoking - excess curd, cheese, panner - non veg food (esp red meat), at least during treatment

LIFESTYLE + YOGA + PRANAYAM

YOGA( 5-20 minutes daily) helps regulate immunity and nervous system. focus on gentle, cooling, and anti stress practices -balasana -shashankasana -viparita karani - supta baddha konasana

PRANAYAM -nadi sodhana -sheetali/sheetakari -bhramari

AVOID -over exertion - over heating - excessive sun exposure - irregular sleep

LONG TERM MANAGEMENT

-BE PATIENT= hair loss due to LPP is often irreversible in scarred areas. but progression can be slowed and some regrowth is possible in early, non scarred follicles

-Early intervention is crucial

-Stress is a major trigger-managing it is as important as medications

DO FOLLOW CONSISTENTLY

THANK YOU

HOPE THIS MIGHT BE HELPFUL

DR. MAITRI ACHARYA

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look there is no permanent cure as per your condition but we can try with some medication

Rx.- dadimashtak churna 1/2 tsf with leukworm water before food Mahamanjishtharishta 15 ml with equal amount of water Aamalki tablet 1 -0-1 tapyadi lauh 1 -0-1 Apply Gunja paste at patchy area

Avoid spicy ,oily and junke food

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Lichen planopilaris is a challenging condition as it’s an autoimmune and scarring form of alopecia. From a Siddha-Ayurvedic perspective, addressing the imbalance in your doshas, particularly focusing on pacifying Pitta and Vata doshas, is essential. To begin with, diet plays a crucial role. Favor foods that are cooling and nourishing, like ghee, warm milk, and fresh fruits such as pears and apples, while reducing spicy, oily, and processed foods which aggravate Pitta. Incorporate turmeric and neem as they have potent anti-inflammatory and immune-modulating properties; you can drink turmeric milk with a pinch of black pepper twice daily.

Apply a topical paste of aloe vera gel mixed with a small amount of bhringraj powder directly onto the scalp to soothe inflammation and promote hair regeneration. Leave it on for about 20-30 minutes, then rinse off with lukewarm water. Massaging the scalp gently with coconut oil infusions, perhaps with Brahmi or Amla, can help enhance blood flow and nourish the hair roots. Do this twice a week ideally in the evening before bed.

Focus on regular relaxation techniques to manage stress, which can exacerbate autoimmune responses, such as practicing yoga nidra or meditation for at least 20 minutes daily. While these measures target symptoms and underlying causes, it’s crucial to closely monitor changes or if conditions worsen. Consulting an Ayurvedic practitioner directly can further tailor these suggestions to suit your specific constitutional needs and ensure safety and appropriateness, especially alongside any current treatments you may be receiving.

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Giloyghan vati Kaishore guggulu Neemghan vati- 1 tab twice daily after food with lukewarm water Amlaki rasayana- 1 tsp with warm water at morning Mahamanjistadi aristha- 4 tsp with equal quantity of water two times daily

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Hello Karthick , what you’re facing lichen planopilaris (LPP) is an autoimmune scalp condition where your body’s own immune system is attacking the hair follicles, leading to patchy hair loss, redness, itching, and burning. In Ayurveda, this is seen as a combination of Pitta aggravation (causing inflammation), Rakta dushti (impure blood), and Vata blockage (preventing hair regrowth). Because it’s autoimmune, the root is deeper than just the scalp your immune system, blood, and skin metabolism are all out of sync. That’s why even after modern treatments, you didn’t get lasting results. The goal in Ayurveda is to cool the blood, detox the liver, reduce inflammation, and slowly bring the scalp back to balance so follicles stop shrinking. It takes patience, but it is treatable especially if the hair follicles aren’t yet fully scarred.

Internal Ayurvedic Medicines (8 weeks):

Panchtikta Ghrita Guggulu – 2 tablets twice daily after food Manjishtadi Kwatham – 15 ml + 45 ml warm water twice daily before meals Mahamanjishtadi Kwatham (if inflammation is high) – can alternate with above Saraswata Ghrita – 1 tsp at bedtime with warm water or milk Triphala Churna – 1 tsp at night with warm water (for regular detox)

External Treatment (3 times/week minimum):

Scalp lepa (paste): Mix Triphala churna + Yashtimadhu + Neem powder with rose water and apply on scalp patches for 20 mins before washing Oil application: Use Neelibhringadi taila + few drops Khadir taila – apply on scalp at night 2–3 times/week Hair wash: Use herbal hair wash with Triphala decoction or gentle reetha/shikakai powder Avoid chemical shampoos and hair dyes

Pathya (What You Should Eat & Follow):

Start day with warm water + 1 tsp ghee Eat cooling, blood-purifying foods: beetroot, pomegranate, moong dal, methi, spinach Soaked almonds (5) + raisins (7) + 2 dates in morning Add turmeric, manjistha, and guduchi powder in food if possible Practice Sheetali pranayama + Nadi shodhana for 10–15 mins daily Ensure early dinner and early sleep

Apathya (Strictly Avoid):

Spicy, sour, fermented, oily foods Tea/coffee, pickles, curd, vinegar Hair products with chemicals, dyes, heat treatments Stress, late nights, overthinking Fried snacks and dry fasting

Investigations (If not recently done):

Vitamin D3, B12, Ferritin ANA test (autoimmune screen) CBC + ESR + CRP (for inflammation levels) Thyroid profile

This condition will require at least 3–4 months of steady treatment, but with internal cooling, regular detox, and scalp healing, the hair loss can be arrested, and the scalp will begin to calm down. You’re still early in the condition which means you can absolutely reverse it naturally.

If you have any doubts, you can contact me. Take care, Regards, Dr. Karthika

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Don’t worry Karthick, First of all avoid excessive spicy, sour and salty food etc. And start taking1.Mahatiktak kwath 15 ml with 30 ml of lukewarm water empty stomach twice in a day. 2.Neem tab 1-0-1 3.Mahamanjishtadi kwath 20ml with equal amount of Lukewarm water empty stomach twice in a day. 4.Kaishore guggulu 1-0-1 for chewing… It will be taking some time but you’ll definitely get result… Follow up after 30 days…

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Along with these start taking 1tsf of Amalki choorna with Lukewarm water twice in a day. .

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Do follow:-

DIVYA DERMAGHRIT TAB=2-2 TAB BEFORE MEAL TWICE DAILY

DIVYA IMMUNOGHRIT TAB NUTRELA ZINC+VITC NUTRELA D2-K=1-1 TAB AFTER MEAL TWICE DAILY

KARANG BEEZ OIL=FOR SCALP MASSAGE (5 DAYS A WEEK)

COCONUT OIL=200ML MIX GANDHANK RASAYAN POWDER 25GM TANKAN BHASMA 5GM…MIX ALL AND SHAKE WELL APPLY ON SCALP AT NIGHT WEEKLY 2 DAYS…

AVOID SWEET/SUGAR/SPICY/JUNK FOOD

YOGA/PRANAYAMA=BHARMRI/UJJAI/UDGEETH

YOU CAN EAISLY CURED

CONSULT AFTER 1 MONTHS

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1 Bhringamalakadi Taila - extly apply and massage for 10 min. 2 times

2 Jeevamrita Leha or Chyavanaprasha Leha-1 tsf after food 2 times with milk

3.Shuddha Shilajatu-250mg+ Saptamrita Loha - 500mg+ bhringaraja Churna -3gm after food 2 times with honey and ghee Diet and Lifestyle Pathya: Fresh fruits, fresh vegetables, nutritious food, adequate sleep Apathya: Avoid salt, sugar, tobacco, and alcohol. Overconsumption of salt and sugar increases dandruff and hairloss. Avoid large amounts of vitamin A Avoid strong soaps, shampoo or hair sprays. Only use mild castile soaps. Hats and wigs are apt to cause hair to fall out faster, since they limit the air to the scalp.

Avoid tension, stress, worry and hurry.

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This will take time to show good results. Since auto immune recurrence is possible. Take mahamanjistadi kadha 10ml twice daily after food with water malaki rasayan 1-0-1 after food with water.

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HELLO KATHICK,

Lichen palnopilarish(LPP) is a form of scarring alopecia, an autoimmune condition where the body’s immune system attacks the hair follicles, leading to permanent hair loss and scalp inflammation. Modern treatments often focus on suppressing the immune system and controlling inflammation, but Ayurveda offers to manage the root cause , reduce inflammation and promotes scalp healing

LPP leads to permanent scarring, so early intervention is key. Ayurveda cannot reverse scarring, but it may help slow or stop progression and improve scalp health

In Ayurveda, LPP can be considered a tridoshic imbalance, primarily involving

PITTA DOSHA= inflammation, redness VATA DOSHA= dryness, hair loss RAKTA DUSHTI = impurity in blood KHA VAIGUNYA= damage to hair follicle channels

MANAGEMENT PLAN

INTERNAL MEDICATIONS

1) SARIVADYASAVA= 25 ml with equal water after meals twice daily =useful in chronic inflammation and autoimmune skin conditions with redness

2) MAHATIKTAKA GHRITA= 1 tsp with warm milk on empty stomach =deep acting, excellent for chronic skin and hair root damage

3) SOOTSEKHARA RASA= 250 mg with ghee twice daily after meals =actis as a Rasayana, for inflammatory autoimmune conditions

4) PANCHANIMBA VATI= 2 tabs twice daily after meals =specifically useful for pitta-raita aggravation seen in LPP

5) TRIPHALA GUGGULU= 2 tabs twice daily after meals =detox, anti inflammatory balances kapha vata

EXTERNAL APPLICATIONS

1) DURVADI TAILA =apply lukewarm on scalp at night =ideal for burning, redness, oozing lesions

2) KARANJA TAILA =antifungal, anti bacterial, often used in chronic dermatoses with scarring

HERBAL PACK -aloe vera + neem paste -hibiscus leaf paste -manjistha+rose water+multani mitti =apply 1-2 times a week for 30 minutes and wash off with herbal shampoo(amla reetha shikakai )

PANCHAKARMA THERAPY if condition is not responding to basic treatment panchakarma is highly beneficial

-VIRECHANA= for pitta detox -RAKTAMOKSHANA= leech therapy for scalp in chronic inflammation -SHIRODHARA= helps calm mind and head doshas

DIET

AVOID= spicy, sour, fried, fermented food

INCLUDE= cooling foods- coconut water, coriander, cucumber, ghee

Drink TRIPHALA WATER or TURMERIC MILK at night

LIFESTYLE -manage stress= meditation, yoga, bhramari pranayam

AVOID= excess sun exposure , heat. alcohol or stress

Maintain regular sleep= before 10 pm

Ayurvedic treatment needs patience and consistency

It cannot reverse hair loss from scarring but arrest progression

THANK YOU

DR. HEMANSHU MEHTA

807 answered questions
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HELLO KATHICK,

Lichen palnopilarish(LPP) is a form of scarring alopecia, an autoimmune condition where the body’s immune system attacks the hair follicles, leading to permanent hair loss and scalp inflammation. Modern treatments often focus on suppressing the immune system and controlling inflammation, but Ayurveda offers to manage the root cause , reduce inflammation and promotes scalp healing

LPP leads to permanent scarring, so early intervention is key. Ayurveda cannot reverse scarring, but it may help slow or stop progression and improve scalp health

In Ayurveda, LPP can be considered a tridoshic imbalance, primarily involving

PITTA DOSHA= inflammation, redness VATA DOSHA= dryness, hair loss RAKTA DUSHTI = impurity in blood KHA VAIGUNYA= damage to hair follicle channels

MANAGEMENT PLAN

INTERNAL MEDICATIONS

1) SARIVADYASAVA= 25 ml with equal water after meals twice daily =useful in chronic inflammation and autoimmune skin conditions with redness

2) MAHATIKTAKA GHRITA= 1 tsp with warm milk on empty stomach =deep acting, excellent for chronic skin and hair root damage

3) SOOTSEKHARA RASA= 250 mg with ghee twice daily after meals =actis as a Rasayana, for inflammatory autoimmune conditions

4) PANCHANIMBA VATI= 2 tabs twice daily after meals =specifically useful for pitta-raita aggravation seen in LPP

5) TRIPHALA GUGGULU= 2 tabs twice daily after meals =detox, anti inflammatory balances kapha vata

EXTERNAL APPLICATIONS

1) DURVADI TAILA =apply lukewarm on scalp at night =ideal for burning, redness, oozing lesions

2) KARANJA TAILA =antifungal, anti bacterial, often used in chronic dermatoses with scarring

HERBAL PACK -aloe vera + neem paste -hibiscus leaf paste -manjistha+rose water+multani mitti =apply 1-2 times a week for 30 minutes and wash off with herbal shampoo(amla reetha shikakai )

PANCHAKARMA THERAPY if condition is not responding to basic treatment panchakarma is highly beneficial

-VIRECHANA= for pitta detox -RAKTAMOKSHANA= leech therapy for scalp in chronic inflammation -SHIRODHARA= helps calm mind and head doshas

DIET

AVOID= spicy, sour, fried, fermented food

INCLUDE= cooling foods- coconut water, coriander, cucumber, ghee

Drink TRIPHALA WATER or TURMERIC MILK at night

LIFESTYLE -manage stress= meditation, yoga, bhramari pranayam

AVOID= excess sun exposure , heat. alcohol or stress

Maintain regular sleep= before 10 pm

Ayurvedic treatment needs patience and consistency

It cannot reverse hair loss from scarring but arrest progression

THANK YOU

DR. HEMANSHU MEHTA

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Lichen planopilaris (LPP) can indeed be challenging. In Ayurveda, conditions like these are primarily associated with an imbalance in Pitta dosha leading to inflammation, which manifests as redness and discomfort. You’ll wanna work on pacifying Pitta to support your healing process.

Lets start with your diet. Aim to include cooling and anti-inflammatory foods. Aloe vera juice, coconut water, and pomegranate are good options. Include Bhringraj (Eclipta alba) because it’s nomally used for promoting hair health. You can find it in powder form; take around 1 teaspoon with water daily.

Your lifestyle matters too—stress reduction is crucial since stress can exacerbate autoimmune conditions. Try practicing yoga, especially poses like Bhujangasana (cobra pose) and Shavasana (corpse pose), these can be calming. Regular meditation can also help stabilize your mind.

For external application, use a cooling herbal oil too, such as Brahmi oil, massaged gently on the scalp. You might find relief using a warm infusion of neem leaves to wash your scalp. Boil the leaves in water, strain, and let it cool before applying. Neem is known for its cooling and antiviral properties.

Remember to keep your scalp clean, avoid chemical-laden products, and stay hydrated. Consistant hydration supports detoxification and helps in maintaining healthy skin.

It’s worth discussing these options with your Ayurvedic practitioner, particularly if you’re already taking medications, to ensure there’s no interference. And, because LPP can lead to scarring, you might wanna always keep in touch with your dermatologist or healthcare provider to monitor your condition. They might offer more targeted treatments if the scarring progresses. Take care of yourself!

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