Scarring Alopecia: Signs, Symptoms, Causes, and Treatment

Photo credit: Bigstockphoto
Photo credit: Bigstockphoto

Cicatricial alopecia – known simply as scarring alopecia – is an umbrella of hair loss disorder that affects about 3% of hair loss patients. This is a rare form of alopecia that affects men and women of all ages in the world.

Although a part of several hair loss disorders, scarring alopecia may also serve as a symptom to autoimmune diseases such as chronic lupus erythematosus. Scarring alopecia also comes in many forms and all types cause irreversible destruction of the hair follicles.

Signs and Symptoms of Scarring Alopecia

Most patients experience gradual hair loss without symptoms. The hair loss goes unnoticed for long periods until hair starts thinning out. However, some patients report severe itching, burning sensation and pain as the condition progresses.

As the scalp becomes inflamed, the underlying hair follicles are destroyed for good. Despite the name, scarring alopecia does not cause visible scarring on the scalp. But there will be signs of inflammation through pustules, redness, and scaling. Because this is a progressive condition, the extent of hair loss is unpredictable.

Causes of Scarring Alopecia

The cause of scarring alopecia remains unknown. Health experts are divided over the reason why this condition occurs. However, scientists agree that inflammation is the key factor that causes the destruction of hair follicles, stem cells, and sebaceous gland. When the stem cells and sebaceous gland are destroyed, the hair follicles will not grow back. This condition is neither contagious nor passed through genetics.

Treating Scarring Alopecia

Diagnosing scarring alopecia requires classifying the inflammatory cells that attack healthy hair follicles. You will go through several tests to determine what’s causing the inflammation. From there, your doctor will develop the right treatment plan for you.

Your doctor will likely prescribe anti-inflammatory medications including hydroxychloroquine, doxycycline, mycophenolate mofetil and corticosteroids. Topical corticosteroid creams may also be prescribed. For alopecia caused by certain pathogens, oral antibiotics and isotretinoin are usually prescribed to keep hair loss at a minimum.

Once the symptoms stopped, your doctor could also stop the treatment. However, scarring alopecia tends to come and go. It will have periods of remission and reactivation throughout your lifetime.

Do note that some alopecia meds cause certain side effects. As such, consult with your doctor about the potential effects of the medication. Also, note that the meds are not meant to restore hair follicles. They are only taken to reduce inflammation. This means these drugs will not restore hair growth nor promote re-growth. Once the hair follicles are destroyed, they are destroyed for good.

The key to reducing hair loss is early detection. If the condition is detected early, seek treatment right away. From the initial consultation, talk to your doctor about treatment options and results you can expect after treatment.

Other Factors to Consider

You can reduce the extent of the damage caused by scarring alopecia by using gentle, non-irritating hair care products. For those who suffered significant hair loss, we recommend using hairpieces, wigs, hats as well as scarves. You can also talk to your doctor about the ideal hair regrowth treatment for you.


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