Scarring Alopecia

When cicatricial alopecia is suspected, skin biopsies are done to identify the particular type of alopecia. A 2-4 millimeter biopsy is taken and examined by the dermatopathologists in the laboratory under laboratoryunder the microscope. In the early stages, inflammatory cells will be present around the hair follicles which induces the destruction of scar tissue. After a while, the bald patches stop expanding and all the pain goes away. In the final stage, a biopsy will no longer show any inflammation and only a few longitudinal scars will be left to show where the hair follicles were present.

What causes scarring alopecia? The scarring alopecia causes are not yet completely known or understood. However, all forms of cicatricial alopecia involve inflammation at the upper part of the hair follicle. This is where the stem cells and the sebaceous glands are located. In cicatricial alopecia, these stem cells and sebaceous glands are destroyed leading to no possibility of regeneration of the hair follicle. Therefore, there is permanent hair loss. The good part is that cicatricial alopecia is not contagious.

Scarring alopecia treatment options are limited. The nature of scarring alopecia treatment depends on the diagnosis and the progressiveness of diease. The ones that have lymphocyte inflammation, such as lichen planopilaris, are treated with corticosteroids in the form of creams or injections. Antimalarial and isotretinoin drugs are also used in some cases. In the case of neutrophils, antibiotics and isotretinoin are used and experimental drugs like cyclosporine and tacrolimus have also been used.

Scarring Alopecia Types

The types of scarring alopecia include primary, secondary, and hereditary.

• Primary scarring alopecia occurs when hair follicles are destroyed and replaced by fibrous tissue. Since the stem cells in the hair root are destroyed, this type of scarring alopecia leads to irreversible hair loss.
• Inflammatory cells like lymphocytes, neutrophils, or a combination of these can cause primary scarring alopecia.
• Secondary scarring alopecia results from damage to hair follicles caused by inflammation. This hair condition occurs when the follicles are destroyed due to burns, trauma, or radiation therapy.

Symptoms of Scarring Alopecia

• Scarring alopecia begins with the development of shiny and smooth bald patches on the scalp which eventually lead to almost total baldness.
• There is itching and a burning sensation on the scalp.
• Pain is experienced in the scalp region.
• This hair condition may cause pus in the scalp region.
• Scarring alopecia symptoms also include blisters and crusting on the scalp.
• Patches of rough and scaly skin may be seen.

Scarring Alopecia Treatment

• Corticosteroids may be injected into the inflammatory lesion, as a treatment for alopecia, as this method helps control hair loss.
• Oral retinoids and oral immunomodulators are other good ways to treat this hair condition.
• Sun protection for the scalp is often recommended.
• Using shampoo may help in treating hair conditions.