Scarring alopecia

Scarring alopecia, also known as cicatricial alopecia, is a form of hair loss that occurs due to the destruction of hair follicles and their replacement with scar tissue. Unlike other forms of alopecia, scarring alopecia can cause permanent hair loss due to the irreversible nature of the scarring process. This condition can affect individuals of any age, gender, or ethnicity, but its prevalence and specific characteristics can vary.

Causes

Scarring alopecia can result from a variety of causes, including inflammatory skin conditions, infections, and other diseases that may affect the scalp. Some of the common conditions leading to scarring alopecia include:

• Lichen Planopilaris: An inflammatory condition that leads to progressive hair loss and scarring.
• Folliculitis Decalvans: A rare disorder that causes inflammation and scarring of the hair follicles.
• Frontal Fibrosing Alopecia: A form of lichen planopilaris that primarily affects postmenopausal women, causing hair loss at the front of the scalp.
• Discoid Lupus Erythematosus: A chronic autoimmune disease that can cause scarring alopecia when it affects the scalp.

Symptoms

The symptoms of scarring alopecia can vary depending on the underlying cause but generally include:

• Gradual thinning of hair on the scalp
• Patchy hair loss with smooth, scarred areas on the scalp
• Itching, pain, or tenderness in the affected areas
• Presence of redness, scaling, or pustules around hair follicles

Diagnosis

Diagnosis of scarring alopecia typically involves a thorough examination of the scalp, medical history review, and may include:

• Dermoscopy: A non-invasive method that allows for the magnified examination of the scalp and hair follicles.
• Biopsy: A small sample of scalp tissue is taken and examined under a microscope to determine the presence of scarring and identify the underlying cause.
• Blood tests: These may be conducted to check for signs of autoimmune diseases or other underlying conditions.

Treatment

Treatment for scarring alopecia aims to halt the progression of hair loss and manage any underlying conditions. Options may include:

• Anti-inflammatory medications: To reduce inflammation and prevent further hair follicle damage.
• Immunosuppressive drugs: Used in cases where autoimmune diseases are the cause.
• Antibiotics or antifungal medications: If an infection is the underlying cause of hair loss.
• Hair transplantation: In some cases, surgical options may be considered to restore the appearance of the hair, although this is not suitable for all individuals.

Prognosis

The prognosis for scarring alopecia varies depending on the cause and the effectiveness of the treatment. Early diagnosis and intervention can help manage the condition and prevent further hair loss, but complete regrowth of hair in scarred areas is unlikely due to the permanent damage to hair follicles.