Scarring Alopecia: How to prevent hair loss and regrow hair
Of all the hair loss causes, behind 7.3% of them is Scarring Alopecia.
Scarring Alopecia is a type of hair loss wherein the body starts attacking its hair follicles.
Since it damages the hair follicles, it is mostly irreversible.
If the symptoms are detected early, the treatment may help stop further hair loss and even reverse the condition.
Read on to educate yourself on this topic.
Scarring Alopecia
Scarring Alopecia is a type of Alopecia in which there is inflammation.
It is also called Cicatricial Alopecia.
Inflammation happens when the body starts attacking its cells. In this case, the body attacks the hair follicles.
It destroys hair follicles and causes Scarring and permanent hair loss.
Types of Cicatricial Alopecia
The two types of Scarring Alopecia are Primary and Secondary Scarring Alopecia.
Primary Scarring Alopecia
Primary Scarring Alopecia results from an autoimmune disorder or inflammation that directly targets the hair follicles and destroys them.
There are several examples of hair fall types that come under primary Scarring Alopecia:
Lichen Planopilaris
It results in inflammation of the hair follicles and scalp. It causes permanent patches of hair loss and Scarring.
Generally, it happens on the head.
Folliculitis Decalvans
In it, you may have peripheral pustules on the scalp.
It is a rare, chronic condition in which a patch of Alopecia gets more prominent over time.
Frontal Fibrosing Alopecia
In this type of Scarring Alopecia, hair is lost on the front and sides of the scalp. It may also affect other body parts, the most common being the eyebrows.
It is better to detect it as early as possible since there is no way to restore hair once it is lost. However, it is possible to slow down the hair fall rate.
Dissecting Cellulitis of the Scalp
It is a type of hair shedding wherein patchy hair loss occurs. Boggy and pus-filled nodules are also seen with the hair fall.
Central Centrifugal Scarring Alopecia
It is a unique form of Scarring Alopecia.
In it, the hair loss starts from the crown or the vertex of the scalp and spreads in a centrifugal manner.
Secondary Cicatricial Alopecia
It occurs due to the destruction of hair follicles in the scalp and eyebrows. Scar tissues are the reason behind this.
It is also called Permanent Alopecia.
Symptoms of Scarring Alopecia
It is essential to recognize the symptoms of Cicatricial Alopecia as soon as it occurs.
Cicatricial Alopecia progresses at a different rate in different people.
While in some cases, it may happen slowly with too few symptoms, while in others, it can develop over a span of months.
It can lead to burning, itching, and even pus formation.
The sooner the hair loss problems are detected, the better their chance of being stopped. Also, it will ensure that more treatment choices are available to you.
Here are the symptoms of Scarring Alopecia:
- Bald patches on the scalp
It begins as a smooth, shiny bald patch on the scalp. These patches eventually lead to total baldness.
- Itching
There may be a burning or itching sensation on the scalp.
- Pain
There may be a pain in your scalp region.
- Pus formation
Pus formation may also occur in the scalp region.
- Rough skin
There may be rough or scaly skin on the scalp.
- Blisters on the scalp
Crusting or blistering on the scalp may happen.
Causes of Scarring Alopecia
Inflammation is the most common cause of Scarring Alopecia, and it can damage your hair follicles to a great extent.
It may also happen due to burns or a severe infection.
The inflammation may involve natural killer cells, lymphocytes, or other cell types.
Diagnosis
It may be challenging to diagnose Cicatricial Alopecia from the hair loss pattern and scalp skin.
Therefore, skin biopsies are done to check the type of Scarring Alopecia.
A minuscule biopsy of 2 mm to 4 mm is taken and examined under a microscope by the dermatologist or pathologist.
They look for inflammation presence and location in the hair follicles, the damage to them, and the scar depth in the skin.
Treatment
To treat Scarring Alopecia, the first order of business is to treat the primary reason for the inflammation.
The following treatment step will be determined by your dermatologist based on the cause of hair loss.
Medications and injections
According to the Cleveland Clinic, anti-inflammatory medicines are the most common treatments for Scarring Alopecia.
Corticosteroid injections work, and anti-inflammatory medicines are available as creams and oils.
Antibiotics may also be used to treat inflammation caused due to bacteria.
Again as per Cleveland Clinic, most people need to take medicines for six months to one year till the hair fall slows or stops.
Depending on the status of the hair fall, you may need to continue taking medications.
Platelet-rich plasma therapy
In this, your body’s cells help your tissues heal and reduce inflammation.
It can help if you have Nonscarring Alopecia. However, even if you have Scarring Alopecia, you can use it in the case of some types, such as Lichen Planopilaris.
Hair transplant
In a hair transplant, hair is taken from where it is densely populated and grafted onto a place where it is not.
Although hair transplant is only sometimes an option, it can be used if there has been no new hair fall in recent years.
You should contact your dermatologist to see if you qualify for it.
Scarring Vs Non-Scarring Alopecia
The fundamental differences between Scarring and Non-Scarring Alopecia are as given below:
| Scarring Alopecia | Non-scarring Alopecia |
| The hair follicles are destroyed, and there can be no further hair growth as fibrous scar tissue replaces the hair follicles. | The hair follicles are not harmed, so hair growth afterward is possible. |
| Irreversible hair loss happens. | The hair loss is reversible. |
| It is rarer in occurrence. | It is more common. |
| Inflammation of the scalp happens in it. | There is minimum irritation or inflammation. |
| Itching and blistering of the skin and burning, rough and scaly skin are the symptoms of Scarring Alopecia. | Itching or burning of the scalp hardly happens. There is no rough and scaly skin or blistering. |
| Pus formation is also seen in Scarring Alopecia. | There is no pus discharge in it. |
| Pain may be there on the scalp. | No pain is experienced. |
Scarring Alopecia Vs Alopecia Areata
The significant difference between Scarring Alopecia and Alopecia lies in its reversibility.
Scarring Alopecia is irreversible, as the hair follicles are destroyed in it.
Alopecia Areata is reversible as the hair follicles are preserved and even reversible.
To conclude
As we saw in this article, some symptoms of Scarring Alopecia include- bald patches on the scalp, pus formation, pain, irritation, or burning of the skin.
Look out for these symptomsâ occurrence along with hair loss. If you experience these symptoms, seek a dermatologist as soon as possible.
Even though Scarring Alopecia permanently damages the hair follicles, you can still use medicines, injections, and surgical procedures if you are eligible for them to stop the further spread of Alopecia. It can even treat Alopecia, provided it is found on time.
Frequently Asked Questions
What does Scarring Alopecia look like?
Although it looks different on different people, it appears as a soft, shiny bald spot on the scalp. There may be one or several such areas.
Is Scarring Alopecia an autoimmune disease?
Primary Scarring Alopecia happens due to an autoimmune or inflammatory problem that damages the hair follicles.
How to tell if you have Scarring Alopecia?
A biopsy is done to examine whether you have Scarring Alopecia or not. The diagnosis depends on the type, location, and severity of inflammation.
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