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Scarring alopecia, also known as cicatricial alopecia, is a condition where there is a potential permanent and irreversible destruction of hair follicles which leads to their replacement with scar tissue. It is a very rare form of alopecia and only occurs among 3% of healthy men and women of all ages.
Most forms of hair loss scarring alopecia start as small patches of hair loss that expand over a period of time. In a lot of cases, hair loss is gradual and without any noticeable symptoms. It also goes unnoticed for a long period of time. However, in some instances, it is associated with severe itching, burning, and progresses very quickly.
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When scarring 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.
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 disease. 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.
The main sign of cicatricial alopecia is hair loss. It usually results in localised hair loss, which means you lose hair in patches. Hair loss can begin gradually and progress over time. It might also begin abruptly and swiftly.
In addition to hair loss, some patients suffer from skin issues such as:
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