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What is Cicatricial (Scarring) Alopecia?

what is cicatrical scarring alopeciaCicatricial alopecia – also known as scarring alopecia – is one of several different types of hair loss. It is an inflammatory condition that causes the hair follicles to be damaged or destroyed. This can cause permanent hair loss and often results in scarring.

The symptoms may appear differently depending on the person and cause. It can develop over long periods or can present more quickly over days or weeks. Some people experience itching, burning, redness, scaly skin, or pustules… while others may only notice the resulting hair loss.

What Triggers Scarring Alopecia?

Scarring (cicatricial) alopecia is usually caused by inflammation or trauma such as burn damage. The condition is seen in both men and women… but rarely in children. This form of hair loss is not considered hereditary, and the causes are not completely understood. Research has shown that inflammation from a variety of sources can lead to the destruction of stem cells, oil glands, and hair follicles which can ultimately lead to hair loss.

According to the American Skin Association, the main known causes for scarring alopecia include (but are not limited to):

  • fungal infection
  • chemicals such as hair relaxers
  • mechanical traction
  • inflammatory disorders

Related inflammatory disorders include “discoid lupus erythematosus, lichen planopilaris, dissecting cellulitis, tufted folliculitis, folliculitis decalvans, alopecia mucinosa, central centrifugal cicatricial alopecia, and acne keloidalis”. These underlying causes can result in a few different types of inflammation by particular cells including lymphocytes and neutrophils (both a type of white blood cell), or mixed inflammatory cells.

How Can You Tell The Difference Between Scarring And Non-Scarring Alopecia?

Determining the type of hair loss that a person is experiencing requires an in-office examination with a health care provider. The appearance of the scalp and hair can help determine whether someone has alopecia and what form of alopecia. Tests such as a biopsy of the area can provide information on the severity of any existing conditions and help your provider determine a diagnosis.

Can Hair Grow Back After Scarring Alopecia?

The Cicatricial Alopecia Research Foundation (CARF) states that “Hair will not regrow once the follicle is destroyed. However, it may be possible to treat the inflammation in and around the surrounding follicles before they are destroyed and for this reason it is important to begin treatment as early as possible to halt the inflammatory process.

While cicatricial alopecia is not technically reversible, treatment options can slow its spread and reduce the appearance of hair loss.

How Is Cicatricial Alopecia Treated?

Treatment of scarring (cicatricial) alopecia will depend greatly on the underlying causes. An examination and tests will be needed to provide a diagnosis that will help inform the appropriate treatment plan.

As mentioned above, there are a few types of inflammation that can cause cicatricial alopecia. The course of treatment will depend on which type is attacking the hair follicles.

Lymphocytic and neutrophilic inflammation is generally treated with oral, topical, or injectable anti-inflammatory medications. The treatment for mixed cell group cicatricial alopecia may include anti-microbials, anti-inflammatory medications, and tumor necrosis factor inhibitors. If nodules exist on the scalp they may also need to be incised and drained to encourage healing.

The course of treatment may last several months or longer. In some cases, medication may be required over the long term to prevent further hair loss and encourage growth.

RHRLI Are the Experts in Hair Restoration

At RHRLI we provide a variety of treatment options to address many different types of alopecia. Advancements in the treatment of hair loss – such as the FDA-approved ARTAS® Robotic Hair Transplant System – can help you get confidence-boosting, natural-looking results. To schedule a free consultation and scalp assessment, contact us today to get started.

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