Scarring Alopecia

Scarring Alopecia is also known as Cicatricial Alopecia where the hair follicles get destroyed and that particular places are replaced with the scar tissues. This disorder may lead to permanent hair loss and people of all ages and genders except the healthy ones can be affected with this form of alopecia.

Forms:
Two types of Scarring Alopecia are there. In the primary form, the hair follicles are targeted directly and in case of the secondary one, hair follicles are the onlooker only. The reason for the secondary one can be an infection, a severe burn, radiation or tumor. To be more specific regarding its forms, the following list can be provided:

Those linking typically lymphocytes:

  • Lichen planopilaris (LPP)
  • Frontal fibrosing alopecia
  • Central centrifugal alopecia
  • Pseudopelade of Brocq

Those involving generally neutrophils:

  • Folliculitis decalvans
  • Tufted folliculitis

Those connecting both (called mixed inflammatory infiltrate):

  • Dissecting cellulitis
  • Folliculitis keloidalis

Cause of Scarring Alopecia:
The main reasons of Scarring Alopecia are barely understood. Redness, inflammation, pain or swelling are seen at the upper part of the hair follicle. Here the sebaceous gland and the stem cells are located. If these are diminished, hair follicles stop producing hairs forever. Basically, this type of alopecia is not associated with any other sickness.

Symptoms:
Basically gradual or progressive hair loss is seen with severe itching, burning sensation, swelling or pain, redness, increased or decreased, draining sinuses etc.

Diagnosis:
The physician can ask for a scalp biopsy, which can provide information about the severity of the problem, involvement of the cells, issue regarding the inflammation, etc.
In addition, a doctor can go for hair-pull test, a clinical evaluation of the scalp or a microscopic evaluation of the hair bulbs. These processes would reveal the details regarding such alopecia and the doctor can start providing proper treatment thereafter.

Treatment:
Because the loss and damage of hair in cicatricial alopecia is permanent and the hair does not grow back, it is significant to start treatment at the primary level. The specific treatment varies and they generally depend largely on whether lymphocytes, neutrophils, or both are predominantly responsible for the destruction of hair follicle.

In major cases, lymphocytes are responsible and these issues are treated with corticosteroids creams or injections. Besides, antimalarial and isotretinoin drugs can also be used. Typical treatments may involve antibiotics and drugs like methotrexate, tacrolimus, cyclosporin, and thalidomide.
If the problem becomes extensive enough and the patient experiences baldness, then, surgical process is the only way out in that case. Hair transplantation or scalp reduction can be done for treating that disorder.

But, every patient has to consult a dermatologist before opting for any sort of medication or surgical process. That will allow them to get the best possible outcome.


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