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Cicatricial alopecia (also called scarring alopecia) is hair loss driven by the destruction of hair follicles. Scarring alopecia causes permanent hair loss since hair cannot regrow once the follicle is destroyed.
What Is the Cause of Cicatricial Alopecia?
Causes for cicatricial alopecia can range from inflammatory or autoimmune disorders to skin injuries, burns or certain medical treatments. No matter the cause, there are commonalities.
In the majority of cases of scarring alopecia, there’s inflammation surrounding the middle (bulge) of your hair follicle. This area contains stem cells and oil glands needed for new hair growth. The inflammation destroys this part of the follicle. Scar tissue then grows (fibrosis) over the area, preventing regrowth of the hair.
In non-scarring alopecia, the damage is usually to the base (bulb) of your hair follicle, not the bulge. This is why hair can sometimes be regrown if you suffer non-scarring varieties of alopecia.
What Does Cicatricial Alopecia Look Like?
Scarring alopecia usually presents itself as one or more bald patches. The skin where hair used to be usually looks smooth and shiny due to the scar tissue. In some cases, symptoms such as redness, flaky skin, or blisters can manifest.
How Is Cicatricial Alopecia Treated?
Treatment methodology depends on the specific variety of cicatricial alopecia you have. In most cases, anti-inflammatory medication is a key element of treatment. These medications fight the inflammatory cells destroying the hair follicles. These medications can be topicals, oral medications (such as hydroxychloroquine), or injections like triamcinolone acetonide.
In cases caused by bacteria and infections antibiotics, such as doxycycline or minocycline, are used in treatment. In either case, most people using medication must do so for six to 12 months in order to see improvement or slowing of hair loss. In addition, some cases require a resumption of medication if hair loss starts again once initial treatment ceases.
Can Hair Grow Back After Scarring Alopecia?
Scarring alopecia causes permanent hair loss as hair cannot regrow from destroyed follicles. If caught very early, medications may be able to stop the inflammation before it completely destroys the hair follicles, improving chances of regrowing the lost hair.
Is Cicatricial Alopecia Reversible?
Due to the destruction of the follicle, hair loss from cicatricial alopecia is not reversible. Its progress can sometimes be arrested if caught early and proper treatment regimens implemented. If the scarring alopecia only occurs in a small area, a hair transplant may be an option to cover up the damaged area.
What Triggers Scarring Alopecia?
Triggers vary and can include infections, chemicals, burns or autoimmune disorders, among others. Some common conditions that cause cicatricial alopecia include the following:
- Folliculitis decalvans
- Central centrifugal cicatricial alopecia (CCCA)
- Discoid lupus erythematosus
- Lichen planopilaris (LPP)
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