Scarring Alopecia

Scarring  (cicatricial) alopecia

Scarring alopecia or cicatricial alopecia refers to a diverse group of uncommon disorders that destroy hair follicles and surrounding sebaceous glands, resulting in permanent hair loss. Although more commonly seen in women, scarring alopecia can occur in men too.

This destructive process can present in different ways. In some cases, the hair loss is gradual with no symptoms, so the loss can go unnoticed for long periods. In other cases, the hair loss is rapidly progressive and associated with itching, burning and pain or discomfort.

Because the inflammation that destroys the follicle is below the skin surface, there is usually no visible scar on the scalp.  Instead, one sees a smooth, shiny area devoid of hair follicles with the affected areas of the scalp showing little, if any, signs of inflammation. Less commonly, the inflammation can be marked with the patient experiencing redness, scaling, pustules, draining sinuses and increased or decreased pigmentation. 

There are many different types of scarring alopecia and the primary scarring alopecia include: lichen planopilaris, frontal fibrosing alopecia, central centrifugal cicatricial alopecia. Secondary scarring alopecia include trauma, burns, radiation therapy, infection, traction, tumours. 

It is important to distinguish between the common male or female pattern hair loss with scarring alopecia. Very often, a scalp biopsy is required for confirmation. We do not treat scarring alopecia in our clinic and a hair transplant will not yield good results usually.