Scarring Alopecia

Scarring Alopecia

Nowadays, hair loss and hair fall are common disorders. There can be various reasons behind hair loss such as the destruction of hair follicles and stem cells are the main reasons. With the new modes of technology and various methods of hair treatments, it is possible to solve the hair disorders that help a person to regrow their hair.

What is Scarring Alopecia

Cicatricial Alopecia is another name for scarring alopecia. It is a hair loss disorder that occurs in both healthy men and women. The hair tissues get replaced or destroyed by fibrous tissues and the hairs will not grow again. Sometimes, the scarring Alopecia results in permanent baldness. Non-scarring Alopecia includes Alopecia areata (hair loss on body or scalp) and Androgenetic Alopecia (common hair loss disorder).

If you are also suffering from hair disorders like scarring alopecia, alopecia areata, and traction alopecia then first you should consult with a good and qualified surgeon. After his recommendations, follow the instructions for the treatment of hair loss disorder. You can also visit the website name for more information about the type of hair loss disorder.

There are three types of scarring alopecia given:-

  • Primary Alopecia: Here, the main target of destruction is the hair follicle. Because of the destruction of stem cells, hair will not regrow. Primary Alopecia is divided into two parts:-
  1. Neutrophilic or mixed Alopecia targets adults and adolescent males. Under this, Dissecting cellulitis falls.
  2. Lymphocytic Alopecia:- This alopecia causes lichen planus follicularis, brocq pseudopelade, frontal fibrosing alopecia, and others.
  • Secondary Alopecia is irreversible and it occurs due to cancers, burns, and radiation therapy (Follicles are destroyed).
  • Developmental Alopecia can be caused because of the main factors as an imbalance of hormones, due to aging, and genetics. It is called men and women pattern baldness. 

The main symptoms of starting alopecia you can face are patches on the scalp, pain, crusting, itching, and burning of the scalp. It also shows symptoms that include erythema and follicular plugging. The skin patches have a shiny appearance. The symptoms depend on the type of alopecia.

Traction Alopecia

The term is commonly used to describe hair loss that is caused by repetitive tension. People of different backgrounds can be affected by traction alopecia. This may affect the temporal and frontal scalp. It depends on the hair care routine of the patient.

The main causes of traction alopecia are the use of hot combs, telogen conversion, by using hair softeners, hair treatment with dyes, beaches, and the use of straighteners. The other causes may include high ponytails, tight caps, braids, weaves, and turbans (it affects Sikhs mostly). The main symptoms of traction alopecia are dandruff and itching problems, patchy areas, and permanent hair loss.

Causes of Scarring Alopecia

Inflammation is the main factor in scarring alopecia because it is responsible for the destruction of oil glands and stem cells which lead to fibrosis or hair loss. Early intervention is the prevention of hair loss. This alopecia is rarely found in children. Hair care habits such as the use of hot combs, excessive traction, and relaxants are responsible for women.

The main causes are inflammation, factors like burns, tumors, injuries, generic factors, HFSC’s self-maintenance, and hair follicle destruction. The causes are not understood by the experts properly. It generally affects all age groups including adults, men, and women. 

Diagnosis of cicatricial or Scarring Alopecia

The diagnosis of primary scarring alopecia helps to understand the condition and reveals the history which helps in knowing the condition better. Inflammation nature is important to identify the suitable treatment.

Dissecting cellulitis usually occurs in adult males and folliculitis decalvans can be seen in adolescent males and adults. Lichen plant follicular is the cause of scarring or cicatricial alopecia.

  • The diagnosis of cicatricial alopecia is performed and based on proper examination and research of the scalp and hair. It should be done by a well-experienced trichologist.
  • Initial classification and overall evaluation help in the further diagnosis process and give an overview of the best treatment options that can be done to solve the hair problem.
  • It is very important to know the history of the patient including the age, skin, and condition of the scalp. Some typical signs like burning and itching on the scalp help in the process of diagnosis.
  • A patient’s age is an important factor that should be considered. Forms of scarring alopecia usually occur in adult life.
  • A hair pull test is better to perform because it helps in understanding the condition of hair follicles. A hair pull test is considered positive when hairs are removed easily on pulling and ensures that alopecia is spreading.
  • The scarring alopecia diagnosis is based on factors such as examination of the scalp, patient’s age, previous skin or hair scalp condition, symptoms like burning and discharge from the scalp, absence of pores, scalp biopsy, and hair pull test. 

Treatment of cicatricial or scarring Alopecia

The main aim of the treatment is to reduce and prevent hair loss. With the help of Hair transplantation, bald patches can be covered. The treatment options may vary or depend on the specific type.

  • Scarring alopecia which is caused by lymphocytes such as frontal alopecia and lichen planopilaris is treated with the help of oral therapies. Corticosteroid injection is used for the treatment that helps in reducing hair loss. Injections may be required based on your treatment.
  • Oral medications (including oral retinoids and antimalarial drugs) are used to treat lymphocytic. In some cases, a sunscreen agent is used with SPF (Sun protection factor). Topical antibiotics are used as a supplement to oral antibiotics. Small doses of isotretinoin may help in the treatment of dissecting cellulitis.
  • The patients are also recommended to consult a dermatologist who can explain in detail the  side effects and tests required to be performed.
  • The other  side effects of lymphocytic scarring alopecia include skin hyperpigmentation, anorexia, abdominal pain, and ophthalmologic damage. Regular monitoring is required for the patients taking the treatment for 4 to 6 months. Steroid dermal atrophy is caused by the excessive use of steroids.
  • Scarring alopecia which is caused by neutrophils can be treated with oral antibiotics in some cases. Dissecting cellulitis is treated by using isotretinoin. The common side effect is diarrhea i.e. caused by the use of antibiotics. The summary of lymphocytic scarring alopecia includes antiseptic shampoos, oral retinoids, and antibiotics.
  • Surgical treatment is also done for scarring alopecia in people showing lesions. The surgery may be required if the hair loss (caused by inflammation) is under control. The patients can go with the treatment or surgery for scalp reduction.
  • Continue the treatment till the signs and symptoms of inflammation are  controlled or redness, pain, itching, burning, and tenderness have  stopped. You can discontinue the treatment after the stoppage of these signs.

Steps to maintain hair care routine

  • It is very important to take proper care of your hair especially when you are suffering from hair loss disorders like scarring alopecia.
  • In case of hair loss disorder, you should consult with a hair specialist. After the consultation, Use the hair products suggested by the hair specialist (known as a trichologist).
  • Avoid using shampoos,  soaps and styling products that can be rough and harsh on the scalp because the products contain chemicals that can irritate the scalp.
  • Use home remedies and ayurvedic shampoo (which contains natural ingredients like shikakai, neem, amla, indulekha, etc with no harmful chemicals) that help in hair management.
  • Take the antibiotics regularly if suggested to you. Protect the scalp from sunlight or UV rays by wearing a hat. To hide the bald patches use hair pieces or wigs to cover the area.
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