Hair Scarring Alopecia

Hair Scarring Alopecia

This is another form of alopecia although less common than androgenic alopecia male pattern baldness and alopecia areata. But it is still as distressing as other hair loss conditions. Scarring alopecia is characterised by areas of scar tissue which is not visible to the naked eye but nevertheless, is painful for the sufferer.

Another name for this form of alopecia is 'cicatricial alopecia'.

There are two types of scarring alopecia:

  • Primary
  • Secondary

The primary version of scarring alopecia affects the hair follicles only. With the secondary version, damage to the hair follicles occurs following an accident or injury, e.g. severe burns.

Who is most affected by scarring alopecia?

Scarring alopecia affects both men and women of all ages.

Difference between scarring alopecia and other hair loss conditions

The main difference is the formation of scar tissue following the destruction of hair follicles. This scar tissue cannot be seen on the surface of the scalp but causes redness, itching and a burning sensation which is uncomfortable. Small blister like swellings may form on the scalp.

Once the hair follicles have died they are unable to grow new hair, resulting in a gradual loss of hair over a period of time.

This hair loss is permanent.

Causes of scarring alopecia

This hair loss is caused by several medical conditions which include:

  • Singles (infection of the nerve endings)
  • Scleroderma (disease of the connective tissues in the body)
  • Lichen planus (skin disease)
  • Trauma, e.g. burns, infections etc
  • Inflammation of the follicles
  • Lupus (autoimmune disease)

It also affects anyone who has undergone cancer treatment such as chemotherapy or radiation therapy.

There is a type of alopecia which causes scarring which occurs in women who have recently gone through the menopause. It is called 'frontal fibrosing alopecia' and causes irreversible damage to the hair follicles, leading to hair loss.

Diagnosis scarring alopecia

If you experience a red, itchy scalp and a loss of hair then visit your GP. He or she will ask you a series of questions about your condition before examining your scalp. He/she will be looking for signs of scaling, blisters and a general redness over the surface of the scalp.

You may be asked to carry out a 'hair pull' test in which you pull out a small sample of hairs. These hairs are examined under a microscope to see what stage they are at in the hair growth cycle. If there are more 'shedding' (telogen stage) hairs than 'growing' (anagen stage) hairs then this indicates this form of alopecia.

A scalp biopsy will also be performed to confirm a diagnosis.

Treatment for scarring alopecia

Hair loss drugs such as corticosteroids can be used to treat this condition either as a topical cream or an injection.

Another option is a hair transplant.