Scarring alopecia is a permanent hair loss condition caused by the destruction of follicles and the development of scar tissue. It can be primary or secondary, and treatment options vary depending on the cause. After treatment, patients can consider hair styling, shaving, implants, or wigs to cover the patch.
Scarring alopecia is a type of permanent hair loss in which follicles are destroyed and scar tissue develops in their place. It is also known as scarring alopecia and can occur in people of all genders and ages. Doctors divide the condition into two forms, primary and secondary, depending on whether it is caused by a problem with the hair follicles or occurs secondary to a larger health problem such as cancer or systemic lupus erythematosus. This condition needs to be treated aggressively if patients want to retain as much hair as possible.
Cases of scarring alopecia usually start out small and low-grade. A small bald patch begins to develop and will not be visible unless the patient has very short hair. Over time, the patch expands and takes on a bumpy, rough appearance. Scarring alopecia will progress through the skull, gradually destroying hair follicles along the way. If treated, it can be stopped, keeping hair loss localized. A biopsy will be needed to diagnose scarring alopecia, and the sample can be examined in a laboratory to learn more about why it’s happening.
Primary scarring alopecia is usually the result of an inflammatory process in the hair follicles, often caused by a bacterial or fungal infection. Treatment may involve medications to kill the causative organism and address the inflammation. Things like topical steroids can be applied to reduce swelling and prevent inflammation from spreading to nearby, healthy follicles. Once the problem is fixed, the hair loss should stop.
In secondary cases, where it is associated with an underlying problem, treatment options vary. Addressing the cause may resolve scarring alopecia, but not necessarily. With cancers, for example, the patient may already be undergoing treatment and the alopecia may be the result of failed treatment or it may actually be caused by the treatment, as radiation can cause hair loss, sometimes permanently. A doctor can discuss options such as treating scalp inflammation to see if this will help slow or stop hair loss.
After a patient has recovered from scarring alopecia, there are a number of options for dealing with hair loss. Growing the hair close together and carefully styling it may allow the patient to cover the patch. Patients may also choose to shave, or consider getting implants or wearing a wig to hide scarring and hair loss. Doctors can discuss options with their patients and provide them with referrals. Patients may also find it helpful to seek out alopecia awareness organizations to connect with other patients and gain insight into methods of coping with hair loss.
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