Could It Be Cicatricial Alopecia?

Cicatricial alopecia, also known as scarring hair loss, occurs when inflammation damages hair follicles, resulting in permanent hair loss and scar tissue formation. This condition is often the result of underlying medical issues, including autoimmune disorders, infections, or certain scalp diseases that disrupt and destroy hair follicle structures.

In some cases, external trauma such as burns or deep injuries can also lead to scarring hair loss. However, the majority of cases stem from internal inflammatory responses that impair the follicle’s ability to grow new hair.

Signs of Scarring Hair Loss
One of the most recognizable indicators of Cicatricial Alopecia is the appearance of smooth, shiny, scarred patches on the scalp where hair no longer grows

Types of Cicatricial Alopecia

Cicatricial (scarring) alopecia includes a range of disorders that cause permanent hair loss due to follicle destruction and replacement with scar tissue. These conditions are typically grouped into two main categories based on the type of inflammation present:

1. Lymphocytic Cicatricial Alopecia - This type involves a lymphocyte-driven inflammatory response.

• Lichen Planopilaris (LPP)
  An autoimmune condition where the immune system attacks hair follicles, causing inflammation and scarring. Often presents with itching, burning, and hair breakage.
• Frontal Fibrosing Alopecia (FFA)
  A subtype of LPP, most commonly seen in postmenopausal women. It causes a progressive recession of the hairline, often accompanied by eyebrow loss.
• Central Centrifugal Cicatricial Alopecia (CCCA)
  Most common in women of African descent. Starts at the crown and spreads outward, often with minimal symptoms initially. Linked to inflammation, genetics, and sometimes hair care practices.
• Discoid Lupus Erythematosus (DLE)
  A chronic autoimmune skin condition that can affect the scalp. It causes red, scaly plaques that eventually lead to scarring and permanent hair loss.

​2. Neutrophilic Cicatricial Alopecia - Driven by neutrophil (a type of white blood cell) activity and often associated with bacterial infections.

• Folliculitis Decalvans
  Characterized by painful pustules, crusting, and hair tufting. Often caused by bacterial infection and can lead to scarring if untreated.
• Dissecting Cellulitis of the Scalp
  A severe, inflammatory condition with painful nodules and abscesses that drain pus. Commonly affects young men and can result in extensive scarring.

3. Mixed or Unclassified - Some cases involve a combination of inflammatory cells or cannot be clearly categorized.

Specialized topicals and nutritional support can help strengthen the remaining healthy follicles and promote scalp health.

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