What is Scarring Alopecia

Know About The Facts, Causes, Treatments for Scarring Alopecia

Scarring alopecia is a condition in which a person suffers hair loss and baldness. There is permanent destruction of hair follicles so that hair cannot grow back. It starts with small patches of baldness that expand with time. Since there is gradual hair loss, the condition is not noticeable by the patient, until the baldness becomes extreme. It may be accompanied by itching and burning sensation on the scalp.

The incidence of scarring alopecia ranges between 3% and 7% of the population. It can affect both men and women. Since the hair will not grow back, it causes stress among people suffering from it. Also known as Cicatricial alopecia, patients will experience hair loss gradually over a period of time, but it could be quite rapid and affect the person in just a few months. The hair follicle gets destroyed. Also, the patients experience discomfort on the scalp, including inflammation, scaling and pigmentation.

Types of Scarring Alopecia

Scarring alopecia can be primary, secondary or developmental. Primary scarring alopecia occurs when the destroying of hair follicles take place. Fibrous tissue takes its place, preventing re-growth. It is called primary scarring alopecia because the disease begins with complete destroying of the hair follicle. The skin of the scalp becomes smooth and shiny, with an absence of pores and follicular openings. Primary cicatricial alopecia has no known causes as there is no identifiable cause.

Secondary scarring alopecia is identified when the hair follicles are not destroyed directly. They face damage as a result of skin inflammation which leads to their destruction. This is also an irreversible condition. It is because of skin conditions, damage due to burns or diseases such as cancer, or psychological trauma.

The third type of primary scarring alopecia is called developmental or hereditary. It is due to genetic factors, hormone imbalances or natural hair loss due to ageing.


Bald patches on the scalp are the primary symptoms of scarring alopecia. Initially, the bald patches are smaller. But, they spread and become bigger with time. The skin has a smooth and shiny look and absence of skin pores. Accompanying symptoms may include discomfort on the scalp such as itching or burning sensation, pain, rough and scaly skin and sometimes blisters as well.


The causes of scarring alopecia are not known and therefore it is challenging to diagnose and treat. One factor is the inflammation on the scalp but this is not necessary. It may also be caused by hot combs, pull on the hair due to hairstyles, and exposure to chemicals and pollution. It can also be due to an inflammation of the skin, occurrences such as injuries and burns, diseases such as cancer and genetic factors.


Usually, the condition requires careful examination of hair and scalp. A scalp biopsy may be required for the diagnosis of scarring alopecia. Patient history, age, skin or scalp conditions are examined to arrive at a proper diagnosis. The doctor may also conduct a microscopic examination of the pores on the skin. A hair pull test can show the extent of damage to the hair follicles. If hair comes off in gentle pulling, the condition is confirmed.


Treatment for scarring alopecia consists of preventing further loss of hair. Since hair cannot be re-grown, covering the scalp with hair systems and wigs is the only solution. The doctor may prescribe medicines for reducing inflammation symptoms. Sometimes topical creams help in reducing itching and inflammation on the scalp, thus controlling the disease. In many cases, hair loss treatment consists of hair transplant which can attempt to re-grow hair on the bald patches. However, this treatment is applicable only if a small amount of hair are present for transplantation.

Medicines that help in treating the disease are drugs for malaria and oral corticosteroids. Doctors recommend avoiding exposure to the sun and using sunscreen creams and lotions.

Preventive Steps

Since the disease will claim your hair and cause permanent baldness, it is important to care for your hair and delay its onset. Patients are advised avoidance of hair care products that contain chemicals. It is important to protect hair from sunlight. One should also avoid hair styling products such as heat treatments. If the condition does set in, covering the bald areas or hair transplant may be the last options.


Baldness is not a happy condition and it affects the self-esteem of sufferers.  Scarring alopecia is particularly harmful as the condition is irreversible. It is important to seek medical attention immediately after noticing hair loss because in early stages the inflammation can be controlled. It is essential to avoid harmful hair habits and maintain regular lifestyle habits. A good, nourishing diet may well prevent scalp diseases. It is important to delay the condition as far as possible through preventive methods.

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