It can be frightening to find smooth patches of skin where hair was once present. Each case of scarring alopecia can appear differently in different people, but the same upsetting process is at work. We’re taking a deep dive into this guide to scarring alopecia so we can better understand this relatively rare condition that affects some 7% of people worldwide.
What Is Scarring Alopecia?
Scarring alopecia, also known as cicatricial alopecia, is a type of hair loss that occurs when hair follicles become damaged, leading to permanent hair loss. (Often characterised by painful, itchy patches of baldness with an inflamed or scarred appearance. )While it is not always clear what causes it, it can be a result of an autoimmune disorder, inflammation, or other skin conditions.
The National Organisation of Rare Diseases tells us, “Primary cicatricial alopecia refers to a diverse group of rare disorders that destroy the hair follicle, replace it with scar tissue, and cause permanent hair loss.
“Hair loss can be gradual, without symptoms, and unnoticed for long periods. In other cases, the hair loss may be associated with severe itching, pain and burning and progress rapidly. Cicatricial alopecia occurs in otherwise healthy men and women of all ages and is seen worldwide.”
What Causes Scarring Alopecia?
The exact cause of this condition is unknown, but it is believed to be related to certain medical conditions, genetic factors, and certain medications.
WebMD tells us that common medical conditions associated with scarring alopecia include:
- Lichen planopilaris
- Bacterial or fungal infections
Certain medications, such as blood thinners, retinoids, and chemotherapy drugs, can also increase the risk of scarring alopecia.
Genetics may also play a role, as some people are more likely to develop the condition than others.
Genetic Factors and Scarring Alopecia
Certain genes are linked to the development of scarring alopecia, such as the IRF4 gene.
The IRF4 gene, also known as interferon regulatory factor 4, is a gene that is involved in the development of the immune system. It has been linked to certain forms of hair loss, including scarring alopecia. Mutations of the IRF4 gene can result in an increased risk of developing scarring alopecia, as well as other conditions such as lupus and lichen planopilaris. Research is ongoing to determine how this gene affects the development of hair loss.
One source notes, “IRF4 activity is regulated by STAT3, a signalling protein that responds to inflammatory signals and controls the expression of genes involved in the growth, development, and activation of immune system cells.
What Are The Symptoms of Scarring Alopecia?
Symptoms of scarring alopecia include patchy bald spots, broken hairs, and scarring on the scalp. Other symptoms may include an itchy, burning, or tender scalp and changes in the texture and colour of hair. These symptoms may appear gradually over a period of months or years or quite suddenly.
A Guide to Scarring Alopecia Treatments
A dermatologist or trichologist will typically diagnose traction alopecia. They will perform a physical examination of the scalp and may take a biopsy of the affected area to determine the cause and extent of the hair loss. You may require additional blood work to determine underlying medical conditions. Additionally, other tests may be performed to ascertain whether fungal infections are at work.
Treatment depends on the severity and type of scarring alopecia you have. It can be treated with topical steroids or immunosuppressants in mild cases, while more severe cases might require oral steroids or even surgery. In some cases, a combination of treatments may be necessary.
Is Scarring Alopecia Different to Traction Alopecia?
Scarring alopecia and traction alopecia are both hair loss disorders, but they differ in cause and treatment. Excessive and repetitive tension on the hair follicles, usually from hairstyles such as ponytails, braids, and buns, results in traction alopecia. On the other hand, scarring alopecia is caused by inflammation of the hair follicles due to medical conditions, medications, or genetics. While the treatments for the two conditions differ, they are both chronic disorders and can cause irreversible hair loss and baldness.
What Is The Prognosis?
The prognosis for people with scarring alopecia is largely dependent on the type and severity of the condition. Hair loss can be reversed, in some cases, with the proper treatment. In other cases, the hair loss is permanent. The most important thing is to visit a trichologist to get proper diagnosis and treatment options.
With the right treatment and management, it may be possible to minimise hair loss and, in some cases, regrow hair.
Are There Any Lifestyle Changes That Can Help Manage Scarring Alopecia?
Yes, there are certain lifestyle changes that can help manage scarring alopecia. These include avoiding excessive heat or styling tools such as blow dryers or flat irons and using high-quality, gentle hair care products.
It is also important to keep the scalp clean and hydrated by using products created specifically for people with scarring alopecia.
Additionally, it is important to pay attention to overall health and reduce stress levels. Eating a balanced diet, exercising regularly, and getting enough sleep can also help manage scarring alopecia. Finally, it is important to visit the right professional who can assess the condition and create a holistic treatment plan tailored to the individual.
Talk to Us
We do hope that our guide to scarring alopecia has helped you to understand this chronic hair loss disorder that can cause permanent hair loss and baldness. If you are experiencing scarring alopecia symptoms, getting a proper diagnosis and immediate treatment is important. The prognosis for people with scarring alopecia is largely dependent on the type and severity of the condition. However, with the right treatment and management, it is possible to minimise the effect of the condition for some.
If you or someone you know is suffering from this distressing condition, please get in touch with us as soon as possible. Let’s find a way forward together.
Q: When does traction alopecia become scarring alopecia?
A: Traction alopecia is a condition that can cause hair loss, particularly around the hairline, due to excessive pulling or tension on the hair. If this condition is left untreated, it can lead to scarring alopecia, which is a more severe form of hair loss. Scarring alopecia is a condition where the hair follicles are permanently damaged, resulting in irreversible hair loss. It is important to seek treatment for traction alopecia as soon as possible, as scarring alopecia can be difficult to treat. If you are experiencing hair loss or thinning, it is important to speak to a qualified trichologist who can help diagnose the problem and provide appropriate treatment options. Don’t wait until it’s too late. (Read more in our article: Can Hair Grow Back After Scarring Alopecia (Cicatricial Alopecia)?)
Q: What is CCCA?
A: CCCA stands for central centrifugal cicatricial alopecia, a type of hair loss that primarily affects women of African descent. This condition is characterised by progressive scarring and hair loss that typically starts at the crown of the head and spreads outwards. CCCA can be a challenging and distressing condition to deal with, and it’s essential to seek professional help from a specialist who can provide a diagnosis and treatment plan. If you or someone you know is experiencing hair loss or other symptoms associated with CCCA, it’s important to remember that you’re not alone, and there is support available to help you.
Q: What is Frontal Fibrosing Alopecia?
A: Frontal Fibrosing Alopecia (FFA) is a condition that affects hair follicles, primarily in post-menopausal women. It is a form of scarring alopecia that causes hair loss along the frontal hairline and temples. The hairline can also appear to recede, and the eyebrows may thin or completely disappear. It can be a distressing experience to lose hair, and FFA can have a significant impact on a person’s self-esteem and confidence. It’s important to seek medical advice if you suspect you may have FFA. Treatment options are available that can help slow hair loss, but we encourage you to talk with a trichologist as soon as possible.
Q: What is Lichen planopilaris?
A: Lichen planopilaris is a chronic inflammatory condition that affects hair follicles and often results in hair loss. It’s a relatively rare condition, and the exact cause is not fully understood. However, it’s thought to be an autoimmune disorder in which the body’s immune system attacks hair follicles. Lichen planopilaris can be distressing and affect your self-esteem, particularly if hair loss is extensive. It’s essential to seek medical advice as soon as possible if you notice any changes in your hair or scalp. Treatment options for lichen planopilaris include topical and oral medications, as well as steroid injections, and a trichologist can help determine the best course of action for you.
Q: What is Discoid lupus erythematosus (DLE)
A: Discoid lupus erythematosus (DLE) is a chronic autoimmune disease that primarily affects the skin. It is a form of lupus that is limited to the skin and does not involve any of the internal organs. DLE is characterized by the development of round or oval lesions on the skin that are typically red, scaly, and thickened. These lesions can appear anywhere on the body but are most commonly found on the face, scalp, and ears. In some cases, DLE can lead to scarring and hair loss. The exact cause of DLE is unknown, but it is thought to be triggered by a combination of genetic and environmental factors. Treatment for DLE may include the use of topical or oral medications, as well as avoiding triggers such as sunlight.