information on hair diseases and their remedies
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Home >> Various types of Alopeica >> Scarring Alopecia
The term "scarring alopecia" refers to a diverse group of rare hair disorders. These disorders destroy the hair follicle and replaces the follicle with a scar tissue causing permanent hair loss. Scarring alopecia is also called 'cicatricial alopecia'
In some cases of cicatricial alopecia, the hair loss is gradual and no symptoms are evident for long periods. In other cases, scarring alopecia causes are associated with severe itching, burning and pain which is rapidly progressive. The inflammation destroys the follicle below the skin surface but above the skin surface generally not much inflammation is visible.
Affected areas of the scalp sometimes may show little signs of inflammation, or only have some redness and scaling. There may also be increased or decreased pigmentation, pustules, or draining sinuses. Cicatricial alopecia can occur in healthy men and women of all ages. It is not restricted to any particular racial groups, though some types of scarring alopecia are more common in African-Americans.
The causes of the various types of cicatricial alopecia are unknown. Cicatricial alopecias are generally associated with illnesses. Patients with chronic cutaneous lupus erythematosus, a type of primary cicatricial alopecia, may have an increased personal or family history of autoimmune disorders.
However, all types of cicatricial alopecia that involve inflammation are directed to the upper part of the hair follicle. In this upper part of the follicle, the stem cells and sebaceous gland (oil gland) are located. If the stem cells and the sebaceous gland are destroyed then there is no possibility for regeneration of the hair follicle and permanent hair loss results.
Types of Cicatricial alopecia
In broad terms cicatricial or scarring alopecias are of two types:
Primary scarring alopecia is further sub categorized into three types on the basis of the inflammatory cells. The various types are:
diagnosis of the different types of primary scarring alopecia is necessary as different types of categories have a different identification and treatments.
Secondary alopecias are more generalized disease mechanisms. They occur in various organs of the body and damage several tissues, organs as well as induce scarring alopecia. The causes of secondary cicatricial alopecia include radiation, drugs, surgeries, tumors, etc.
Some unusual observations
In the early stages of the diagnosis of scarring alopecia, a lot of inflammatory cells are found around the hair follicles. It is generally believed that the destruction of the hair follicles and the scar tissue development is induced by these inflammatory cells. However, there are some arguments about this among some dermatologists. In some biopsies of scarring alopecia very little inflammation is found in the affected hair follicles.
Scarring alopecia leads to the formation of bald patches. At the end stage of scarring alopecia the bald patches stop expanding. Any inflammation, itching, burning or pain in the hair follicles goes away. In this end stage of scarring alopecia a biopsy of the affected scalp usually shows no more inflammation.
The bald areas are usually left devoid of any hair follicles. Sometimes hair follicles, at the boundary of a bald patch, are not completely destroyed and they can regrow. But generally hair regrowth is not possible and all that is left are just a few longitudinal scars deep in the skin. These scars indicate that the hair follicles were present in that place.
Cicatricial alopecias can affect both men and women, most commonly young adults of all ages may be affected. Keratosis follicularis spinulosa decalvans, a type of primary scarring alopecia, usually manifests itself in the teenage years.
Central centrifugal alopecia is a type of primary scarring alopecia that affects black African-American women most commonly.
Frontal fibrosing alopecia is another type of primary scarring alopecia which is evident in post-menopausal women. In frontal fibrosing alopecia the recession of the frontal hairline is a common event. Also, the skin in the affected area may be of one to eight centimeters in width. It is usually pale or mildly scarred, and stands out in sharp contrast to the skin of the forehead.
For treating any type of alopecia cause, whether of low or high degree severity, the first step is proper diagnosis. So instead of being anxious, the best way to treat the severe alopecia causes is to be methodical, diagnose, find out the real reason and begin the appropriate treatment for hair loss control as soon as possible.