Any form of hair loss can be challenging to deal with, but scarring alopecia can particularly feel like an uphill battle. Unfortunately, this type of hair loss is permanent, leading to entire patches of the scalp becoming completely bald.
Do you have scarring alopecia, or want to learn more about it for prevention purposes? If so, you are in the right place. In this guide, learn all you need to know about scarring alopecia, including the most common causes, symptoms, and treatments.
What is Scarring Alopecia?
Scarring (cicatricial) alopecia is a type of permanent hair loss that occurs when the hair follicles become completely destroyed. There are several different types of scarring alopecia, all falling into two categories: primary scarring alopecia and secondary primary alopecia.
Primary scarring alopecia occurs due to non-external causes such as alopecia mucinosa, frontal fibrosing alopecia, erosive pustular dermatosis, and lichen planopilaris.
On the other hand, secondary scarring alopecia typically occurs because of external factors such as burns, radiation treatments, and infections that can lead to scarring.
Scarring Alopecia Causes
It is hard to say exactly what causes scarring hair loss, as there are many different types. Here are some of the most common:
- Inflammatory or Autoimmune Disorders
- Skin Injuries
- Burns
- Medical Treatments
All of these lead to one common factor: it destroys the hair follicle which leads to a permanent type of hair loss.
Scarring Alopecia Symptoms
Here are the most common symptoms of scarring alopecia:
- Scaly Skin
- Redness
- Patches of Hair Loss
- Smooth Hair Loss
- Itching
- Pain
- Burning
- A Tender Scalp
If you have any of these symptoms, speaking to a medical professional is important, as they can help identify the underlying cause. You can also use a hair track app to monitor hair loss and growth.
Diagnosing Scarring Alopecia
Scarring alopecia is a rare hair loss condition. As such, it can be tricky to diagnose, but there are some methods a dermatologist often uses to see whether a patient has this disorder.
Hair Pull Test
The hair pull test [1] is a common diagnosis method for anyone experiencing hair loss. The test involves a dermatologist gently tugging at the hairs on your head and then examining how many hairs get pulled out. These hairs can then be further examined under a microscope to see the strands’ stage of the hair loss cycle. It is very quick and painless.
A Physical Scalp Examination
A dermatologist can determine whether you have scarring alopecia (or another form of hair loss) by physically examining the scalp. During this examination, the dermatologist will look closely at the scalp, the sebaceous glands, and your strands, looking for symptoms of scarring alopecia, such as smooth bald patches or scaling.
A Scalp Biopsy
A scalp biopsy is a typical diagnosis method for anyone who has experienced hair loss. It’s a simple method that involves taking a small sample of skin cells from the scalp that looks at the stem cells and oil glands. After this, the dermatologist will send the sample to the lab to look more closely at what’s causing the hair follicle damage.
Asking About Your Medical History
Dermatologists can get a pretty good idea of the cause of your hair loss (and whether it is scarring alopecia) by asking you specific questions about your medical history. By understanding your age, diet, medical conditions, the medications you take, and when you started experiencing hair loss, the dermatologist may have enough information for a diagnosis – especially when asked alongside another diagnosis method like the hair pull test or a scalp biopsy.
Be aware that you a professional diagnoses scarring alopecia, it cannot be done from home. While you might have a good idea of what type of hair loss you have, you will need to see a hair specialist to know with any certainty. Plus, getting an official diagnosis means putting on a treatment plan to prevent worsening symptoms.
Can Scarring Alopecia Be Reversed?
Unfortunately, no. As of right now, there is no cure for scarring alopecia, meaning that any hair loss caused by the disorder is permanent.
However, all hope is not lost, as there are ways to slow or stop hair loss. Patients will not lose more hair when put on the right treatment plan.
Diagnosing scarring alopecia early is key here. The earlier the disorder is diagnosed, the less hair loss the patient will experience.
Scarring Alopecia Treatment Options
These are the most common hair loss treatment options for scarring alopecia:
Anti-Inflammatory Medications
The best treatment for scarring alopecia is targeting the root cause of the hair loss. In many cases, that means using anti-inflammatory drugs. Taking a medication like this will help fight the inflammatory cells that are causing the destruction of hair follicles.
Antibiotics
If an infection is the cause of scarring alopecia, antibiotics can be used as a treatment. The antibiotics target the infection, subsequently stopping any further hair loss. It is hard to say how long the antibiotics need to be taken, but a patient may need to take them for a year.
Steroid Injections
Another treatment option for scarring alopecia is steroid injections. A doctor will inject these steroid injections directly into the scalp, with the goal of reducing inflammation in that area.
Minoxidil
Minoxidil is a popular hair restoration medication that you can buy over the counter. It works well for boosting blood flow to the hair follicles, which can stimulate growth. While you cannot regrow hair from destroyed follicles, minoxidil may work to boost hair growth from the healthy hair follicles a patient still has, thus leading to thicker, healthier-looking hair.
A Hair Transplant
In some cases, a hair transplant can work well for scarring alopecia. A hair transplant involves a surgeon grafting hair follicles from one area of the scalp and then transplanting them to another, thus leading to new hair growth.
It’s important to note that a hair transplant has a lower success rate when used for scarring alopecia when compared to other types of hair loss. You must also have enough hair to make up a good donor area. On top of that, the hair loss from scarring alopecia should have stabilised – for hair transplants to work, most patients won’t have experienced any more hair loss within the last couple of years.
Despite all those barriers, a hair transplant can still work very well, and it’s worth at least speaking to a hair specialist about this option, especially if you have already addressed the root cause of your scarring alopecia and you want to regrow your locks.
Other hair restoration methods can boost the effectiveness of the hair transplant. For example, platelet rich plasma, minoxidil, and microneedling can all work alongside a hair transplant for patients with scarring alopecia.
Dealing with Permanent Hair Loss
Hair loss is never an easy thing to deal with. It can seriously affect a person’s confidence, in some cases even causing mental health problems.
Scarring alopecia is particularly challenging to deal with due to its permanence – the idea of never being able to regrow hair can affect some people. The good news is there are some fantastic ways of dealing with this disorder.
Getting a Diagnosis: Getting a diagnosis is one of the best steps for anyone dealing with scarring alopecia. It demystifies all of the symptoms, and having a clear cause can help you feel more in control of what is happening. Plus, it means you can get started on a treatment plan as soon as possible – the earlier a treatment begins, the better the results.
Getting Counselling: Losing your hair can affect your mental health. It helps to know you’re not alone. You can either pursue individual counselling or go to group counselling sessions to help work through the emotional complexities that accompany scarring alopecia.
Wearing Wigs and/or Hair Pieces: In this modern day and age, wigs and hair pieces look incredible. If you find the right wig or hairpiece, your locks will look natural, and you will feel like yourself again. If your hair loss is extensive, it’s definitely worth pursuing.
Final Thoughts
Scarring alopecia is a type of permanent hair loss that has several potential causes, including autoimmune diseases and external factors such as scar tissue. It causes the destruction of hair follicles, which is why the hair cannot grow back.
Not all hope is lost, though – many people who receive an early diagnosis can stop the hair loss in its tracks. Then, there are ways to hide the hair loss or boost hair growth in the hair follicles that are still present.
Have you experienced scarring alopecia and are interested in getting a hair transplant? You are in the right place – here at Harley Street Hair Clinic, we endeavour to give every one of our patients the chance to enjoy a full head of healthy hair once more. Head over to our patients gallery to see what we can do for you!