Scarring alopecia

Introduction Scarring alopecia

Scarring alopecia, a group of hair loss conditions, is a less common but often distressing problem that affects both men and women. These conditions result in permanent hair loss due to the destruction of hair follicles and their replacement with scar tissue.

Types of Scarring Alopecia

  1. Discoid Lupus Erythematosus (DLE)
    DLE is an autoimmune condition that primarily affects the skin, leading to red, scaly patches that can develop on the scalp. These patches can cause hair loss over time, and treatment typically involves managing the underlying autoimmune response.
  1. Lichen Planopilaris (LPP)
    LPP is characterized by reddish-brown, itchy patches on the scalp and can lead to progressive hair loss. The condition involves inflammation of hair follicles and can cause scarring.
  1. Frontal Fibrosing Alopecia (FFA)
    FFA predominantly affects postmenopausal women, causing hairline recession and scarring of the frontal scalp. The exact cause is unknown, but hormonal factors may play a role.
  1. Fibrosing Alopecia with Pattern Distribution (FAPD)
    FAPD is characterized by hair loss in a male-pattern distribution and fibrosis of the scalp. It primarily affects women of African descent and can be challenging to treat.
  1. Folliculitis Decalvans
    Folliculitis decalvans is a condition marked by inflammation and infection of the hair follicles, leading to pustules and scarring hair loss. Treatment may include antibiotics and anti-inflammatory medications.
  1. Dissecting Cellulitis
    Dissecting cellulitis, a rare condition, presents with painful, inflamed nodules on the scalp that can result in scarring and hair loss. It often requires extensive treatment, including antibiotics, surgical intervention, or biologic medications.
  1. Central Centrifugal Cicatricial Alopecia (CCCA)
    CCCA primarily affects women of African descent and begins at the crown of the scalp, leading to scarring and permanent hair loss. Proper hair care practices and early diagnosis are crucial in managing CCCA.

Causes of Scarring Alopecia

Scarring alopecia often results from inflammation, immune system dysfunction, or genetic predisposition. Identifying the underlying cause is essential for effective treatment. In some cases, a biopsy may be necessary to confirm the diagnosis.


Treatment for scarring alopecia varies depending on the specific condition and its severity. Dermatologists may recommend a combination of treatments, such as:

  1. Topical and Intralesional Steroids: Corticosteroid creams or ointments can help reduce inflammation and slow down hair loss in some cases.
  2. Oral Medications: Immunosuppressive drugs or anti-inflammatory medications may be prescribed to manage autoimmune-related scarring alopecias.
  3. Topical Calcineurin Inhibitors: These medications can help reduce inflammation in certain types of scarring alopecia.

Book A Consultation

Scarring alopecia encompasses various conditions that can lead to permanent hair loss, making early diagnosis and treatment crucial. If you suspect you may be experiencing scarring alopecia or have concerns about hair loss, consult with a dermatologist or healthcare professional for a comprehensive evaluation and personalized treatment plan.

Dr. Wipawan Vathananai, a dermatologist and a hair transplant surgeon of BHI Clinic, provides treatment for scarring. Please contact us in order to make an appointment with the doctor.

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