Scarring Alopecia

Cicatricial alopecia is the collective name for forms of scarring hair loss (scarring alopecia). This is in contrast to non scarring alopecia such as alopecia areata, in the way to treat it and in the looks of your hair.

In this article you will learn everything you need to know about alopecia scarring and alopecia cicatricial. The following topics will be explained: 

  • What is scarring alopecia? 
  • How does scarring alopecia start? 
  • What does scarring alopecia look like? 
  • Can stress cause scarring alopecia? 
  • Is scarring alopecia genetic? 
  • How is scarring alopecia diagnosed? 
  • Can scarring alopecia be misdiagnosed? 
  • How to stop scarring alopecia from spreading? 
  • What is non scarring alopecia? 
  • Alopecia scarring vs non scarring 
  • Scarring alopecia vs alopecia areata 

View our Hair Growth products

What is scarring alopecia? 

Scarring alopecia is an inflammatory condition that destroys hair follicles causing scarring and permanent hair loss. Once the hairs fall off it cannot be reversed, but you can treat yourself to help further prevent hair loss and scarring. The treatment recommended for you will depend on the cause of your scarring alopecia and later in this article we give you the solution for this type of hair loss. But first we are going to tell you about the fundamentals of cicatricial alopecia, how it starts and what is looks like.

How does scarring alopecia start? 

To answer the question: ‘What causes scarring alopecia’, the answer is that generally, cicatricial alopecia causes are inflammation and irritation, which damages the hair follicles. Scarring alopecia causes can also stem from a trauma such as a burn or serious infection. The inflammation can involve different types of cells, including lymphocytes which are natural killer cells.  

Scar alopecia can affect both men and women and there are different types of scarring alopecia. It is rare in children and the exact causes of scarring alopecia are not fully understand by researchers. So far, it is believed that inflammation destroys the stem cells and oil glands of the hair follicle, leading to scarring.

What does scarring alopecia look like? 

Scarring alopecia generally starts with the appearance of small patches of hair loss that may grow larger and larger over time. In some cases, there might be no noticeable symptoms, while in others the patches may become inflamed and cause itching or pain.

There are different scarring alopecia types which are primary scarring alopecia and secondary scarring alopecia. Primary scarring alopecia is a form of alopecia where the hair follicle is the target of inflammation. Secondary scarring alopecia is a form of alopecia where the hair follicle is destroyed by an injury or inflammation which causes a larger area to be inflamed. Various health conditions, infections, or injuries can cause secondary scarring alopecia.

A well-known type of cicatricial alopecia is central centrifugal cicatricial alopecia CCCA (Hot comb alopecia, follicular degeneration syndrome). This is a form of scarring alopecia that occurs mainly in dark-skinned women and begins centrally around the crown and vertex. The main non scarring alopecia causes for this type of alopecia are unknown.

Damage caused by de-scalding techniques including hot combing has been considered as one of the causes. The condition is slowly progressive, with most disease activity at the edges. The activity of inflammation is variable in central centrifugal scarring alopecia.

The central centrifugal cicatricial alopecia treatment is often with a topical steroid medication that is being applied by the patient at home, sometimes combined with local corticosteroid injections in the scalp performed by the physician at 4 to 8 week intervals.

Can stress cause scarring alopecia? 

Stress is often an underlying factor for hair loss. But this type of hair loss is called Telogen effluvium and is possible to treat by taking effective hair growth products. In scarring alopecia stress is not known as a cause. While in some cases potential underlying factors of scarring alopecia can be heat styling, bleaching, or using straightening agents. This is because these will give a chemical reaction that could destroy your hair follicles. This is called scarring alopecia from bleach.

Is scarring alopecia genetic? 

Hair scarring alopecia can have sometimes a genetic cause. However, the majority of patients with cicatricial alopecia have no family history of a similar condition. The most common type of alopecia cicatricial that affects family members is central centrifugal alopecia, in other words scarring alopecia black hair.  

How is scarring alopecia diagnosed? 

In some people, scarring hair follicles can cause itching and pain. Diagnosis of scarring alopecia is tricky because the destruction of the hair follicles takes place under your skin and the outward signs on your scalp can range from one smooth spot to several with small blisters. A good indicator of scarring alopecia is a ragged edge around the patch, but since irritated patches don’t always form, a biopsy can be used to detect the inflammatory cells around your hair follicles.

Can scarring alopecia be misdiagnosed? 

Hair loss scarring alopecia is a much-researched form of hair loss. This form of hair loss is also relatively often misdiagnosed because it is difficult to diagnose. The problem of this form of hair loss is underneath the skin and scarring alopecia symptoms also often match symptoms of lupus or alopecia areata, for example. 

Studies showed that scarred alopecia was misdiagnosed in 14.3% of cases. The CCCA form of cicatricial alopecia is one of the forms that is most misdiagnosed.

How to stop scarring alopecia from spreading? 

Scarring alopecia is a type of baldness that destroys hair follicles. Scarred hair follicles cannot be treated with a treatment for cicatricial alopecia, because these hair follicles are finished. Fortunately, alopecia scarring is not contagious so you cannot transmit it to others. 

According to the National Organization for Rare Disorders (NORD), scarring alopecia can be caused by neutrophils which are treatable by eliminating the microbes that trigger inflammation. You might be able to achieve this by using a treatment for scarring alopecia in oral antibiotics, or something that your doctor prescribes.

A hair transplant cannot stop existing hairs from falling out. But it could be a solution to improve appearance of the hairs after falling out.  Scarring alopecia and hair transplant can follow up on each other according to a study because a hair transplant surgery can be a cicatricial alopecia treatment for certain primary scarring types. However, data of this study must be interpreted with caution due to concern for positive-result publication bias, so you should also take to an account that it is not the best way to stop scarring alopecia from spreading.

What is non scarring alopecia? 

There are several forms of non scarring alopecia. The most known is alopecia areata what is a non scarring alopecia that can affect men and woman, adults, and children. This type of hair loss is usually in round or oval patches and is possible to treat with a alopecia areata treatment that consists of a hair growth stimulating shampoo, hair growth stimulating lotion, hair growth supporting tablets, and an enhancing scalp roller. 

The second most known non cicatricial alopecia is androgenetic alopecia. This is a common type of hair loss that is known as male-pattern baldness but can also appear in women. Hair is lost in well-defined patterns, beginning above the temples. Androgenetic alopecia appears in people due to genetics. And is possible to treat with a non scarring alopecia treatment. 

The last type of alopecia we will discuss is traction alopecia. Traction alopecia is hair loss due to pulling. It occurs when your hair is constantly being pulled, causing tensions on the hair root. You are able to get this from tightly braided hair, tight ponytails, or fad hairstyles. Traction alopecia scarring is rarely seen. But some people think they have scarring alopecia when they in fact wear these types of hairstyles which can also be the problem for your hair loss.  

Therefore, we recommend you look closely to the possible causes of your hair loss by reading more articles. Determine your actual cause to know how you can combat your hair loss with the best treatment. 

Receive Personalised Hair Advice

Would you like to know which treatment is best for your hair situation? Receive Personalized Hair Advice now by filling in our online tool in 2 minutes.

We help you to start a treatment with only the best, proven effective products, in combination with personalised advice.

Personalised Hair Advice