Cicatricial Alopecia

Cicatricial  alopecia  refers to a group of rare skin diseases in which hair follicle get destroyed and replaced by scar tissue. It is one of the rare causes of hair loss. Hair loss could be gradual or sudden. Hair loss could be without any symptoms or it could present with sever itching, burning and pain. There is usually no visible scar, because the inflammation is below the level of skin. Cicatricial  alopecia  could occur in otherwise healthy men and women of all ages.

Cicatricial  alopecias  could be primary or secondary. This discussion is confined to the primary cicatricial  alopecias  in which the hair follicle is the target of the destructive inflammatory process. In secondary cicatricial  alopecias , a non-follicle-directed process or external injury, such as severe infections, burns, radiation, or tumors could cause destruction of the hair follicle.

The causes of the cicatricial  alopecias  are not completely known. However, all cicatricial  alopecias  involve inflammation directed at the hair follicle, the upper part of the follicle where the stem cells and sebaceous gland are located are generally involved. Permanent hair loss occurs when the stem cells and the sebaceous glands are destroyed. This type of hair loss is usually irreversible.

Cicatricial  alopecias  can affect both men and women. The majority of patients with cicatricial  alopecia  have no family history of a similar condition. Central centrifugal  alopecia  is a type of cicatricial  alopecia  that is more prevalent among black woman. Frontal fibrosing  alopecia  on the other hand is seen most commonly in post-menopausal women.

could be seen in association with chronic skin conditions such as lupus erythematosus and in people with personal or family history of autoimmune disorder. A scalp biopsy is necessary for diagnosis of cicatricial  alopecia . Presence of inflammatory cells and scarring could be diagnostic and essential for determining the type of treatment.

Treatment of the lymphocytic group of cicatricial  alopecias  involves use of anti-inflammatory medications such as steroids, cyclosporine, hydroxychloroquine. When hair follicle destroyed, hair will not grow back. However in some cases using minoxidil solution can help to stimulate growth of some of the remaining hair. Hair transplant could only be used in the patients who have normal healthy hair in donor area. If hair multiplication becomes a reality in the future that might potentially be an option for patients who lost their scalp hair extensively as result of this condition. Dr. Parsa Mohebi, a Los Angeles hair transplant surgeon offers free evaluation for all hair loss patients.