What Is Cicatricial Alopecia?

Cicatricial alopecia occurs in both women and men, and is more commonly seen in young adults. Cicatricial alopecia causes hair follicles to cease hair production, which leads to hair loss. The reason this happens with cicatricial alopecia is because the hair follicles that are destroyed by the disease get replaced with scar tissue. Hair loss as a result of this is permanent.

Signs and Symptoms

• Cicatricial alopecia causes bald spots on the scalp and in some cases it also shows, scaling and redness. People who suffer from this form of alopecia, generally experience gradual hair loss with no symptoms at all. Other people with cicatricial alopecia report having intense itching, burning or pain at the site of hair loss.

Causes

• Two forms of cicatricial alopecia exist: primary and secondary. Primary cicatricial alopecia causes aren't understood well, but it occurs when the hair follicle becomes inflamed around the, sebaceous gland. Once this gland is destroyed along with the hair follicle stem, hair re-growth is not possible.

  Secondary cicatricial alopecia is caused by direct damage to the hair follicles from things, such as burns to the scalp, radiation, severe skin infections and tumors.

Diagnosis

• Diagnosis is determined by way of a biopsy and clinical evaluation. A biopsy will tell your physician the location of the inflammation, the amount, type, and if there are any changes in your scalp. These results will help him determine the amount of activity present so he can prescribe the correct treatment for you.

  Secondly, you will undergo a clinical evaluation. You will be asked about your symptoms, which may help determine if the cicatricial alopecia is still active. In addition, you will be given what's called a hair pull test, to determine how easily your hair comes out of the follicles. The hairs pulled are then put under a microscope and evaluated for further evidence of the disease.

  If at the time, pustules are visible on the scalp, a culture examination on a swabbed sample will determine if any microbes are present. (According to the Cicatricial Alopecia Research Foundation, it is challenging to get a proper diagnosis, so have your evaluations done by a dermatologist with interest, and experience, in the subject of alopecia.)

Treatments

• Treatment for primary cicatricial alopecia depends on the classification. There are three classes: lymphocytic, neutrophils and mixed inflammatory cells. If you have the lymphocytic class, you will be treated with anti-inflammatory medications. This type of medication is used to irradiate or minimize the lymphocytic inflammatory cells that attack hair follicles. Some medications that are prescribed for this are hydroxychloroquine, doxycycline and corticosteroids. You may also be prescribed topical medications such as Derma-Smoothe and triamcinolone acetonide. The later is a corticosteroid that is injected into the inflamed lesions on the scalp.

  In the neutrophilic class, treatments are given to rid microbes that inflame the area. For this, oral or topical antibiotics are given. Lastly, treatment for the mixed group of cicatricial alopecia consists of antimicrobials and anti-inflammatories.

Hair Regrowth

• Unfortunately, if the hair follicle is destroyed hair will not grow back. You can treat the surrounding areas for inflammation to keep those hair follicles from being destroyed. This treatment consists of a Minoxidil solution of either 2 or 5 percent. This solution is applied to the unaffected areas twice daily.