Scarring alopecia is not a specific disease: the term includes a number of health problems that lead to hair loss . What they have in common is that the damage they cause to hair follicles can be permanent and irreversible , rendering them unable to produce hair.
Most of the diseases listed in this category have no proven links to genetic inheritance , that is, family history is of little use in predicting events. They can occur in men and women of all ages, although rarely in children.
They are much less common than the other cases of alopecia, so it is important that you know a few important things to identify and treat as soon as possible .
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Index
What is scarring alopecia?
The appearance and development of symptoms vary with the disease and are divided into two groups: primary, which consists of diseases in which the hair follicle is the target of destructive inflammation, and secondary, which involves clinical pictures whose objective is not specifically attack the follicle (such as burns, radiation, or tumors).
Within the main group, diseases are subdivided according to the type of cells of the immune system that participate in the inflammatory process: there are those with a predominance of lymphocytes in the affected areas (lichen planus pilar, AFF, pseudopelada Brocq, centrifugal alopecia central), others with a predominance of neutrophils (decalvante folliculitis, tufted folliculitis, dissecting cellulitis of the scalp), as well as those classified as mixed , with the participation of both types of cells (keloid folliculitis, erosive pustular acne).
Some clinical pictures show no symptoms other than hair loss, but several of them can cause tenderness, itching, burning, pain, redness, or the formation of plaques or pustules. Baldness often begins in small areas with irregular contours, gradually progressing (several bald areas may merge as the disease runs its course). It is common for the texture of the affected skin areas to obtain a “smooth” appearance, because the follicular ostium (openings of the follicles, where the hairs come out) is disappearing.
Treatments for Scarring Alopecia
It is important that diagnosis and treatment be carried out as soon as possible , to try to prevent follicle damage from reaching the advanced stage. The default appearance of bald patches can lead to a false diagnosis of alopecia areata , so detailed investigation of the case is essential. The patient should seek a good dermatologist to perform the necessary tests (blood tests, observation of the hair under a microscope, the fluid from the pustules, if it is the case, or even a biopsy of the scalp while the disease is active ) and identify your specific case.
In cases of lymphocytes, the predominant preferential treatment is with corticosteroids or other anti-inflammatory drugs , by injection, topical application (creams or lotions) or by oral administration.
An aggravated presence of neutrophils indicates the presence of bacteria or fungi, and is usually combated with oral and topical antibiotics . A combination of the two types of treatments is possible in the affected area. In the specific case of cellulite dissection, treatment is normally carried out with isotretinoin . In some situations, minoxidil lotion is used to restore follicles that have weakened but are not totally corrupted.
Treatments are usually long-lasting, and are carried out until hair loss stops. The problem can be solved in a satisfactory way, but unfortunately, none of the available treatments are capable of recovering the destroyed follicles or preventing new episodes in the future. After a period of stabilization, it is possible that the symptoms reappear and a new treatment should be started.
In less advanced cases, it may be possible to perform a hair implant , or even surgically remove bald areas with a reduction of the scalp (nearby parts not affected by alopecia, with which the normal appearance can be reconstituted), but only They recommend these procedures when the alopecia is inactive (ideally, the condition is controlled for 2 or 3 years).
For people who do not want or cannot have these procedures, the use of capillary prostheses can be a good solution. Today you can find pieces made with modern and comfortable materials, which can be attached to the skin with resistant adhesives and allow the user to perform all normal activities without removing them (for example exercising, swimming and washing the head). For more information, also read our article on hair replacement .
Problems in the emotional aspect
Dealing with hair loss that is often difficult to diagnose (due to the rarity of the disease), which can have rapid progression, including swelling and considerable pain, and whose prognosis is permanent hair loss , is not easy, and can affect the emotional health of patients .
The support of friends and family is important to go through this difficult time, but you should not rule out professional help, psychological care can be an important tool for the patient to have the strength and perseverance to face treatment and be able to live with it. disease in the best possible way.
It is also important to talk with other people who have the same problem, since knowing that your case is not unique and being able to exchange stories, confidences and impressions about the treatments can be a very valuable help. If there are no groups in your city, look for communities on the internet that bring together people with all types of alopecia.
Kathie Sand always saw the world of beauty as the terrain on which to build her professional career, a goal that was clear to her when she was only 15 years old. Her great concern to expand knowledge led her to settle in Paris where she studied hand in hand with the best beauty professionals and with the most advanced techniques for skin care.
