Cicatricial alopecia, also known as scarring alopecia, is an inflammatory disorder that causes scarring of the skin of the scalp and the destruction of hair follicles on the human head. The destroyed hair follicle is replaced by scar tissue, so the resulting hair loss is permanent. Normally, the inflammation begins below the surface of the scalp, so it is unusual to see visible follicle scars or other signs that indicate this type of alopecia when it is in the developmental stages. Both men and women can suffer from cicatricial alopecia, and it can occur at any age; some studies show a tendency to affect family groups, but this is not confirmed by scientific evidence. The disorder is not typically associated with any other diseases or disorders, but people who suffer from psoriasis or other sebaceous gland disorders may be more prone to developing this type of alopecia.
The cicatricial alopecia disorder differs considerably from the various forms of what is considered noncicatricial alopecia in both its onset and treatment options. Nonscarring forms of alopecia do not turn into cicatricial alopecia; examples include telogen effluvium, alopecia areata, lichen planus, pressure alopecia, and infectious folliculitis, disorders that do not cause permanent destruction of the damaged hair follicle. There is no one set of symptoms or a single time frame that determines the progress the disorder makes once it manifests. In some cases, the sufferer's scalp may show small signs, such as inflammation or discoloration that either lightens or darkens the scalp, but these signs in and of themselves do not always indicate the disorder.
It is always necessary to consult a dermatologist in order to confirm a diagnosis of cicatricial alopecia. The dermatologist will take a biopsy of the inflamed and scarred tissue, perform a physical examination of the damaged scalp, and take cultures of the hair follicles and any surrounding pustules that may reveal useful information about the patient's condition. Depending on the cause for the disorder's onset, cicatricial alopecia will be diagnosed as being either primary or secondary.
A primary diagnosis means that the hair follicle itself is the direct target of the inflammation. If the scarring and hair loss is the result of an external injury such as radiation, trauma, or other severe injury to the follicle, it is considered to be secondary. In both cases, the follicle cannot be restored and hair loss will be permanent.
The primary goal of treatment for cicatricial alopecia is to decrease the lymphatic cell activity in the sufferer's system that causes the scarring. Treatment usually consists of both injected and topical anti-inflammatory corticosteroids, supplemented by oral and topical antibiotics. Typically, treatment is recommended until the inflammation is under control and the condition is stopped. If the condition returns, the treatment must be resumed.
