Scarring Alopecia

For most individuals, losing their hair is awful news. Except for those of us who are lucky enough to look great bald, few individuals usually choose to remain hairless. Because of this, the majority of people could be inclined to believe, in part, that all hair loss is unwanted. However, the truth is that while all causes of hair loss result in the loss of hair, some of them also cause more severe permanent damage, including scar tissue that occurs in people with scarring alopecia.

Keep reading this article to learn more about scarring alopecia.

What is Scarring Alopecia?

According to the Canadian Medical Association Journal, scarring, or cicatricial alopecia refers to a range of hair loss conditions in which the hair follicle is permanently damaged and replaced by fibrous tissue. It is a rare disorder that causes hair follicles to be permanently destroyed leading to irreversible hair loss.

What are the Types of Scarring Alopecia?

There are two classifications of scarring alopecia: primary and secondary.

  • Primary scarring alopecia: A condition in which hair follicles are damaged by inflammation beneath the skin’s surface, resulting in scar tissue replacing the damaged tissue and permanent hair loss. Examples: Lichen Planopillaris (LPP) and Frontal Fibrosing Alopecia (FFA).
  • Secondary scarring alopecia: A condition where hair follicles are destroyed by external factors. These may consist of injuries brought on by straightening irons, chemical straightening, hot combs, radiotherapy, and accidents involving trauma to the scalp.

What Causes Scarring Alopecia?

Although the exact causes of Scarring alopecia are not yet established, inflammation is believed to be the primary factor. The majority of scarring alopecias are caused by irreversible damage of hair follicles as a result of inflammation and gradual collagen deposition and are commonly linked with sebaceous gland loss. Scarring alopecias can afflict individuals of any age, however, they most frequently affect adults. Most people with scarring alopecia don’t have a family history of the disease, so it is not genetic.

What are the Symptoms of Scarring Alopecia?

Scarring alopecia arises differently in each individual. With too few signs being seen, hair loss may develop slowly over several years. Some individuals experience burning and itching as it advances quickly over months. Redness and scaling could appear in the impacted areas. It is advised to seek early diagnosis since scarring alopecia can cause irreversible hair damage.

Here are the most common symptoms of scarring alopecia:

  • Itching, burning, discomfort, and soreness in the scalp
  • Inflammation of the hair follicles and scalp
  • Hair strands becoming thinner
  • Scale development on the scalp
  • Crusting
  • Bleeding
  • Blistering

How is Scarring Alopecia Diagnosed?

There are a few ways to diagnose scarring alopecia, such as:

  • Physical exam: This procedure is started by examining the location and pattern of your hair loss, as well as looking for areas of baldness on your skin. This procedure is also done to evaluate if you still have obvious hair follicle openings and physical inflammation and to see if your hair follicle openings are still there.
  • Medical history: Your medical background is thoroughly examined by your doctor. They assess your age, sexual orientation, hair maintenance habits, and general health. Any medical issues you have, such as thyroid illness, anemia, or lupus, should be disclosed to your doctor. Blood tests may be performed to detect diseases that might result in hair loss.
  • Skin biopsy: Scarring alopecia can be diagnosed by a skin biopsy. A little skin sample is taken from your scalp or another location affected by hair loss. That skin sample then will be examined to look for immune cells that cause inflammation and also to let you know what kind of scarring alopecia you have.

How to Treat Scarring Alopecia?

Scarring alopecia cannot be cured and at its final stages is frequently described as an irreversible condition. However, with the help of treatment, it can relieve symptoms and postpone hair loss–especially when you are still at the early stage, you can have scarring alopecia therapy to stop it from worsening and repair the surrounding areas.

Since each subtype has a distinct treatment approach, it is advisable to go through all of your options with your doctor before choosing the most appropriate one. Which type of cells are inflaming your body is one of the things that determine the best treatment options for scarring alopecia.

Here are a few treatments for scarring alopecia:

  • Anti-inflammatory Medicines
    The most often used medication for most types of scarring alopecia is an anti-inflammatory medicine. Anti-inflammatory drugs attack the inflammatory cells that are destroying hair follicles. You may be given a pill, such as hydroxychloroquine, or a corticosteroid injection, such as triamcinolone acetonide. Some anti-inflammatory drugs are available as creams or oils that you apply topically. Most people take medication for six to twelve months before their symptoms get better and their hair loss slows down or quits. If you start losing more hair, you might need to resume taking your prescription.
  • Platelet-rich Plasma (PRP)
    PRP treatment is a non-invasive procedure for hair restoration. As the name implies, platelet-rich plasma is generated by removing a patient’s blood sample and centrifuging it. Following that, a microneedle is used to inject the activated plasma into the scalp’s top layer. It naturally feeds the follicles and maintains the remaining hair, resulting in hair regeneration and repair, as well as reducing inflammation and promoting tissue healing.

PRP may work on dermal papilla cells to promote new hair growth, contribute to a rapid telogen-anagen transition, and improve hair density; hence, good results should be expected with PRP treatment.

According to research, PRP is able to increase the number of hair follicles and bulge cells, epidermal thickness, and vascularity. More precisely, some findings suggest that the release of proteins and cytokines by platelet activation causes folliculogenesis, encourages the anagen-growing stage of dormant bulbs, and has anti-inflammatory effects.

Some studies show that PRP may help with some kinds of scarring alopecia, including lichen planopilaris (LPP) and frontal fibrosing alopecia (FFA). LPP is a kind of primary lymphocytic cicatricial alopecia that is difficult to cure. Meanwhile, FFA is the most common type of scarring alopecia to date. FFA is a lymphocytic scarring alopecia characterized by increasing frontal and temporoparietal hairline loss. Eyebrows, eyelashes, and body hair can all be impacted.

Based on the research and studies, PRP has shown positive impacts on scarring alopecia treatment. However, further clinical trials are needed to provide more data.

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