Home ServicesScarring Alopecia |
|
Scarring Alopecia |
The term "scarring alopecia" refers to a diverse group of rare hair disorders. These disorders destroy the hair follicle and replaces the follicle with a scar tissue causing permanent hair loss. Scarring alopecia is also called 'cicatricial alopecia'.
In some cases of cicatricial alopecia, the hair loss is gradual and no symptoms are evident for long periods. In other cases, scarring alopecia causes are associated with severe itching, burning and pain which is rapidly progressive. The inflammation destroys the follicle below the skin surface but above the skin surface generally not much inflammation is visible.
Affected areas of the scalp sometimes may show little signs of inflammation, or only have some redness and scaling. There may also be increased or decreased pigmentation, pustules, or draining sinuses. Cicatricial alopecia can occur in healthy men and women of all ages.
Types of Cicatricial alopecia
In broad terms cicatricial or scarring alopecias are of two types:
• Primary
• Secondary
Primary cicatricial alopecia involves destruction of the hair follicle and their openings from which the hair fibers emerge. As the alopecia causes is primarily focused on the hair follicles it does not affect other tissues and organs of the body.
Secondary alopecias are more generalized disease mechanisms. They occur in various organs of the body and damage several tissues, organs as well as induce scarring alopecia. The causes of secondary cicatricial alopecia include radiation, drugs, surgeries, tumors, etc.
|
| Causes |
The causes of the various types of cicatricial alopecia are unknown. However, all cicatricial alopecias involve inflammation directed at the hair follicle, usually the upper part of the follicle where the stem cells and sebaceous gland (oil gland) are located. If the stem cells are destroyed, and the sebaceous gland as well, there is then no possibility for regeneration of the hair follicle and permanent hair loss results.
Scarring Alopecia can have many causes some of these causes and different types of Scarring Alopecia are discussed below.
Scarring Alopecia caused by Discoid Lupus Erythematosus
Discoid Lupus Erythematosus is a diffuse connective tissue disease which can result in hair loss on the scalp. In Discoid Lupus Erythematosis lesions occur a round scaling papules 5 to 10 mm across with follicular plugging. There may or may not be scaling. Eventually the skin becomes smooth atrophic and scarred. Lupus is a photosensitive disease therefore exposure to sunlight should be minimised. Topical cortocosteroid ointments such as Triamcinolone Acetonide may be helpful in the treatment of small lesions. Also anti malarial drugs such as hydroxychloroquine are useful in the management of Discoid Lupus Erythematosis.
Lichen Planus
Lichen Planus is a rather uncommon skin disease that affects about 1% of the population. Lichen Planus is an inflammatory disease that strikes primarily the skin and mucous membranes. It usually starts as an itchy patch on the front of the wrists and forearms, the sides of the legs and ankles and lower back. In rare cases, when Lichen Planus can affect the scalp and other hairy areas this is called Lichen Planopilaris. It appears on the scalp as raised reddish-purple areas that look like lichen on a rock, or as an area of Alopecia with follicle plugging which usually clears up. Steroid lotions are used to relieve itchiness, antimalarial drugs may reduce inflammation.
Pseudopelade of Brocq
Pseudopelade of Brocq is a rare Scarring Alopecia which has no potential for regrowth. It usually affects middle aged people.
Aplasia Cutis Congenita
Aplasia Cutis Congenita is a rare disorder that often results as a small blistered atrophied area usually in the midline of the scalp and present from birth. In most cases the problem heals itself however in larger areas it may be associated with underlying developmental disorders.
Congenital Atrichia
Congenital Atrichia occurs when a baby is born without hair follicles in certain areas. This can be quite common and usually only occurs in a few spots which are easy to cover.
Effects
Scarring alopecia leads to the formation of bald patches. At the end stage of scarring alopecia the bald patches stop expanding. Any inflammation, itching, burning or pain in the hair follicles goes away. In this end stage of scarring alopecia a biopsy of the affected scalp usually shows no more inflammation.
The bald areas are usually left devoid of any hair follicles. Sometimes hair follicles, at the boundary of a bald patch, are not completely destroyed and they can regrow. But generally hair regrowth is not possible and all that is left are just a few longitudinal scars deep in the skin. These scars indicate that the hair follicles were present in that place.
|
| Treatment |
Non surgical treatment at Hairline
Non-surgical hair replacement can be a wonderful option for those who suffer from significant hair loss and would like to regain the appearance of having a full head of hair without surgery. The two main systems followed at Hairline are hair weaving and bonding.
Hairpieces are the most popular method of hair replacement, but the cost and appearance of any given hair piece varies widely based on the materials used and the level of craftsmanship in their creation.
Wigs
In general, treatments are much less effective for extensive alopecia For this reason, an attractive wig is an important option for some people. Proper attention will make a quality wig look completely natural; every wig has to be cut, thinned and styled, often several times.
|
|
|
|
