Scarring alopecia, also known as cicatricial scarring alopecia, refers to a category of hair loss disorders. There are many types of scarring alopecia, but normally in most scarring alopecia cases, the hair follicles are permanently destroyed and replaced with scar tissues. In most cases, when this disorder occurs, the patient starts loosing hair in small patches.
While in some forms of scarring alopecia the hair loss is rapid and accompanied by severe irritation and pain in the scalp, in most types, the hair loss is slow and gradual, without any obvious symptoms and may not even be noticeable for a long time.
The cause of each kind of scarring alopecia cannot really be diagnosed very well, but the disorder may evolve from conditions like hot comb alopecia (follicular degeneration syndrome), dissecting cellulitis, lichen planopilaris and others. At times, chronic lupus erythematosus, an autoimmune disease which affects different parts of the body, may also involve scarring alopecia.
Nevertheless, most forms of scarring alopecia causes inflammation of the hair follicle, thereby destroying stem cells and sebaceous glands, leading to permanent hair loss. Scarring alopecia symptoms may include, redness of the base of the hair shaft, itchiness, scaling, and skin (scalp) pigmentation. At times symptoms may include emergence of pustules (boils or blisters), which may have pus or fluid oozing out of it.
Usually biopsy is performed to diagnose and help treat the condition. Local anesthesia is administered and a piece of skin is removed with the help of a biopsy punch. Usually more than one skin specimen is required to establish a correct diagnosis and begin appropriate treatment.
Treating cicatricial scarring alopecia may be very difficult because once the hair follicle is destroyed, restoration becomes difficult. The main focus of treatment usually revolves around arresting further hair loss and retaining the remaining hair which too are at a risk of getting affected. Treatment also is targeted at reducing redness or pigmentation and scaling and inflammation.
Because, as such there are no real FDA approved scarring alopecia treatments, all treatment depends upon the physician or dermatologist. Many times patients initially do not respond to treatment. Generally corticosteroids (in the form of injections or topical applications) are used to treat inflammation of hair follicles caused during scarring alopecia.
Another method to treat scarring alopecia involves surgery. Once the hair fall has stopped and the condition has burnt out, surgery can be conducted to remove big spots and transplant smaller spots with hair taken from other spots which are in good condition.
Also some studies indicated that a combination of hair grafting surgery and topical application of minoxidil provided good results. Other methods include intake of antimalarial and isotretinoin drugs, topical application of creams and natural remedies for instance, including foods rich in biotin into the diet.
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