Cicatricial alopecia is a rare form of hair loss where the hair follicle becomes destroyed and is replaced with scar tissue causing permanent hair loss. For some people, the loss of hair may be gradual and go unnoticed or it may be accompanied by itching, burning or pain in the scalp. Some forms of cicatricial alopecia cause scalp redness and inflammation and others show no signs of infection as hair seems to gradually diminish without an apparent cause.
Diagnosis of cicatricial alopecia is usually made after one or more skin biopsy samples are taken from the scalp. The skin is examined under a microscope to look for signs of inflammation to determine if an infection may be causing the hair loss. Scarred cells are examined to determine whether the hair in that area of the scalp may re-grow from unaffected hair follicles.
Causes and types:
Cicatricial alopecia occurs to both men and women usually in mid adult years. The main forms are classified based on the type of inflammatory cells involved either: lymphocytes or neurophils. Cicatricial alopecia affects both caucasians and African Americans though each ethnic group has a tendency towards different types of hair loss.
One form that occurs more commonly to African American females called central centrifugal cicatricial alopecia (CCCA) may be related to increased use of hair extensions, chemicals for straightening and other tight traction type hairstyles such as cornrows. The hair loss appears centered in the back of the head and may at first be mistaken for general female related hair loss.
Lichen planopilaris is another chronic inflammatory form of cicatricial alopecia that more commonly occurs to caucasians, particularly women. The cause is unknown but is believed to be related to exposure to certain chemicals, medication and even gold or a virus. It appears on the scalp as flattened, itchy, pimple like shiny eruptions that may be purple or white. Lichen planopilaris can go dormant then cause an outbreak again years later.
There is no cure for cicatricial alopecia and once the hair follicle is destroyed, the hair loss will be permanent. The main goal of treatment is to prevent further risk of damage to hair follicles and treat any redness or inflammation present. Antibiotics, corticosteroids either taken orally or injected into the scalp and retinoids or vitamin A based creams are used. Minoxidil solution applied to the scalp my help increase growth in the remaining hair follicles.
There have not been any widespread studies or FDA approved drugs for the treatment of cicatricial alopecia. Working with a knowledgeable experienced dermatologist who has seen progress from the use of a variety of therapies is the best step to take in treating cicatricial alopecia.
Support and resources:
The North American Hair Research Society at www.nahrs.org
The Cicatricial Alopecia Research Foundation at www.carfintl.org
Michele is an R.N. freelance writer with a special interest in woman’s healthcare and quality of care issues. Other articles by Michele can be read at http://www.helium.com/users/487540/show_articles