All About Scarring Alopecia – Types, Symptoms, Causes, Treatment & Hair Care

What is Scarring Alopecia

Scarring alopecia is a condition in which a person suffers hair loss and baldness. There is permanent destruction of hair follicles so that hair cannot grow back. It starts with small patches of baldness that expand with time. Since there is gradual hair loss, the condition may not be noticed by the patient, until the baldness becomes extreme. It may be accompanied by itching and burning sensation on the scalp.

The incidence of scarring alopecia ranges between 3% and 7% of the population. It can affect both men and women. Since the hair cannot be grown back, it causes stress among people suffering from it. Also known as Cicatratial alopecia, patients will experience hair loss gradually over a period of time, but it could be quite rapid and affect the person in just a few months. The hair follicle gets destroyed and patients experience discomfort on the scalp, including inflammation, scaling and pigmentation.

Types of Scarring Alopecia

Scarring alopecia can be primary, secondary or developmental. Primary scarring alopecia occurs when the hair follicle is destroyed. Fibrous tissue takes its place, preventing re-growth. It is called primary scarring alopecia because the disease begins with hair follicle which is completely destroyed. The skin of the scalp becomes smooth and shiny, with an absence of pores and follicular openings. Primary cicatricial alopecia has no known causes as there is no identifiable cause.

Secondary scarring alopecia is identified when the hair follicles are not destroyed directly but face damage as a result of skin inflammation which leads to their destruction. This is also an irreversible condition but is caused by skin conditions, damage due to burns or diseases such as cancer, or psychological trauma.

The third type of primary scarring alopecia is called developmental or hereditary and is caused by genetic factors, hormone imbalances or natural hair loss due to aging.


Bald patches on the scalp are the primary symptoms of scarring alopecia. Initially the bald patches may be small but spread and become bigger with time. The skin has a smooth and shiny look and absence of skin pores. Accompanying symptoms may include discomfort on the scalp such as itching or burning sensation, pain, rough and scaly skin and sometimes blisters as well.


The causes of scarring alopecia are not known and therefore it is challenging to diagnose and treat. One factor is the inflammation on the scalp but this is not necessary. It may also be caused by hot combs, pull on the hair due to hair styles, and exposure to chemicals and pollution. It has also been traced to inflammation of the skin, occurrences such as injuries and burns, diseases such as cancer and genetic factors.


Usually the condition is diagnosed by careful examination of hair and scalp. A scalp biopsy may be required for the diagnosis of scarring alopecia. Patient history, age, skin or scalp conditions are examined to arrive at a proper diagnosis. The doctor may also conduct microscopic examination of the pores on the skin. A hair pull test can show the extent of damage to the hair follicles. If hair comes off in gentle pulling, the condition is conformed.


Treatment for scarring alopecia consists of preventing further loss of hair. Since hair cannot be re-grown, covering the scalp with hair systems and wigs is the only solution. The doctor may prescribe medicines for reducing inflammation symptoms. Sometimes topical creams help in reducing itching and inflammation on the scalp, thus controlling the disease. In many cases, treatment consists of hair transplant which can attempt to re-grow hair on the bald patches. However, this can be done only if some amount of hair is left to transplant.

Medicines that help in treating the disease are drugs for malaria and oral corticosteroids. It is recommended to avoid exposure to the sun and the use of sunscreen creams and lotions.

Preventive Steps

Since the disease will claim your hair and cause permanent baldness, it is important to care for your hair and delay its onset. Patients are advised avoidance of hair care products that contain chemicals. It is important to protect hair from sunlight. Hair styling products such as heat treatments are also to be avoided. If the condition does set in, covering the bald areas or hair transplantation may be the last options.


Baldness is not a happy condition and it affects the self-esteem of sufferers.  Scarring alopecia is particularly harmful as the condition is irreversible. It is important to seek medical attention the moment hair loss is noticed, because in early stages the inflammation can be controlled. Harmful hair habits must be avoided and regular lifestyle habits must be maintained. A good, nourishing diet may well prevent scalp diseases. It is important to delay the condition as far as possible through preventive methods.

About Atul Vashishta

With a long experience in the industry and a profound knowledge of human skin and hair biology, my beauty and hair science offers turn-key solutions to increase hair care and skin care effectiveness. Known as the founder of Kabera Global, the best hair treatment, and skin care clinics in India, I am always happy to provide flexible guidance for a professional skin and hair care routine by my blogs.

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