The Three Type of Scarring Alopecia

On your search for an explanation behind your thinning hair and hair loss you may have visited a doctor. Having a scalp biopsy performed by a dermatologist can help diagnose conditions that can be causing your hair loss. Occasionally a dermatologist may find a reason behind your hair loss which can help you treat it.
One of the conditions dermatologists uncover after a scalp biopsy is scarring alopecia. Scarring alopecia has three different subtypes and we will discuss them here.

Frontal Fibrosing Alopecia (FFA)

Hair loss and scarring around the hair line and temples is frontal fibrosing alopecia. While sometimes confused with traction alopecia, hair loss due to continuous tension of hair around the hair line from pony tails or tight hair styles, FFA is an untreatable form of permanent hair loss. Its distinguishing feature is symmetrical hair loss along the front hairline and down the sides of the scalp. Sometimes one might also notice hair loss in their eyebrows as well. Another common occurrence seen in FFA is a change in the color of the skin along the hairline, perhaps paler and shinier or with visible scars and scaling where the hair follicles are.
Researchers feel the cause may be an autoimmune response to the small or intermediate sized hair follicles that naturally occur towards the hair line. It is also notable that this condition tends to occur in women after menopause and so there may be a hormonal component involved.
There is no cure for FFA but doctors may try to treat it with oral steroids to slow the progression of the condition. Also, anti-inflammatory and antibiotic medications are sometimes used. None of these treatments regrow hair and so the hair loss experienced is usually permanent.

Cictricial Centrifugal Alopecia (CCA)

Hair loss that can cause destruction of the hair follicle is called scarring alopecia or cictricial centrifugal alopecia. If you have scarring alopecia your hair follicles become destroyed and as they heal, scar tissue forms inhibiting further hair growth. This condition leads to permanent hair loss which may happen gradually over time. It can be difficult for doctors to diagnose because it happens at different levels of severity and at such a slow rate many people do not notice symptoms for many years. For others, this condition can happen quickly in a matter of a few months leading to significant hair loss in a short amount of time. When the hair loss happens at such a quick pace one can also experience irritation or itching. This may be because CCA can cause inflammation which may explain the burning sensation some people feel. A hair biopsy performed by a dermatologist is the proper way to be diagnosed with CCA. On occasion the skin may show signs of scaling or redness, signs of inflammation and damage to the hair follicle. Scarring is not usually apparent as the condition often doesn’t affect the top layer of the skin rather, it affects the layers of skin below the surface.
A specific cause of CCA has not been determined, all researcher have come up with is that it always starts with inflammation that impacts the hair follicle. It can happen to men and women of all ages but it seems to be most apparent in African American women. It is not associated with a disease or an illness nor is hereditary.
Since inflammation is a factor, the use of anti-inflammatory medications can help stop the spread of the condition and reduce its symptoms. This is usually most effective if caught in the early stages. If early detection results in prompt action, for example, a course of treatment for six months to a year, the condition can potentially stabilize.

Lichen Planopilaris (LLP)

A subtype of scarring alopecia that is caused by an inflammatory autoimmune disease is called lichen planopilaris or LLP. This condition usually appears in middle aged women when their immune system attacks healthy hair follicles. Scarring results and causes permanent hair loss. Occasionally purplish bumps can be seen on the scalp tipping off doctors but usually a scalp biopsy is necessary to diagnose this condition because it can cause patchy hair loss throughout the scalp which is easily mistaken for more common forms of alopecia. Redness and scaling of the skin around the hair follicle is often seen, a rough texture on the scalp may appear where hair follicles are being blocked. Ultimately a shiny smooth texture is noticed when the hair follicle is destroyed.
There is no cure for LLP but it may go away on its own. If the condition is uncomfortable you can ask your doctor for topical corticosteroids to help minimize swelling, prednisone can help treat sores and antihistamines can help calm the itching.

If you are dealing with a form of scarring alopecia it is important for you to complete your course of medications. Once you have done that Images International can help you feel good about your hair. We will use a combination of trichology treatments to soothe the scalp and hair additions to address the areas where you are experiencing permanent hair loss. For a free consultation to discuss these options, please call (248) 540-0900.