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Hair Transplantation

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Dr. Karalexis answers himself as an expert on questions related to hair transplantation or other treatments.

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Scarring Alopecia

What is scarring alopecia?

Scarring alopecia refers to a permanent loss of head hair due to a disease that destroys the hair follicle and creates a scar.

The scar is due to various inflammatory skin conditions which creates  scars and  destroys the ability of the hair to regenerate again. Hair loss starts gradually and then the skin atrophies and becomes smooth. In some cases healthy patches of hair remain.

Early diagnosis of the skin condition leading to scarring alopecia combined with case-specific individualized treatment can be life-saving to prevent extensive destruction of hair follicles.

Forms of scarring alopecia

Scarring alopecia is divided into:

  • Primary scarring alopecia
  • Secondary scarring alopecia

In case the causes are internal [dermatoses], scarring alopecia is classified as primary. If the causes are external [e.g. burns, injury or neoplasm] it is called secondary

Lichen Planopilaris  is a syndrome that causes scarring alopecia and occurs most commonly in women.

What are the factors that lead to scarring alopecia?

Scarring alopecia is usually caused by diseases such as :

  • lupus erythematosus
  • Thyroid Lichen
  • Scarring Pemphigoid
  • Achorrhoids
  • fungal infections of the scalp

In addition, it may occur as a result of:

  • Skin or systemic diseases.
  • Infections or inflammations of the skin.
  • External natural causes.
  • Neoplasms
  • Hereditary diseases

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What are the symptoms of scarring alopecia?

The main features of scarring alopecia are as follows:

  • hair loss
  • skin smooth, atrophic and scarring.

In some cases of scarring alopecia, hair loss is gradual and without symptoms, making it difficult to diagnose. Sometimes the inflammation is intense and presents with itching, burning and pain.

How is the disease diagnosed?

Diagnosis involves a histological examination. A biopsy is taken from areas showing evidence of inflammation.

What are the treatment options?

Depending on the type of scarring alopecia, the doctor in charge will prescribe the patient the appropriate medication. The conservative treatment that will be followed includes some of the following:

  • Steroids are the treatment of choice.
  • azathioprine
  • systemic administration of cyclosporine
  • intravenous injection of steroids.
  • topical minoxidil
  • topical cyclosporine.
  • antimalarial drugs, alone or in combination with systemic steroids.
  • thalidomide
  • antibiotics

If conservative treatment is not sufficient and if the disease is chronically inactive, treatment with hair transplantation is recommended. In addition, FUE hair transplantation is indicated for certain cases of scarring alopecia caused by trauma or burns.

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