Cicatricial or scarring alopecia comprises diverse groups of scalp disorders that result in permanent hair loss. This destructive process can occur as a primary or secondary cicatricial alopecia.
Primary cicatricial alopecia: This is a group of idiopathic (unknown cause) inflammatory processes that attack the hair follicles, leading to their destruction.
Secondary cicatricial alopecia: This type is caused by external factors that damage the scalp and hair follicles. These factors can include:
Regardless of the type, cicatricial alopecia leads to the replacement of healthy hair follicles with scar tissue. Because of this scarring, hair cannot regrow in the affected areas.
Hair loss that may develop slowly over years, potentially with few noticeable symptoms
Rapid hair loss that progresses over months in some individuals
Burning and itching of the scalp
Redness of the affected areas
Scaling or the presence of pustules on the scalp.
Medications
Corticosteroids, either applied topically or taken orally, may help reduce inflammation and slow down the progression of the condition. Other medications such as antibiotics or antimalarials may also be prescribed in certain cases. Minoxidil 2% solution has shown to be effective, but hair transplant is the best treatment.
Immunomodulators
Drugs that suppress the immune system may be used to control the inflammatory response causing hair loss, such as cyclosporine or methotrexate.
Laser therapy
Low-level laser therapy is sometimes used to stimulate hair growth in the affected areas.
Hair transplantation: In some cases, hair transplantation may be an option to restore hair in areas of scarring that are stable.
Supportive care
Managing symptoms, such as using medicated shampoos or topical corticosteroids to relieve itching and prevent infection, is important.
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