As a dermatologist with a focus on hair disorders, I have extensive experience in understanding and treating various types of alopecia. Scarring alopecia, formally known as cicatricial alopecia, is a serious condition that leads to permanent hair loss due to the destruction of hair follicles. It is often accompanied by the formation of scar tissue, which is a significant concern as it indicates the damage is irreversible. The causes of scarring alopecia are varied and can be broadly categorized into several groups:


1. Inflammatory Disorders: These are the most common causes of scarring alopecia. They include conditions such as discoid lupus erythematosus, which is an autoimmune disease that causes inflammation and scarring of the skin, and folliculitis decalvans, a chronic inflammatory condition affecting the scalp and hair follicles.


2. Infections: Certain infections can lead to scarring alopecia. Fungal infections like tinea capitis, bacterial infections such as pseudomonas folliculitis, and viral infections like herpes zoster (shingles) can cause inflammation and damage to the hair follicles.


3. Trauma: Physical trauma to the scalp, such as burns, deep cuts, or other injuries, can result in scarring and subsequent hair loss.
Trichotillomania, a psychological disorder characterized by compulsive hair pulling, can also lead to scarring if the hair follicles are damaged.


4. Neoplastic Conditions: Benign and malignant tumors of the scalp can cause scarring alopecia. Conditions like epithelioma and basal cell carcinoma can invade and destroy hair follicles.


5. Connective Tissue Diseases: Diseases that affect the body's connective tissues, such as systemic lupus erythematosus and sarcoidosis, can lead to scarring alopecia as they can cause inflammation and damage to various body parts, including the scalp.


6. Drug-Induced Alopecia: Certain medications, particularly those used in chemotherapy, can cause hair loss. While this is typically reversible, in some cases, the damage to the hair follicles can be permanent.

7.
Genetic Disorders: Some rare genetic conditions, such as frontoparietal alopecia, can lead to scarring alopecia.

8.
Irritation and Allergic Reactions: Chronic irritation or allergic reactions to hair products, chemicals, or other substances can cause inflammation and scarring of the scalp.

9.
Surgical Procedures: In some cases, surgical procedures involving the scalp can lead to scarring and hair loss.

10.
Autoimmune Diseases: Autoimmune diseases, such as alopecia areata, although typically non-scarring, can in rare cases lead to scarring alopecia if there is an overlap with other conditions or if the inflammation is particularly severe.

It's important to note that the diagnosis of scarring alopecia requires a thorough examination and often a biopsy to confirm the presence of scar tissue and to determine the underlying cause. Treatment options vary depending on the cause and may include medications, lifestyle changes, or surgical interventions. Early diagnosis and treatment are crucial to minimize the extent of hair loss and to manage the condition effectively.

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Scarring hair loss, also known as cicatricial alopecia, is the loss of hair which is accompanied with scarring. ... It can be caused by a diverse group of rare disorders that destroy the hair follicle, replace it with scar tissue, and cause permanent hair loss. A variety of distributions are possible.read more >>