As a dermatologist with a focus on hair and scalp disorders, I have encountered numerous cases of hair loss, including cicatricial alopecia. This is a particularly concerning condition due to its permanent nature and the impact it can have on a patient's self-esteem and quality of life.

Cicatricial alopecia is a type of scarring hair loss that results from damage to the hair follicles, which are replaced by scar tissue. Unlike non-scarring alopecia, such as androgenetic alopecia (commonly known as male or female pattern baldness), cicatricial alopecia leads to permanent hair loss because the follicles are destroyed and cannot regenerate hair.

The causes of cicatricial alopecia are varied and can include:

1. Inflammatory disorders: Conditions like discoid lupus erythematosus, pseudopelade, and folliculitis decalvans can cause inflammation that leads to scarring.

2. Infections: Bacterial, fungal, or viral infections can result in scarring, particularly if they are not treated promptly.

3. Trauma: Physical damage to the scalp, such as from burns or deep cuts, can also cause scarring.

4. Neoplastic processes: Certain tumors can lead to scarring of the scalp.

5. Connective tissue diseases: Diseases like systemic lupus erythematosus and sarcoidosis can affect the scalp and lead to scarring alopecia.

6. Drug-induced: Some medications can cause a loss of hair with scarring as a side effect.

Diagnosis of cicatricial alopecia typically involves a thorough examination of the scalp, which may include:
- Clinical evaluation: Looking for signs of inflammation, scarring, and hair loss patterns.
- Trichogram: A microscopic examination of plucked hairs to assess hair and follicle health.
- Biopsy: Taking a small sample of scalp tissue to examine under a microscope for signs of scarring and inflammation.

Treatment for cicatricial alopecia is challenging due to its permanent nature. However, some approaches can be taken:

1. Topical treatments: Corticosteroids can help reduce inflammation in some cases.

2. Disease-specific treatments: Targeting the underlying cause, such as treating an infection or managing an autoimmune condition.

3. Surgical options: In some cases, hair transplantation may be possible if there are areas of non-scared scalp where hair can be transplanted.

4. Supportive measures: This can include the use of wigs or hairpieces to improve appearance and self-esteem.

It's important to note that early diagnosis and treatment are crucial in managing cicatricial alopecia, as the damage caused by scarring is irreversible. Patients should seek medical advice if they notice any unusual changes in their hair or scalp.

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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 >>