There are a variety of reasons patients develop scarring alopecia, including inflammatory skin diseases, chronic hair styling habits, infection and trauma. As a board certified dermatologist, Dr. Avram can diagnose, and then treat your scarring alopecia medically and/or surgically depending on the stage of your hair loss.
Scarring alopecia refers to a group of hair loss disorders that create permanent destruction of hair follicles by scar tissue formation in the skin. There are a variety of causes including - primary inflammatory skin diseases, excessive heat/chemicals applied to the scalp for hair styling for months/ years, and less commonly from bacterial or fungal infections.
Scarring alopecia is treatable. If the inflammation, heat, chemical, or infection is controlled the hair loss can be stopped and even reversed at the early stage of the condition. There are a variety of treatment options including - topical steroids, intralesional steroids, antibiotics, oral anti-inflammatories, and most recently platelet-rich plasma therapy and low-level light laser therapy.
Symptoms such as itching or pain in the scalp associated with hair loss may indicate scarring alopecia. A physical exam of the scalp coupled with a scalp biopsy will confirm a diagnosis. Once confirmed it is treatable for the vast majority of patients.
For patients with visible hair loss not reversible with medical therapy, hair transplantation is an excellent reconstructive procedure
Scarring alopecia generally starts with the appearance of small patches of hair loss that may grow larger over time. For some, there are no other noticeable symptoms, while in others the patches may become inflamed and cause itching and pain.
Diagnosis of scarring alopecia is tricky because the destruction of the hair follicle takes place under your skin and the outward signs on your scalp can range from a smooth spot to small blisters. One good indicator of scarring alopecia is a ragged edge around the patch, but since irritated patches don’t always form, a small biopsy is usually performed to detect inflammatory cells around your hair follicles that may indicate scarring alopecia.
The first order of business in treating scarring alopecia is to treat the primary inflammatory disease medically. Once the underlying cause of the hair loss patches has been addressed, you may begin to treat and remedy the affected areas.
Typically, your scarring alopecias can be corrected by adding a large number of follicular groupings into the affected scar tissue. The growth of transplanted hair in scarring alopecias is more unpredictable than for typical male or female pattern hair loss and often requires one to three procedures to achieve your cosmetic goal.
It is also important to note that future flare-ups of your scalp disease can occur and could affect your transplanted hair.
Dr. Avram will discuss with you how and when your hair loss areas may be corrected based on the diagnosis of the underlying cause for your scarring alopecia.