Scarring alopecia -
permanent hair loss - and the diseases that cause it
Characteristics
of permanent hair loss
Also
called cicatricial alopecia, the
word "scarring" is used in scarring alopecia
to mean "permanent". It
also just means permanent hair loss. There is usually
no visible scarring. In fact for advances scarring alopecia,
what you usually see is a shiny scalp. The scarring
has happened underneath the scalp surface, where the
hair follicles are replaced with scar tissues.
All
scarring alopecias show the body's immune cells attacking
the skin and hair follicles. It occurs when the hair
follicles are destroyed. The skin and hair follicles
undergo certain changes and can look quite similar to
non-scarring alopecia: These changing conditions can
be based on the following:
- Changing
skin characteristics: The attack of the immune cells
causes the skin to lose its shine and becomes dull
and hard to touch, but susceptible to erupt.
- Particular
areas of the scalp may be affected in similar ways.
Meanwhile the surrounding skin can be perfectly normal.
- The
skin may develop blister type changes with redness
that may appear to be infectious.
- Different
alopecias have their own evolutionary changes in the
skin over time. Different parts of the body may be
affected differently.
- The
skin may appear to weep, producing wetness. Some of
these diseases can also cause the skin to be dry and
crusty, some stay normal, while others develop fine
thin skin.
- While
the skin changes, hair follicles are destroyed below
the surface.
The
hair follicles are destroyed in different ways. When
the hair folicles are attacked directly, it is called
primary cicatricial alopecia. An example of
this is lichen planopilaris
(see below). When attacked indirectly, it is called
secondary scarring alopecia. Examples of this
are damages from radiation therapy and burn injury to
the scalp.
Uncommon
conditions that cause permanent hair loss are as follows:
- Lichen
planopilaris:
This is manifested as purplish bumps or red-to-purple
rims around the hair follicles. It can be on the scalp
alone or associated with the skin condition lichen
planus.
 |
Lichen
planopilaris |
Under
this condition, the white blood cells attack the hair
follicles, causing permanent damage. The cause of
this condition is unknown.
- Frontal
fibrosing alopecia: This is more common among
postmenopausal women. It is characterized by large
spaces between hair follicles.
 |
Frontal
fibrosing alopecia |
In
this condition, the immune cells are destroying the
hair follicles they surround.
- Pseudopelade:
The general shape of this disease is similar to alopecia
areata, a non-permanent hair loss disease.
 |
Pseudopelade |
It
is not a specific disease but a pattern of old scarring
alopecia resulting from a variety of causes.
- Dissecting
cellulitis of the scalp:
This is characterized by multiple pustules and large
cystic nodules in the scalp and can be associated
with severe facial acne.
 |
Dissecting
cellulitis |
It
is commonly occurs at the back of the scalp and common
with ethnic Africans.
When
you have an unusual hair loss issue, it is difficult
to know if it will develop to be permanent. Therefore
treat hair loss conditions early.
The
links related to this page on hair loss diseases are:
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