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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.
    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:

bullet Alopecia areata - circular bald spots on the scalp
bullet Telogen effluvium - sudden hair shedding
bullet Tinea capis - fungal infection of the hair
bullet Thyroid gland diseases that cause hair loss
bullet Illnesses that cause non-permanent hair loss
bullet Scarring alopecia - permanent hair loss
bullet Lupus and hair loss
bullet Medications that cause hair loss
bullet Other diseases that cause hair loss
bullet How hair loss diseases are diagnosed






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My thinning hair head after 3 months
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