What is Cicatricial Alopecia?
Cicatricial alopecia (CA), also known as scarring alopecia, refers to diverse forms of hair loss disorders associated as a result of allergic reactions. The many forms of CA have a common theme of potentially triggering the inflammatory cells to destroy the stem cells around the hair follicles, the development of scar tissue, and leading to permanent hair loss.
What Causes Cicatricial Alopecia?
The specific cause of CA is not clearly understood. However, environmental, genetic, and biologic or immunologic factors are believed to play critical roles in the onset and development of CA. Typically, CA occurs in two different forms: primary and secondary. In the primary form of CA, the entire hair loss involves the inflammation role of immune cells, lymphocytes or neutrophils, targeting and destroying the hair follicles. However, the destructive processes of hair follicles in the secondary form of CA are instigated by other causes such as radiation, infections, tumor, severe chemical burns, and exposure to other chemical irritants on the hair scalp and skin.
Who is at Risk?
According to American Hair Loss association, CA is a rare disease diagnosed in up to 3% of patients around the world. It occurs among healthy populations of all ages irrespective of gender, class, or race. Compared to adults, CA is not common among children where the incidence of the disease usually involves only one member of the family. However, the central centrifugal alopecia is an exceptional CA that commonly occurs among women of African-American origin, and may affect more than one family member.
Cicatricial alopecia is clinically manifested by symptoms of gradual or rapidly progressive patches of hair loss associated with severe itching, burning, and pain below the scalp skin surface. In some cases, the affected bald areas may appear scaly, redness, or have raised blisters with oozing pus.
Diagnosis and Prevention
Skin and scalp biopsies are often performed to confirm the diagnosis of a suspected CA. The results from biopsies are coupled with diagnostic assessments on visual indicators on hair loss patterns, the nature of the scalp skin, including the presence and location of scar tissue to help the dermatologists identify the particular form of CA for proper treatment options.
Prompt treatment measures are critical to prevent further spread of permanent hair loss. The nature of treatment varies according to the confirmed diagnostic form of CA, whether lymphocytes, neutrophils, or both primarily contribute to follicle destruction. The CA disorders caused by lymphocyte inflammations are usually treated with topical corticosteroid creams or injections into the affected areas of the skin, while most of the neutrophil inflammations are treated with oral or topical antibiotics and anti-inflammatory drugs. The disorders of mixed inflammatory cells are treated with antibiotics, antimalarial drugs, immunosuppressive drugs, and certain drugs like methotrexate, cyclosporin, tacrolimus, thalidomide, retinoids, and thiazolidinediones.
In the recent past, hair restoration surgery, also known as follicular micrografting or hair transplant has been a promising treatment intervention for scarring alopecia. The surgical treatment involves transplanting or grafting hair follicles into the bald areas of the scalp to restore the hair loss after the disease becomes inactive for one or two years using medications.
The prevention measures to avoid and prevent cicatricial alopecia may include:
- Avoiding regular exposure of your skin and hair to various chemical irritants, such as hair dyes, chemical relaxer treatments, latex, fragranced skin care cosmetics, and among other hair washing and treatment products.
- Purchasing and using allergy-free products manufactured from100% naturally-organic ingredients for routine hair care, cosmetics, and fabric materials, such as cotton
American Hair Loss Association. (2010). Scarring Alopecia (Cicatricial Alopecia). Retrieved 6th, September 2017 from http://www.americanhairloss.org/types_of_hair_loss/scarring_alopecia.asp
National Institute of Arthritis and Musculoskeletal and Skin Diseases (December 2012). Cicatricial Alopecia: Overview. Retrieved 6th, September 2017 from https://www.niams.nih.gov/health_info//Cicatricial_Alopecia/default.asp
WebMD. (March, 2010). Scarring Alopecia. Retrieved 6th, September 2017 from http://www.webmd.com/skin-problems-and-treatments/hair-loss/scarring-alopecia#1