Cicatricial alopecia

Cicatricial alopecia is one of the most severe and irreversible forms of alopecia. It is partial hair loss that occurs unevenly on one or several areas of the scalp, unlike ordinary alopecia (androgenetic and seborrheic alopecia, which generally appear on the top and sides of the head).

The hair follicle, which is essential to hair growth, is completely and permanently destroyed, which generally makes the scalp appear smooth and shiny. The inflammation of the follicle kills the hair, which does not grow back.

In general, it is caused by physical or chemical trauma to the scalp.

There are several causes and forms of cicatricial alopecia

  1. It can be congenital:
    • For example, cutis aplasia or keratosis pilaris atrophicans.
  2. It can be caused by infectious, bacterial or viral diseases:
    • Syphilis and favus are two diseases that cause it. Certain serious bacteria and viruses destroy the scalp, including lichen planus follicularis, skin cancers, granulomas, systemic lupus erythematosus and cutaneous lupus (lesions), and scleroderma. Mycosis can also trigger alopecia. Alopecia mucinosa (Pinkus) is another disease that affects the hair follicle. It involves the secretion of a protein substance, mucin, which is produced if there is inflammation. In young people, it presents as red patches, and the disease can spread to the eyebrows.
  3. A self-defense reaction by the body may be responsible
    • A person suffering from scleroderma, widespread lupus erythematosus or, more rarely, sarcoidosis, develops antibodies as a natural reaction, and these antibodies attack its own cells, causing hair loss.
  4. It may be caused by a metabolic deterioration
    • Certain skin diseases called dermatoses, some tumors and other causes such as amyloidosis or basal cell carcinoma lead to metabolic dysfunction and hair loss.
  5. It can be caused by external aggression 
    • Serious skin burns or radiodermatitis (exposure to X-rays during a treatment, for example) completely destroy the hair follicle.

No treatment currently exists that can revive dead follicles. If certain areas are not affected, hair implants can be applied.

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