Scarring alopecia

What it is

A group of conditions where inflammation destroys follicles and replaces them with scar tissue, making hair loss permanent in affected areas.

Who gets it

Relatively rare; some types are more common in certain groups (e.g. CCCA in women of African descent).

Signs to look for

• Shiny, smooth skin with no visible follicle openings
• Itching, burning or tenderness
• Redness or scaling around hairs

Common causes and triggers

• Lichen planopilaris
• Frontal fibrosing alopecia
• Central centrifugal cicatricial alopecia (CCCA)
• Discoid lupus
• Folliculitis decalvans

How it is diagnosed

• Scalp biopsy is usually needed

Treatment and care options

These are the options commonly discussed. What suits you depends on your diagnosis — a dermatologist can help you choose.

• Anti-inflammatory treatments to stop progression
• Early specialist care is key
• Transplant only once inactive

Outlook

Lost hair usually doesn't return; the goal is to stop further loss.

When to see a doctor

Promptly — early treatment saves hair.