What Is Scarring Alopecia?

Cicatricial alopecia refers to localized hair loss that suddenly occurs in the body's hair, and the hair follicle epithelium is replaced by connective tissue, resulting in permanent baldness. The disease is called "ghost steamed bun" and "oil wind" by the traditional Chinese medicine.

Basic Information

English name

cicatricial alopecia

Visiting department

dermatology

Multiple groups

30 to 50 year old women

Common locations

Body hair parts

Common causes

Suffering from deep burns, radiation dermatitis, skin malignancies, skin sarcoidosis and other diseases

Common symptoms

Limited hair loss in the body's hair, permanent baldness

Classification of Scar Alopecia

Primary scar alopecia

(1) Lymphocytic chronic cutaneous lupus erythematosus, hair follicular lichen planus, classic pseudoalopecia areata, central eccentric scar alopecia, mucinous hair loss, alopecia keratosis.

(2) Neutrophilic bald folliculitis and deep cellulitis of the neck.

(3) Mixed scar folliculitis, necrotic folliculitis, erosive pustular skin disease.

(4) Idiopathic.

2. Secondary Scar Alopecia

Deep burns, radiation dermatitis, skin malignancies, skin sarcoidosis, scleroderma, progressive lipid-like necrosis, and chronic infections such as skin tuberculosis.

Clinical manifestations of scar alopecia

Sudden hair loss occurs suddenly in the body's hair. Hair follicle epithelium is replaced by connective tissue, resulting in permanent baldness. Histopathology is important to diagnose and assess the extent of inflammation.

Differential diagnosis of scar alopecia

Pseudoalopecia areata

Symptoms are similar to alopecia areata, but the skin of the affected area is atrophic, and hair cannot be regenerated. There are island-shaped normal hair bundles on the surface, and there are narrow red halo bands around the periphery of the lesion.

2. Tinea capitis

The onset is often broken, non-hair loss, and a positive fungal test.

3. Hair pluck

Patients have mental disorders, often unconsciously plucking hair frequently.

4. Leprosy hair loss

Hair loss starts from the hairline and gradually spreads upwards. In severe cases, only flaky or linear hair remains along the blood vessel path. In addition to hair loss, it also has other damage and paresthesia.

5. Syphilitic hair loss

Have a history of syphilis or unclean sex. Hair loss is worm-like, irregularly distributed, and is more common on the occipital-temporal side. Positive syphilis serology.

Scar Alopecia Treatment

Choose different drugs according to the cause of scarring alopecia.

Drug treatment

(1) Glucocorticoid Steroids are effective orally or intramuscularly, and are only used for those who experience general baldness, general baldness, and rapid progress of baldness.

(2) Immunosuppressive cyclosporine, mycophenolate mofetil, methotrexate.

(3) Retinoids.

(4) Others such as antibiotics, vitamin B family, dapsone and hydroxychloroquine.

2. Topical treatment

Mostly stimulants, cause local moderate contact inflammation, make local congestion and promote hair regeneration.

(1) glucocorticoid preparations for external use or injection into the skin.

(2) Anthracene ointment.

(3) Nitrogen mustard hydrochloride.

(4) Minoxidil.

3. physical therapy

(1) Freezing Use low temperature liquid nitrogen freezing method.

(2) Laser He-Ne laser irradiation.

(3) Photochemotherapy.

(4) Other therapies such as massage and wax therapy.

4. Surgery

Hair transplant.

5. Psychotherapy

Give appropriate treatment according to the cause to relieve the mental burden. Wigs can be worn to reduce mental stress, and sedatives such as diazepam and bromine should be given to those who have obvious mental factors.