Understanding Cicatricial Alopecia: Symptoms, Causes, and Treatment at NIS
Cicatricial Alopecia, also known as scarring alopecia, is an inflammatory hair disorder characterized by permanent hair loss due to the irreversible destruction of hair follicles caused by inflammation. It affects about 7% of adult men and women, leading to mentally distressing permanent baldness. Let’s delve into the details of this condition, including its symptoms, causes, and available treatments.
Exploring Cicatricial Alopecia
Cicatricial Alopecia manifests as progressive hair loss and the eventual formation of scar tissue due to inflammation. The scarring primarily affects the hair follicles, leading to irreversible hair loss that is often permanent. Along with the hair follicles, the sebaceous glands may also be affected. This condition can affect individuals of all ages and genders, though it’s rare in children. The progression of Cicatricial Alopecia varies, sometimes advancing slowly with minimal symptoms, while at other times progressing rapidly with accompanying symptoms such as pain and itching. It typically begins as small bald patches that may expand over time.
Classification of Cicatricial Alopecia
Cicatricial Alopecia is classified into primary and secondary types based on the underlying causes:
Primary Cicatricial Alopecia: In this type, the immune system targets the hair follicles, triggering inflammation. Further classification is based on the specific inflammatory cells involved, such as lymphocytes and neutrophils.
Secondary Cicatricial Alopecia: Here, external factors such as burns, severe infections, tumors, allergens, or radiation lead to the destruction of hair follicles.
Differentiating Scarring Alopecia Based on Histological Features
Scarring alopecia encompasses various disorders with similar clinical presentations. Proper diagnosis is crucial for determining treatment options and prognosis. Diseases such as Lichen Planopilaris, Frontal Fibrosing Alopecia, and Folliculitis decalvans fall under this category, each with distinct characteristics and treatment approaches.
Signs & Symptoms of Cicatricial Alopecia
Cicatricial Alopecia may present with symptoms such as pain, tightness, redness, and inflammation on the scalp, though some individuals may remain asymptomatic. The progression of hair loss can vary, with symptoms ranging from itching and burning sensations to the formation of purulent pustules. Smooth bald patches with minimal pigmentation are typical features of this condition.
Causes of Cicatricial Alopecia
The exact cause of Cicatricial Alopecia remains unknown, but it’s believed to involve the destruction of hair follicles due to inflammation. Various factors, including genetic predisposition, changes in lipid metabolism, and external factors like harsh chemicals or injuries to the scalp, may contribute to its development.
Diagnosis of Cicatricial Alopecia
Diagnosing Cicatricial Alopecia involves a thorough dermatologic examination, including a skin biopsy to confirm the presence of inflammatory cells and tissue damage. Trichoscopy, a non-invasive imaging technique, may also aid in diagnosis.
Treatment Options for Cicatricial Alopecia
Treatment of Cicatricial Alopecia depends on the type and severity of inflammation. Corticosteroids, anti-inflammatory medications, and antibiotics may be prescribed based on the underlying cause. However, since hair loss in scarring alopecia is usually irreversible, treatment options are limited.
Hair Transplantation as a Treatment Option:
Hair transplantation may be considered in cases of Cicatricial Alopecia, but its effectiveness depends on the extent of tissue damage and the viability of implanted follicles.
Affected Populations and Related Disorders
Cicatricial Alopecia can affect individuals of all ages, with adults being more commonly affected. Certain populations, such as individuals of African descent, may be predisposed to specific types of scarring alopecia, such as Central Centrifugal Cicatricial Alopecia. Related disorders, such as Cutaneous Lupus Erythematosus, share similar symptoms and may require differential diagnosis.
Understanding and managing Cicatricial Alopecia requires a multidisciplinary approach, involving dermatologists, Trichologist and sometimes surgeons, to provide personalized treatment and support to affected individuals.
