About Hair Loss

Scarring Alopecia – Hair Restoration – Plano, TX

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Overview

There are many varying types of alopecia, the medical term used to describe hair loss. Scarring alopecia, known as cicatricial alopecia, refers to a group of conditions that destroy the hair follicles, causing permanent hair loss. This type of hair loss is associated with fibrosis and scar tissue that replaces the hair follicles. The destruction of the hair follicles may cause symptoms such as burning, itching and redness. In these cases, the hair loss is usually rapid. Some individuals may have no real symptoms, other than the gradual loss of hair. Those that suffer from scarring alopecia will not have scarring from the hair loss, instead, the scalp will appear smooth and shiny and devoid of any hair follicles. This condition affects both men and women and is not related to genetics. Plano, TX hair restoration surgeon, Dr. Joseph Yaker, will provide a thorough medical examination to determine the cause and create a custom treatment plan to slow down or restore the hair loss.

Causes

It is still not quite fully understood what causes this type of alopecia. However, in all cases, there is inflammation located at the upper part of the hair follicle where the sebaceous (oil) glands are located. Once these are destroyed, permanent hair loss occurs and there is no possibility for the hair follicle to regenerate.

Types

In all cases of scarring alopecia there is inflammation located at the upper part of the hair follicle where the stem cells and sebaceous (oil) glands are located. Once these are destroyed, permanent hair loss occurs and there is no possibility for the hair follicle to regenerate. Diseases that can cause permanent hair loss include:

Trauma

  • Physical 
  • Burns
  • Radiation 
  • Traction (extensions, cornrows, braids, ponytails)
  • Chemical (hair straighteners, bleaches, perming solutions)
  • Trichotillomania (compulsive hair plucking)

Infections

  • Bacterial (chronic staphylococcus folliculitis)
  • Fungal (tinea capitus)
  • Viral (shingles)

Skin Diseases

  • Lichen Planopilaris
  • Frontal Fibrosing Alopecia
  • Folliculitis Decalvans
  • Dissecting Cellulitis
  • Central Centrifugal Cicatricial Alopecia
  • Discoid Lupus Erythematosus
  • Scleroderma

Clinical features, skin biopsy and exclusion of other hair loss disorders are generally required to establish the diagnosis and to help guide treatment.

Treatment

Because hair loss that occurs with scarring alopecia is likely permanent, it is important to begin treatment in the early phases, since it may be possible to stimulate follicles in the affected area before permanent damage occurs. Most importantly, the nature of treatment varies depending on the particular diagnosis. To help with inflammation, antibiotics and/or topical steroids may be applied directly to the skin. Once the diagnosis has been made, it is still possible to save the hair follicles that have not yet been destroyed by stimulating them with either Minoxidil (brand name: Rogaine®), growth factors such as platelet rich plasma (PRP) with placenta-derived extracellular matrix therapy, and even low level laser therapy. After the disease has been inactive for a period of 1 or 2 years, hair transplant surgery may be an option for patients who wish to restore the bald areas. Hair can be taken from the back of the scalp using Follicular Unit Transplantation (FUT) or Follicular Unit Extraction (FUE) and transplanted to the front where balding has occurred.