What are the other Names for this Condition? (Also known as/Synonyms)

• Alopecia Cicatrisata
• Primary Cicatricial Alopecia
• Scarring Hair Loss

What is Cicatricial Alopecia? (Definition/Background Information)

• Cicatricial Alopecia consists of a group of conditions that result in irreversible hair loss. Following the loss of hair from the scalp, there is no further hair growth in the affected part of the scalp or other hair-bearing skin. The hair follicles have been destroyed by the disease process
• In most of the conditions leading to Cicatricial Alopecia, the surface of the skin is smooth and does not show the visual changes usually associated with ‘scarring’. Hence, the condition is also known as Scarring Alopecia or Scarring Hair Loss. The term ‘cicatricial’ means ‘relating to a scar’
• The condition is generally uncommon and observed mainly in adults. The hair loss may occur in a gradual manner or rapidly. When the loss occurs slowly over time, no other symptoms are noted; but, when the loss is rapid, it may be accompanied by itching, burning, or pain 
• Cicatricial Alopecia can cause severe emotional stress due to bald patches or extensive areas on one’s scalp. Also, reactivation of the underlying condition is known to take place after suitable treatment
• The treatment for Cicatricial Alopecia includes medications to control hair loss and surgery, if necessary. The prognosis of the condition is based on the severity of Cicatricial Alopecia and may vary from one individual to another

Who gets Cicatricial Alopecia? (Age and Sex Distribution)

• Cicatricial Alopecia affects individuals of all ages, but it is very uncommon in children
• The condition affects both males and females
• All racial and ethnic groups are at risk and the condition is observed worldwide

What are the Risk Factors for Cicatricial Alopecia? (Predisposing Factors)

Presently, there are no specific risk factors identified for Cicatricial Alopecia.

• A family history of the condition has not been noted
• Also, the condition is not associated with any infection
• If Cicatricial Alopecia is linked to an autoimmune disease, there is an increased risk of that appearing in family members

It is important to note that having a risk factor does not mean that one will get the condition. A risk factor increases one's chances of getting a condition compared to an individual without the risk factors. 

Some risk factors are more important than others.

Also, not having a risk factor does not mean that an individual will not get the condition. It is always important to discuss the effect of risk factors with your healthcare provider.

What are the Causes of Cicatricial Alopecia? (Etiology)

The exact cause of Cicatricial Alopecia is not entirely understood. Hence, it may be also known as Primary Cicatricial Alopecia.

• The condition causes irreparable damage to certain special cell types (the stem cells) and oil (sebaceous) glands that are essential for continued hair growth
• Following destruction of these structures, hair loss occurs permanently

Cicatricial Alopecia is non-transmissible, and it cannot spread from one individual to another.

The conditions which most commonly cause Cicatricial Alopecia are the following:

• Central centrifugal cicatricial alopecia
• Lichen planopilaris
• Frontal fibrosing alopecia
• Discoid lupus erythematosus
• Acne keloidalis
• Dissecting folliculitis of the scalp

What are the Signs and Symptoms of Cicatricial Alopecia?

The signs and symptoms of Cicatricial Alopecia may include the following: 

• Hair loss that is accompanied by itching, burning sensation, tenderness, and pain in the affected region
• Areas of baldness may indicate slight redness and formation of skin sores and pustules (fluid-filled blisters)
• Bleeding and ulceration may present secondary infections
• Scale formation may be present in some cases
• Gradual loss of hair may not result in any symptoms, or may only cause mild symptoms

How is Cicatricial Alopecia Diagnosed?

Healthcare providers may suspect Cicatricial Alopecia following a clinical observation. Generally, no laboratory studies are necessary to make a diagnosis of the condition. However, the following may be undertaken:

• Assessment of signs and symptoms including observing the hair loss region for any signs of hair regrowth
• A hair pull test is performed to determine the ease with which hair can be pulled out
• A scalp tissue biopsy may be performed to rule-out other skin conditions or help determine the specific disease causing the destruction of hair follicles and adjacent structures
• Blood tests may be performed to rule-out other medical conditions

Many clinical conditions may have similar signs and symptoms. Your healthcare provider may perform additional tests to rule out other clinical conditions to arrive at a definitive diagnosis.

What are the Possible Complications of Cicatricial Alopecia?

The complications associated with Cicatricial Alopecia may include:

• Patches of hair loss region on scalp that present with scarring alopecia. The loss can also be extensive
• Severe emotional stress and insecurity with regards to one’s physical appearance due to hair loss
• Recurrence of the condition following stoppage of long-term treatment and surgery

How is Cicatricial Alopecia Treated?

The treatments for Cicatricial Alopecia may include the use of medications and/or surgery. The treatments may be specific to the underlying cause, and may include:

• Use of topical medications and applications
• Medications may be administered orally or injected into scalp skin
• Use of medication to treat secondary infections
• Hair transplant surgery to cover up the bald patches of skin: It is recommended only if the loss of hair stops for a period of 12-24 months, and the loss is not too extensive to cover with available donor hair (i.e., hair must be taken from the patient, not donated from others)
• Use of wigs or other hair prostheses to cover baldness

How can Cicatricial Alopecia be Prevented?

Currently, there are no known measures to prevent the occurrence of Cicatricial Alopecia.

What is the Prognosis of Cicatricial Alopecia? (Outcomes/Resolutions)

• The prognosis of Cicatricial Alopecia depends on the severity of the condition
• Appropriate therapy and/or surgery may help improve the condition, although the condition can recur following stoppage of therapy

Additional and Relevant Useful Information for Cicatricial Alopecia:

There are several types of alopecia (hair loss). Some of the common ones include alopecia areata and male or female pattern baldness.