Cicatricial (Scarring) Alopecia

Scarring, or cicatricial, alopecia is an inflammatory condition in which hair follicles are destroyed, resulting in scarring and permanent hair loss.

The Mount Sinai Health System is home to dermatologists who have deep experience diagnosing and treating this form of alopecia.

Causes of Cicatricial Alopecia

Cicatricial alopecia is primarily caused by inflammation that damages the hair follicle, although the damage may also be caused by a trauma such as a burn or serious infection. The inflammation could involve different types of cells, including lymphocytes, natural killer cells, or a combination of cell types.

This condition can occur in both men and women but is not usually seen in children. While the causes of cicatricial alopecia are not yet fully understood, it is thought that inflammation destroys the stem cells and oil glands of the hair follicle, leading to fibrosis and hair loss. It is not thought to be hereditary. It is a condition where it is important to intervene early to prevent fibrosis and permanent hair loss.

Symptoms of Cicatricial Alopecia

Cicatricial alopecia may progress differently in different people. Hair loss may develop slowly over years with too few symptoms to notice, or it could progress rapidly over months, causing burning and itching. The areas of the scalp affected could appear red and develop scaling or pustules, or these areas could remain relatively clear.

Treatments for Cicatricial Alopecia at Mount Sinai

The Department of Dermatology at the Mount Sinai Health System offers skilled care for cicatricial alopecia based on the newest research that has been uniquely performed at Mount Sinai.

Diagnosing cicatricial alopecia involves a clinical exam, but the most essential component of the diagnosis is a biopsy. This test provides information about the type, location, and severity of inflammation.

The type of cells that are found to be causing the inflammation determine the treatment approach for each patient. Treatment options may include systemic (oral or biologic), topical, or injected anti-inflammatory medications.