Alopecia comes in many forms, some serious, some not. Scarring alopecia, also called cicatricial alopecia, is considered a very serious form because without aggressive treatment, the hair loss can be permanent. The treatment for scarring alopecia depends on its cause.
Scarring alopecia can be caused by many different factors. These causes include physical trauma to the hair follicles, like repeated pulling of hairs or burns to the scalp. Autoimmune disorders can cause scarring alopecia; so can fungal, bacterial and viral infections, inflammation of the hair follicles, and folliculitis decalvans. The thing these causes have in common is the potential to cause permanent hair loss, so it is important to begin treatment for scarring alopecia immediately.
Some disorders that cause scarring alopecia respond to treatment with steroids. These disorders, like lichen planopilaris, usually cause scarring alopecia through lymphocyte inflammation of hair follicles. A doctor can prescribe a topical cream that contains corticosteroids that should be rubbed into the affected area. Intralesional steroids, or steroids injected into the skin, are also a treatment option.
If a patient’s scarring alopecia is caused by a bacterial infection, then antibiotics are a treatment option. Once the infection is gone, hair growth should begin again. Isotretinoin drugs are sometimes used in conjunction with steroids and antibiotics to combat scarring alopecia. If the problem is caused by a fungal infection, than anti-fungal drugs will help. Antimalarial agents have also proven effective in treating scarring alopecia.
If scarring alopecia destroys hair follicles and they cannot be saved then surgery is an option to treat the resulting baldness. A doctor can perform a hair transplant, during which he will harvest donor hair follicles from healthy parts of the scalp, then place them in the affected area. A newer surgical option is scalp-reduction surgery. To perform this, a doctor removes the portion of the scalp affected by scarring alopecia and then stretches healthy scalp to cover the area of missing skin.
Doctors are looking for more effective treatments for scarring alopecia. Some are working to fine-tune surgical options. Doctors are also trying different drugs alone and in combination. Some of the drugs under investigation as possible treatment options are cyclosporin, methotrexate and thalidomide.