What should you know about early scarring alopecia?

Scarring alopecia is a group of inflammatory disorders that damage the hair follicle and may replace it with scar tissue. Early clues include a widening or irregular patch, broken hairs, loss of eyebrow hair, or a scalp that feels sore, itchy, burning, or unusually sensitive. The skin may look smooth and shiny where follicle openings have disappeared, although early disease can be subtle.

Not every patch of hair loss is scarring. [Bald Patches](/symptoms/bald-patches/) can result from several conditions, and a dermatologist may use magnification, examination, or a small biopsy to distinguish them. [Frontal Fibrosing Alopecia](/conditions/frontal-fibrosing-alopecia/) is one scarring pattern that can affect the frontal hairline and eyebrows.

Photograph the hairline and affected areas in consistent lighting, and note when shedding, tenderness, or itching began. Avoid tight hairstyles, harsh chemical processing, vigorous scalp scratching, and picking at scale. Use a mild shampoo unless a clinician recommends another product. A dermatologist may discuss anti-inflammatory treatment, including [Steroid Injection Into The Skin](/treatments/injectables/intralesional-steroid-injection/), based on the examination and suspected subtype.

Book a dermatology appointment soon when a patch is enlarging, the hairline is receding, eyebrows are thinning, or scalp discomfort accompanies hair loss. Seek faster care for pus, marked swelling, fever, or rapidly worsening pain, which can signal infection or active inflammation. Early review cannot restore a follicle that has been destroyed, but it can help identify ongoing activity and protect unaffected areas.

Ask whether the pattern appears scarring, whether a biopsy or scalp imaging is useful, which signs would show active inflammation, and how treatment will be monitored. Ask how to care for the scalp while diagnosis is being confirmed and whether family members should watch for similar changes.