Scarring Hair Loss Types: What to Know

Scarring alopecias are grouped by the inflammatory process affecting follicles, and may cause redness, scale, pustules, burning, tenderness, or shiny skin with missing follicle openings. Traction alopecia can begin where hair is repeatedly pulled and may become scarring if tension continues. Infection such as scalp ringworm can cause scale, broken hairs, and inflammation. Alopecia areata, pattern hair loss, and telogen effluvium usually involve follicles without the same type of permanent scar destruction, although appearances can overlap.

Record the distribution of loss and any symptoms, and pause tight hairstyles, extensions, harsh chemicals, and scratching. Do not start multiple oils or supplements at once; they can irritate the scalp and make changes harder to interpret. A dermatologist may use a magnified scalp examination and, when needed, a biopsy or other testing. The treatment plan follows the cause: inflammation, infection, tension, or a shedding trigger requires a different response. Finasteride treatment applies only to selected pattern hair-loss diagnoses.

Arrange care promptly for expanding patches, scalp pain or burning, persistent redness, scale, pustules, crusts, or skin that looks smooth and shiny. Seek urgent help for fever, pus, rapidly spreading redness, severe swelling, or marked pain. These warning signs concern active inflammation or infection, regardless of how common any particular type may be.

Ask which category best fits the pattern, whether the follicles are still active, what testing is needed, and how progress will be checked over time.