What causes scarring alopecia?

Scarring alopecia, also called cicatricial alopecia, is a group of hair-loss disorders. Inflammatory cells can attack the follicle, injuring the part that produces hair. Once that follicle is replaced by scar tissue, it cannot produce a new hair in the usual way. Different disorders affect different areas and progress at different speeds.

Possible causes include autoimmune inflammation, inflammatory scalp disorders, infection, burns, injury and some forms of repeated traction. Early signs may include itching, burning, tenderness, scaling, pustules or a smooth patch with fewer visible follicle openings. Hair loss can be subtle at first, so photographs taken in consistent lighting may help show change.

Arrange a dermatology assessment if hair loss is accompanied by scalp symptoms or expanding areas of reduced density. A clinician may examine the scalp with magnification and may recommend a scalp biopsy to identify the pattern. Treatment aims to calm active inflammation and protect remaining follicles; it may include prescribed anti-inflammatory or immune-modifying treatment, depending on the diagnosis.

Handle the scalp gently, avoid tight hairstyles and harsh chemical processing, and do not self-treat pustules with leftover antibiotics or steroid products. Cosmetic hair options can be discussed after the active process is understood.

Seek prompt specialist care for rapidly expanding hair loss, scalp pain, burning, marked itch, crusting, pus, bleeding or shiny areas where follicle openings are disappearing. Seek urgent help for fever, rapidly spreading redness or severe swelling. Early review can help distinguish active inflammation from established scarring.

Ask whether the loss appears scarring, whether a biopsy is needed, which signs suggest active inflammation, and how treatment will be monitored for progression.