Scarring Alopecia – Causes, Symptoms, And Treatment Options

Written by Annie Jangam

If you are experiencing hair loss and finding it difficult to grow it back, it could be a sign of something serious. Scarring Alopecia is a type of baldness triggered by inflammation leading to the destruction of hair follicles. Although it is not contagious, it does cause embarrassment, frustration, and mental distress. In this article, we discuss in detail the causes, types, symptoms, and treatments available for managing scarring alopecia. Keep reading to find out more.

 What Is Scarring Alopecia?

Scarring alopecia or cicatricial alopecia is an inflammatory hair loss disorder where the hair follicles are permanently damaged, resulting in bald patches on the scalp (1). The tissue surrounding the hair gets replaced with fibrous tissue. The hair loss may start off gradually and without any specific symptoms in the beginning.

Wondering what could trigger this type of hair loss? Find out in the next section.

What Causes Scarring Alopecia?

The exact cause of scarring alopecia is not yet known. This type of hair loss is associated with inflammation, destruction of hair follicles, and deposition of collagen. Some of the possible causes include genetic predisposition, faulty lipid metabolism, and compromised immune system. Anecdotal evidence suggests that improper hair care practices such as using relaxants or hot combs frequently can cause traction and lead to scarring alopecia.

These are some of the probable causes of scarring alopecia. Keep reading to find out the different types of this hair loss.

Types Of Scarring Alopecia

Scarring alopecia is classified into three major types:

  1. Primary: This type of hair loss is permanent as the stem cells in the hair follicles are permanently damaged. It is speculated that the immune cells such as lymphocytes and neutrophils are involved. Thus, it is further categorized as lymphocytic (lichen planopilaris) or neutrophilic (1). It is commonly observed in adolescent males.
  1. Secondary: The skin cells surrounding the hair follicles are inflamed, resulting in irreversible damage to the hair follicles. This is a common side effect of cancer, radiation therapy, or severe burns (1).
  1. Developmental/Hereditary: Like the name suggests, this type of hair loss is due to genetic factors. The exact mechanism is unknown, and research is still ongoing regarding this type of scarring alopecia.

Although scarring alopecia is irreversible in most cases, it can be managed to some extent by recognizing the symptoms on time. Scroll down to learn what are the most common telltale signs of scarring alopecia.

Symptoms Of Scarring Alopecia

  • Scarring alopecia starts out as small, ragged bald patches on the scalp that progress over time, eventually leading to complete loss of hair (1).
  • These patches have a shiny and smooth appearance due to a lack of pores or loss of follicular openings (1).
  • This condition can be accompanied by various other symptoms such as pain, itching, or a burning sensation on the scalp (1).
  • In a few cases, rough, scaly skin and pus-filled blisters have also been observed in scarring alopecia (1).

Find out the treatment options available for scarring alopecia in the next section.

Treatment Of Scarring Alopecia

Since hair growth is not possible due to the permanent damage of hair follicles, the best way to manage this type of hair loss is to minimize further hair loss (1). Some ways suggested to manage scarring alopecia include:

  • Hair transplants on the bald areas as well as using wigs to cover the bald patches are often suggested.
  • It is recommended to use SPF to protect the exposed skin.
  • The inflammation can be controlled by prescribing corticosteroids or retinoids either orally or topically (1). In case of any side effects, consult a doctor immediately.


Scarring alopecia is a type of hair loss that leads to bald patches on the hair. It is irreversible as the hair follicles are permanently damaged, so there is no chance of hair regeneration. This condition is believed to be caused due to inflammation and, in some cases, burns or radiation therapy. Although the symptoms differ from person to person, itching, redness, and pain are commonly observed. It can be managed by using corticosteroids and retinoids under medical supervision. Finally, hair transplants or the use of wigs is advised to deal with bald patches.

Frequently Asked Questions

Can hair grow back after scarring alopecia?

No, hair cannot grow back after scarring alopecia since the hair follicles are permanently damaged.

What triggers scarring alopecia?

Inflammation is believed to be a major cause of scarring alopecia. Burns and cancer treatments such as radiation therapy can also lead to scarring alopecia.

Is scarring alopecia rare?

Scarring alopecia is believed to affect 7% of the population, including both men and women (1).

Does Rogaine work for scarring alopecia?

Research shows that Rogaine or minoxidil can help in minimizing scarring, a common symptom of scarring alopecia.

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Annie Jangam is a Molecular Biologist with 7 years of research experience in Rice Functional Genomics and Nutrient Signalling with International Publications in Abiotic stress, Nitrogen, and G-protein signaling. She specializes in writing on Health and Wellness. She has been an avid reader since childhood and is passionate about stories that help decipher life and its meaning. She believes in Human Rights for all and that one should "love others like we love ourselves."