Cicatricial Alopecia: What Is It?

Alopecia is one of the most widespread conditions in the general population. Around 50% of men and approximately 30% of women will experience it at some point in their lives. While the vast majority of cases are androgenetic in nature, other types exist, such as alopecia areata, universal alopecia, and cicatricial alopecia — the latter being the focus of this article.

Cicatricial alopecia involves the permanent destruction of the hair follicle. In this type of alopecia, an external agent typically affects the scalp, causing hair to fall out and the follicle to be destroyed. Once destroyed, regrowth is impossible — unlike alopecia areata, which may or may not reverse over time.

Not all cases are caused by an external agent. Frontal fibrosing alopecia is also classified as cicatricial. This is a type of hair loss in which tissue inflammation occurs, and it is the person’s own body that attacks and irreversibly destroys the follicular units.

For this reason, it is extremely important to be seen by a skilled doctor — one who specialises in trichology and has the knowledge and tools to make the most accurate diagnosis. In some cases, a small biopsy may be necessary and sent for analysis to confirm the type of alopecia, ensuring it is not confused with another condition.

Why Does Cicatricial Alopecia Occur?

Cicatricial alopecia does not have a single cause. It can arise from a range of factors, including scalp infections, inflammatory skin conditions, and radiation to the area that results in follicle destruction. Burns and trauma that lead to hair loss must also be considered.

Regarding the possibility of a hair transplant, expert medical assessment is essential. Grafting into scar tissue can involve several complications — among them, the implanted follicle may not survive, resulting in an unsatisfactory outcome.

FREQUENTLY ASKED QUESTIONS

Can a hair transplant be performed in cases of cicatricial alopecia?

The best answer can only be found through a diagnostic consultation with a specialist. A qualified doctor is best placed to provide an accurate diagnosis and determine whether a hair transplant is a viable option. A small test procedure may be carried out prior to any transplant.

Is medication necessary?

This will always depend on the doctor’s diagnosis. It is the specialist who will determine what medication, if any, needs to be prescribed for each individual case.

Is cicatricial alopecia only caused by an external agent?

No. Cicatricial alopecia does not arise exclusively from external factors such as infection, trauma, or any other situation that leaves scarring and results in follicle loss. It can also develop through an autoimmune inflammatory process that destroys the follicles — this is known as frontal fibrosing alopecia.

Dr. Espinosa Custodio works at the Instituto Médico del Prado, his hair clinic in Madrid and in Mexico City. To book an appointment, you can contact us by phone at 912 468 664, via WhatsApp at 627 396 322, or through the contact page on our website. If you are calling from Mexico, our number is +52 55 4590 9909.