Scarring alopecia

In scarring (cicatricial) alopecia, inflammation damages hair follicles and replaces them with scar tissue. Once a follicle has scarred it cannot grow hair again. The aim of treatment is to calm the inflammation and slow or stop further loss.

Signs can include redness or scaling around the follicles, itching, burning or tenderness, and areas where the scalp looks smooth and shiny with no visible follicle openings. Some types cause a slowly receding hairline or loss of eyebrows. Symptoms can be subtle at first.

Because lost hair cannot be recovered, anyone with these signs should see a GP promptly and ask about referral to a dermatologist. A scalp biopsy is sometimes needed to confirm the diagnosis. Cosmetic treatments are not a substitute for medical care here.