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Scarring Alopecias

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Hair and Scalp Treatments

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Abstract

Scarring alopecias are a heterogeneous group of disorders characterized by the irreversible destruction of hair follicles. Follicular damage in scarring alopecias may be either primary or secondary. In primary cicatricial alopecia (PCA), the hair follicle itself is the principal target for destruction. Secondary cicatricial alopecias result from events not directed to the follicular unit that end up having an effect on and eventually destroying the follicle. Clinically, the hallmark of cicatricial alopecias is the loss of follicular openings, while under pathology, they are characterized by the replacement of follicular structures with fibrous tissue. Treatment of PCA is many times challenging, and there are no fully satisfactory evidence-based regimens available for the treatment of such conditions. Here, we will focus on the treatment of the main causes of PCA according to published data and our experience on the field. In scarring conditions, the central aim of treatment will not be hair regrowth but rather to reduce symptoms and, most importantly, to stop disease progression. Early treatment is key to minimizing the extent of permanent alopecia.

We will review the practical management of lichen planopilaris, frontal fibrosing alopecia, fibrosing alopecia in a pattern distribution, discoid lupus erythematosus, central centrifugal cicatricial alopecia, dissecting cellulitis, folliculitis decalvans, and acne keloidalis nuchae.

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Authors and Affiliations

  1. Ramon y Cajal Hospital, Trichology Unit, Dermatology Department, Madrid, Spain

    Sergio Vañó-Galván

  2. Ramón y Cajal University Hospital, Department of Dermatology, Madrid, Spain

    David Saceda-Corralo

  3. Department of Dermatology Santa Casa da Misericordia, Rio De Janeiro, Brazil

    Rodrigo Pirmez

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  1. Sergio Vañó-Galván
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  2. David Saceda-Corralo
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  3. Rodrigo Pirmez
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Editors and Affiliations

  1. Fredric Brandt Endowed, Professor of Dermatology, Dr. Phillip Frost Department of Dermatology and Cutaneous Surgery, University of Miami Miller School of Medicine, Miami, FL, USA

    Antonella Tosti

  2. Dermatoncology & Trichology Clinic, National University of Mexico, Mexico City, Mexico

    Daniel Asz-Sigall

  3. Department of Dermatology, Santa Casa da Misericordia, Rio De Janeiro, Brazil

    Rodrigo Pirmez

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Vañó-Galván, S., Saceda-Corralo, D., Pirmez, R. (2020). Scarring Alopecias. In: Tosti, A., Asz-Sigall, D., Pirmez, R. (eds) Hair and Scalp Treatments. Springer, Cham. https://doi.org/10.1007/978-3-030-21555-2_11

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