Scarring Alopecias

  • Sergio Vañó-Galván
  • David Saceda-Corralo
  • Rodrigo Pirmez


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.


Cicatricial alopecia Frontal fibrosing alopecia Lichen planopilaris Folliculitis decalvans Discoid lupus Fibrosing alopecia in a pattern distribution Dissecting cellulitis Acne keloidalis nuchae Central centrifugal cicatricial alopecia Scarring alopecia 


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Copyright information

© Springer Nature Switzerland AG 2020

Authors and Affiliations

  • Sergio Vañó-Galván
    • 1
  • David Saceda-Corralo
    • 2
  • Rodrigo Pirmez
    • 3
  1. 1.Ramon y Cajal Hospital, Trichology Unit, Dermatology DepartmentMadridSpain
  2. 2.Ramón y Cajal University Hospital, Department of DermatologyMadridSpain
  3. 3.Department of Dermatology Santa Casa da MisericordiaRio De JaneiroBrazil

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