Scarring Alopecia: Causes, Symptoms, Diagnosis and Treatment

Scarring alopecia, also called cicatricial alopecia, refers to a group of inflammatory hair-loss disorders. These conditions can permanently damage hair follicles and replace them with scar tissue.

Unlike many non-scarring forms of hair loss, scarring alopecia may cause permanent loss in affected areas. Therefore, early diagnosis and treatment are especially important.

This complete guide explains how scarring alopecia develops and describes its most common forms. It also covers symptoms, causes, diagnosis, treatment, supportive scalp care, and when to see a trichologist or dermatologist.

For a broader overview of hair and scalp disorders, visit the hair and scalp conditions hub.

What Is Scarring Alopecia?

Scarring alopecia is not one disease. Instead, it describes a group of conditions that damage hair follicles through inflammation, injury, infection, or another destructive process.

The defining feature is damage to the follicular structure needed for future hair growth. In primary scarring alopecia, inflammation often targets the upper follicle and its stem-cell region, sometimes called the follicular bulge.

When severe inflammation destroys this region, the follicle may lose its ability to repair itself and produce new hair.

Over time, scar-like tissue replaces the damaged follicle. As a result, the small openings where hairs normally emerge may disappear.

This process distinguishes scarring alopecia from non-scarring conditions such as telogen effluvium and androgenetic alopecia. In many non-scarring conditions, follicles remain present and may still respond to appropriate treatment.

For a closer look at chemical processing and follicular damage, read about cicatricial alopecia and chemical hair straightening.

Primary and Secondary Scarring Alopecia

Clinicians generally describe scarring alopecia as primary or secondary.

• Primary scarring alopecia: Inflammation directly targets and damages the hair follicle. Examples include lichen planopilaris, CCCA, and folliculitis decalvans.
• Secondary scarring alopecia: Another injury or disease destroys the follicles. Causes may include burns, radiation, severe infection, trauma, tumours, surgery, or deeply inflamed skin disease.

This article mainly focuses on primary scarring alopecia.

How Scarring Alopecia Damages Hair Follicles

Inflammation drives most primary forms of scarring alopecia.

Depending on the condition, the main inflammatory cells may be lymphocytes, neutrophils, or a mixture of both.

These cells collect around the follicle and nearby tissue. If inflammation continues, it can damage the stem-cell region and destroy the follicle.

During the active stage, a person may notice redness, scale, itching, burning, tenderness, pustules, bumps, drainage, or increased shedding.

Later, the affected area may become smooth, pale, shiny, tight, or scar-like. Follicular openings may no longer be visible.

Lymphocytic Scarring Alopecia

In lymphocytic forms, lymphocytes make up the main inflammatory population around the follicle.

Examples include:

• Lichen planopilaris.
• Frontal fibrosing alopecia.
• Central centrifugal cicatricial alopecia.
• Discoid lupus erythematosus.
• Some cases classified as pseudopelade.

Neutrophilic Scarring Alopecia

In neutrophilic forms, neutrophils dominate the inflammatory pattern.

Therefore, pustules, crusting, drainage, scalp bumps, and repeated tenderness may appear more often.

Examples include folliculitis decalvans and dissecting cellulitis of the scalp.

Mixed Inflammatory Patterns

Some conditions contain both lymphocytic and neutrophilic inflammation. In addition, the inflammatory pattern may change as the disease progresses.

For this reason, a dermatologist may need clinical examination, trichoscopy, cultures, and biopsy findings before selecting treatment.

Common Types of Scarring Alopecia

Clinicians classify scarring alopecias by their clinical pattern and by the inflammation seen under a microscope.

Common forms include lichen planopilaris, frontal fibrosing alopecia, folliculitis decalvans, discoid lupus erythematosus, central centrifugal cicatricial alopecia, pseudopelade of Brocq, and dissecting cellulitis.

1. Lichen Planopilaris

Lichen planopilaris is a chronic inflammatory condition that usually involves lymphocyte-driven inflammation around hair follicles.

The condition may cause irregular patches of loss, redness around follicles, scale, burning, itching, discomfort, or tenderness.

Hairs near an active edge may also pull out more easily.

As the condition progresses, affected areas may become smooth, pale, shiny, and permanently hairless. Follicular openings may disappear.

2. Frontal Fibrosing Alopecia

Frontal fibrosing alopecia is closely related to lichen planopilaris.

It commonly causes a band-like recession across the frontal and side hairline.

Eyebrow loss is also common. Some people develop facial papules, body-hair loss, or redness and scale around the remaining hairs at the edge.

The condition most often affects women after menopause. However, younger women and men can also develop it.

3. Folliculitis Decalvans

Folliculitis decalvans is a neutrophilic form of scarring alopecia.

It may cause persistent inflammation, pustules, bumps, crusting, soreness, drainage, and repeated scalp irritation.

Bacterial involvement, particularly from Staphylococcus aureus, may contribute. However, the condition is more complex than an ordinary scalp infection.

A characteristic sign is tufting. Several hair shafts may appear to emerge from one enlarged follicular opening.

Without effective treatment, inflammation may destroy follicles and create larger scarred areas.

4. Discoid Lupus Erythematosus

Discoid lupus erythematosus can affect the scalp and create inflamed, coin-shaped patches.

Early areas may look red, scaly, thickened, or blocked around the follicular openings.

Later, the skin may become lighter or darker than the surrounding scalp. It may also become thin, smooth, scarred, and permanently hairless.

Discoid lupus can remain limited to the skin. However, some patients need medical assessment for systemic lupus symptoms or other autoimmune findings.

5. Central Centrifugal Cicatricial Alopecia

Central centrifugal cicatricial alopecia, commonly called CCCA, usually begins at the crown or vertex.

It then spreads outward in a centrifugal pattern.

CCCA most often affects Black women. However, men and people from other backgrounds may also develop it.

Learn more in the guide to central centrifugal cicatricial alopecia.

The exact cause remains unclear. Genetics and inflammation appear important.

Tight styles, repeated tension, high heat, chemical processing, and other hair-care practices may add stress in some patients. However, these factors do not explain every case.

6. Pseudopelade of Brocq

Pseudopelade of Brocq is a rare diagnosis or clinical pattern associated with permanent scalp hair loss.

It may cause small, irregular, smooth, pale patches with little visible inflammation.

These patches are sometimes described as resembling footprints in snow.

Because visible inflammation may be absent, the condition can be difficult to recognise. A biopsy and exclusion of other causes may be necessary.

7. Dissecting Cellulitis of the Scalp

Dissecting cellulitis is a deeply inflammatory scalp disorder.

It may cause painful nodules, abscesses, drainage, tunnels beneath the skin, and permanent scarring.

The condition often affects the crown and back of the scalp.

Because it can produce severe infection-like symptoms, medical treatment should not be delayed.

Scarring Alopecia Symptoms and Warning Signs

Symptoms vary according to the condition, disease activity, and stage.

Some people experience clear discomfort and inflammation. Others develop gradual loss with few symptoms.

Therefore, painless hair loss does not completely exclude scarring alopecia.

Changes in Hair Density and Distribution

• Patchy loss: Hair may disappear in small patches or larger irregular areas.
• Crown-centred thinning: Loss beginning in the centre of the scalp may suggest CCCA.
• Frontal hairline recession: A smooth band of recession may suggest frontal fibrosing alopecia.
• Eyebrow thinning: This commonly occurs with frontal fibrosing alopecia and may occur with autoimmune disease.
• Tufted hairs: Several shafts emerging together may occur with folliculitis decalvans.
• Expanding areas: A patch may gradually increase in size while active inflammation continues.

Inflammatory Scalp Symptoms

• Redness: Redness around individual follicles may indicate active inflammation.
• Scaling or crusting: Fine scale, thick scale, crusts, or follicular plugs may develop.
• Pustules or bumps: These are particularly common in neutrophilic conditions.
• Burning or pain: Burning, tenderness, or soreness may signal active disease.
• Itching: Itching may range from mild to severe.
• Drainage: Pus or fluid may occur with deeply inflamed conditions.

Signs of Established Scarring

• Smooth or shiny scalp patches.
• Pale, white, darker, or otherwise discoloured skin.
• Loss of visible follicular openings.
• A tight, thin, or scar-like scalp texture.
• Permanent areas without visible regrowth.

It is important to separate ordinary hair thinning from inflammatory scarring disease.

Scarring alopecia needs faster medical assessment because delay may allow permanent follicular loss.

What Causes Scarring Alopecia?

The cause depends on the specific diagnosis.

In many primary conditions, researchers do not yet know exactly why inflammation begins to target the follicle.

Autoimmune and Inflammatory Activity

Several forms appear to involve abnormal immune activity directed towards structures around the follicle.

This mechanism is particularly relevant to lichen planopilaris, frontal fibrosing alopecia, discoid lupus, and CCCA.

Genetic Susceptibility

Some conditions, including CCCA and frontal fibrosing alopecia, may occur in families.

Therefore, inherited factors may increase susceptibility to inflammatory follicular damage.

Bacterial Involvement

Bacteria may contribute to neutrophilic disorders such as folliculitis decalvans.

However, repeated antibiotics without a clear diagnosis may not control the complete inflammatory process.

Hair-Care and Mechanical Stress

Tight hairstyles, repeated pulling, high heat, chemical relaxers, and scalp trauma may worsen inflammation or breakage in some people.

However, these practices do not explain every case. Genetic and immune factors may also play a major role.

Patients should not be blamed for developing the condition.

For more detail, read the guide to chemical straightening and cicatricial alopecia.

Infection, Injury, and Other Diseases

Deep infection, burns, radiation, trauma, tumours, surgery, and severe inflammatory skin disease can cause secondary scarring alopecia.

In these cases, treatment must address the original cause as well as the resulting scalp damage.

How Scarring Alopecia Is Diagnosed

Accurate diagnosis is essential because different forms of scarring alopecia require different treatments.

The assessment may involve medical history, scalp examination, trichoscopy, biopsy, microbial testing, and selected blood tests.

1. Medical History

A clinician may ask when the hair loss started, how quickly it progressed, and whether any areas have expanded.

They may also ask about burning, pain, itching, scale, pustules, drainage, eyebrow loss, or body-hair changes.

In addition, the assessment may cover autoimmune disease, medication, family history, infection, hair-care practices, chemical treatment, previous diagnoses, and earlier therapies.

2. Clinical Scalp Examination

A dermatologist or trained hair-and-scalp professional will examine the pattern of loss.

They will also look for redness, scale around follicles, pustules, crusting, tenderness, smooth skin, and missing follicular openings.

The location may provide valuable clues. For example, CCCA commonly starts around the crown, while frontal fibrosing alopecia affects the frontal hairline and often involves the eyebrows.

3. Trichoscopy

Trichoscopy uses magnification to examine the scalp and follicles more closely.

It may reveal:

• Redness or scale around follicles.
• Blocked follicular openings.
• Loss of follicular openings.
• White or scarred areas.
• Tufted hairs.
• Broken hairs or unusual shaft patterns.
• Changes in scalp blood vessels.

Trichoscopy can help locate an active edge and guide the biopsy site. However, it does not always replace microscopic tissue examination.

4. Scalp Biopsy

A scalp biopsy is often valuable when a dermatologist suspects scarring alopecia or when the diagnosis remains uncertain.

The dermatologist usually removes one or more small skin samples under local anaesthetic.

The most useful sample often comes from an active, recently affected edge rather than the centre of an old scarred patch.

A pathologist examines the tissue for inflammation, follicular damage, fibrosis, and the type of inflammatory cells.

This information may help separate lymphocytic, neutrophilic, and mixed conditions. It may also distinguish scarring alopecia from non-scarring loss.

5. Bacterial or Fungal Testing

When pustules, crusting, drainage, or infection-like symptoms are present, a clinician may collect a bacterial swab or fungal sample.

The results may guide antimicrobial treatment.

However, a positive culture does not always explain the complete disease process.

6. Blood Tests

Blood tests do not diagnose most primary scarring alopecias on their own.

However, they may identify related disease or reveal an additional cause of shedding.

Depending on the symptoms, a clinician may assess:

• Autoimmune or lupus-related markers.
• Inflammatory markers.
• Thyroid function.
• Iron and ferritin.
• Vitamin D and selected nutritional factors.
• Hormonal markers when medically appropriate.

How Scarring Alopecia Is Treated

The main treatment goal is to stop active inflammation before it destroys more follicles.

Treatment may also reduce burning, pain, itching, scale, pustules, drainage, or crusting.

Once mature scar tissue replaces a follicle, medicine cannot reliably recreate that follicle. Therefore, preserving the hair that remains is usually the main objective.

The treatment plan depends on the exact diagnosis, inflammatory activity, severity, affected area, medical history, pregnancy considerations, and response to earlier treatment.

1. Topical Corticosteroids

Dermatologists may prescribe potent topical corticosteroids for selected inflammatory forms of scarring alopecia.

These medicines may reduce redness, itching, burning, scale, and inflammation around follicles.

However, prolonged or incorrect use may cause skin thinning, visible blood vessels, folliculitis, pigment changes, or irritation.

A licensed clinician should supervise treatment.

2. Intralesional Corticosteroid Injections

A dermatologist may inject a corticosteroid, such as triamcinolone, into active areas.

These injections may reduce local inflammation and slow progression in selected cases of lichen planopilaris, frontal fibrosing alopecia, or CCCA.

Possible adverse effects include temporary thinning of the skin, dents, pigment changes, and discomfort.

3. Oral Corticosteroids

Doctors may use oral corticosteroids for a limited period when disease activity is aggressive or rapidly progressing.

Because systemic corticosteroids can cause important side effects, clinicians generally limit their dose and duration when possible.

4. Oral Anti-Inflammatory or Immune-Modifying Medicines

Depending on the diagnosis, a dermatologist may consider:

• Hydroxychloroquine.
• Doxycycline or another tetracycline.
• Methotrexate.
• Mycophenolate mofetil.
• Cyclosporine.
• Pioglitazone in selected circumstances.
• Other immune-modifying medicines.

These medicines require medical supervision.

Some also require blood tests, eye examinations, infection screening, pregnancy precautions, or other safety monitoring.

5. Antibiotics and Antimicrobial Treatment

For folliculitis decalvans and other neutrophilic conditions, dermatologists may use antibiotics to reduce bacterial activity and inflammation.

Options may include tetracyclines, clindamycin, rifampicin, or other treatments.

The choice depends on the diagnosis, culture findings, severity, previous response, and medical history.

People should not use leftover antibiotics or begin prolonged treatment without professional supervision.

6. Anti-Androgen Treatment

Clinicians sometimes consider finasteride or dutasteride in selected cases, particularly frontal fibrosing alopecia.

These medicines are not suitable for everyone.

The prescribing clinician must review pregnancy risks, contraception, side effects, medication interactions, and medical history.

7. Diagnosis-Specific Treatment

Some conditions require additional measures:

• Discoid lupus: Sun protection and lupus-directed medical treatment may be important.
• Dissecting cellulitis: Treatment may include isotretinoin, antibiotics, corticosteroids, drainage, biologic therapy, or surgery in selected cases.
• Folliculitis decalvans: Clinicians may combine antimicrobial and anti-inflammatory approaches.
• CCCA: Anti-inflammatory treatment, low-tension styling, and gentle scalp care may be used together.

Regenerative and Emerging Treatments

Researchers continue to study regenerative treatments for hair loss.

However, established scar tissue remains difficult to treat because the original follicles are no longer intact.

Platelet-Rich Plasma

Platelet-rich plasma, or PRP, has more evidence for non-scarring hair loss than for cicatricial alopecia.

In selected patients whose inflammatory disease is controlled, a specialist may consider PRP as supportive care.

However, PRP cannot reliably recreate follicles that scar tissue has already replaced.

For this reason, clinicians should diagnose and control active inflammation before considering regenerative procedures.

Exosomes

Exosome-based hair-loss treatments remain experimental.

Product preparation, regulation, quality, safety, and evidence vary considerably.

Therefore, exosomes should not be presented as a proven treatment for scarring alopecia or as a replacement for medical anti-inflammatory care.

Peptide Therapy

Researchers are investigating peptides for possible roles in inflammation and cell signalling.

However, evidence supporting peptide products as standalone treatments for scarring alopecia remains limited.

Be cautious with products that claim to reverse established scar tissue or recreate destroyed follicles.

Can Hair Transplantation Treat Scarring Alopecia?

Hair transplantation is generally unsuitable while scarring alopecia remains active.

Ongoing inflammation may damage transplanted follicles and cause poor graft survival.

In carefully selected cases, a surgeon may consider transplantation after the disease has remained inactive for a prolonged period.

Some specialists look for at least one to two years of stability, although the required period varies by diagnosis and clinical judgement.

Before surgery, the specialist may review symptoms, serial photographs, trichoscopy findings, biopsy results, treatment history, and changes in the affected area.

Even when the disease appears stable, results remain less predictable than they are in non-scarring pattern hair loss.

In addition, inflammatory activity may return later.

Scalp Care and Supportive Measures

Supportive care cannot replace medical treatment.

However, it may reduce additional irritation, improve comfort, and protect fragile hair that remains.

Use Gentle Hair-Care Practices

• Avoid tight braids, ponytails, extensions, and high-tension styles.
• Reduce heat from flat irons, hot combs, and blow dryers.
• Avoid scratching, picking, or aggressively brushing the scalp.
• Pause chemical relaxers, bleach, or strong dyes if they worsen symptoms.
• Choose gentle shampoo and conditioning products.
• Avoid home scalp needling while inflammation is active.

Follow the Prescribed Scalp Routine

A clinician may recommend a medicated shampoo, topical medicine, or another scalp treatment.

Use it as directed rather than increasing the amount or frequency independently.

Stronger or more frequent use does not always produce faster improvement. Instead, it may increase irritation or side effects.

Correct Confirmed Nutritional Deficiencies

Nutritional deficiencies do not usually cause primary scarring alopecia directly.

However, low iron, vitamin D, protein, or another deficiency may add to shedding or poor hair quality.

Correct confirmed deficiencies with medical guidance. Avoid combining several high-dose supplements without testing.

Manage Stress and General Health

Stress does not explain every case of scarring alopecia.

Still, it may increase symptom burden or make a chronic condition harder to manage.

Regular sleep, physical activity, emotional support, and management of other health conditions may improve general wellbeing during treatment.

Can Scarring Alopecia Be Reversed?

Scarring alopecia can permanently destroy follicles.

Once mature scar tissue replaces a follicle, there is currently no reliable treatment that restores normal growth from that follicle.

However, early treatment may stop or slow active disease before more follicles are lost.

In addition, inflammation around follicles that remain alive may improve with treatment.

The main treatment goals are to:

• Stop or slow disease activity.
• Reduce pain, burning, itching, scale, pustules, or drainage.
• Preserve follicles that remain intact.
• Prevent the formation of new scarred areas.
• Support cosmetic management after the disease becomes stable.

People who notice frontal recession, eyebrow thinning, or a smooth band along the hairline may benefit from learning what frontal fibrosing alopecia is.

However, reading about the condition should not delay professional assessment.

How Doctors Monitor Treatment Progress

Symptoms may improve before visible changes occur.

Therefore, monitoring should include more than photographs alone.

A clinician may track:

• Changes in burning, pain, itching, or tenderness.
• Redness, scale, pustules, or crusting.
• Whether the hairless area is expanding.
• Trichoscopy findings.
• Hair-pull results near active areas.
• Standardised photographs.
• Medication side effects.
• Blood-test or safety-monitoring results.

Do not stop prescribed treatment simply because symptoms improve.

Disease activity may persist even when discomfort decreases. In addition, stopping treatment without advice may allow inflammation to return.

When to See a Trichologist or Dermatologist

Seek prompt professional evaluation when you notice:

• Persistent scalp burning, pain, itching, or tenderness.
• Patchy hair loss with redness or scale.
• Pustules, crusting, drainage, or recurring bumps.
• Smooth, shiny, pale, or scar-like patches.
• Loss of visible follicular openings.
• Rapidly worsening hair loss.
• Eyebrow thinning with frontal recession.
• Crown-centred thinning with pain, itching, or tenderness.
• Hair loss that continues despite ordinary treatment.

When to See a Trichologist

A trichologist may help by examining the visible pattern, documenting progression, reviewing hair-care practices, identifying warning signs, and supporting scalp care.

A responsible trichologist should refer promptly when the findings suggest inflammatory, autoimmune, infectious, or scarring disease.

Learn more about what a trichologist does and when to see one.

When to See a Dermatologist

A dermatologist is especially important when scarring alopecia is suspected.

Dermatologists can provide medical diagnosis, perform a scalp biopsy, order appropriate testing, prescribe medicines, and monitor treatment risks.

Severe pain, drainage, rapidly expanding loss, smooth scar-like patches, or loss of follicular openings should not be managed with cosmetic products alone.

Frequently Asked Questions About Scarring Alopecia

Symptoms, Causes and Diagnosis

What causes scarring alopecia?

Inflammation or another destructive process damages the follicles and replaces them with scar-like tissue. The cause varies and may involve autoimmune activity, genetics, bacteria, infection, trauma, burns, or another scalp disease.

What does scarring alopecia look like?

Signs may include irregular patches, crown-centred thinning, frontal recession, smooth or shiny scalp areas, redness, scale, pustules, crusting, discolouration, or missing follicular openings.

Does scarring alopecia hurt or itch?

It can cause burning, itching, pain, tenderness, or soreness. However, some patients have few symptoms, so painless loss does not completely rule it out.

How is scarring alopecia diagnosed?

Diagnosis may involve medical history, scalp examination, trichoscopy, bacterial or fungal testing, selected blood tests, and scalp biopsy.

Is a scalp biopsy always necessary?

Not every patient needs a biopsy. However, it is often useful when the diagnosis is uncertain, scarring disease is suspected, or treatment depends on identifying the inflammatory pattern.

Is scarring alopecia contagious?

No. Primary scarring alopecia is not contagious and cannot spread from one person to another.

Treatment and Hair Regrowth

Can hair grow back after scarring alopecia?

Hair usually cannot grow from areas where follicles have been completely destroyed. Early treatment may still preserve follicles that are inflamed but remain alive.

What treatments are available?

Treatment may include topical corticosteroids, steroid injections, oral anti-inflammatory medicines, immune-modifying treatment, antibiotics for selected conditions, anti-androgens, and diagnosis-specific scalp care.

How quickly should treatment begin?

Arrange assessment as soon as warning signs appear. Early control of inflammation may reduce additional permanent follicular damage.

Can minoxidil treat scarring alopecia?

Minoxidil does not control the underlying inflammation and cannot restore destroyed follicles. A dermatologist may use it to support nearby non-scarred or miniaturised follicles in selected patients.

Can PRP reverse scarring alopecia?

PRP cannot reliably regrow hair where follicles have been destroyed. A specialist may consider it as supportive care in selected stable cases after active inflammation has been controlled.

Can a hair transplant fix scarring alopecia?

Transplantation may be considered after a prolonged inactive period in carefully selected patients. Results are less predictable than in non-scarring hair loss, and the disease may reactivate.

Types and Progression

Is scarring alopecia the same as alopecia areata?

No. Alopecia areata is usually non-scarring, meaning follicles remain present. Scarring alopecia destroys follicles and can cause permanent loss.

Can scarring alopecia spread?

Yes. Active disease may expand while inflammation continues. Treatment aims to stop or slow this progression.

Is CCCA caused by chemical relaxers?

No single practice fully explains CCCA. Genetics and inflammation appear important. However, heat, tension, and chemical processing may add stress in some people.

Can scarring alopecia become inactive?

Yes. Treatment may bring the disease into a stable or inactive phase. Ongoing monitoring remains important because activity can return.

Choosing the Right Professional

Should I see a trichologist or dermatologist?

A trichologist can identify warning signs, document the pattern, review hair-care practices, and support monitoring. A dermatologist is needed for medical diagnosis, biopsy, prescription treatment, and management of inflammatory or autoimmune disease.

When is urgent assessment needed?

Seek prompt care for rapid progression, severe pain, drainage, pustules, smooth scar-like patches, loss of follicular openings, or eyebrow loss with frontal recession.

Can I manage scarring alopecia with oils or supplements?

No oil or supplement can replace medical control of active inflammatory disease. Some products may also irritate the scalp or delay appropriate treatment.

References

1. American Academy of Dermatology Association: Scarring Alopecia
2. StatPearls: Cicatricial Alopecia
3. StatPearls: Alopecia
4. DermNet: Cicatricial Alopecia
5. DermNet: Lichen Planopilaris
6. DermNet: Frontal Fibrosing Alopecia
7. DermNet: Folliculitis Decalvans
8. DermNet: Discoid Lupus Erythematosus
9. StatPearls: Central Centrifugal Cicatricial Alopecia
10. Review of Platelet-Rich Plasma in Primary Cicatricial Alopecia

Conclusion: Why Early Scarring Alopecia Treatment Matters

Scarring alopecia is a group of inflammatory hair-loss disorders that can permanently destroy hair follicles.

Once mature scar tissue replaces a follicle, normal growth from that follicle is usually no longer possible.

Do not ignore burning, pain, redness, scaling, pustules, drainage, eyebrow loss, crown-centred thinning, frontal recession, or smooth and shiny patches.

Diagnosis may involve trichoscopy and, in many cases, scalp biopsy. The exact treatment depends on the diagnosis, inflammatory pattern, disease activity, and individual health factors.

The main goal is to stop inflammation, prevent further loss, and preserve the follicles that remain.

Next step: If your symptoms may indicate scarring alopecia, find a trichologist near you. Arrange a dermatology assessment when medical diagnosis, biopsy, or prescription treatment is needed.

Disclaimer: This content is for general informational and educational purposes only. It is not medical advice and should not replace consultation with a qualified healthcare professional. Treatment choices, risks, and monitoring requirements vary by diagnosis and patient. Seek prompt professional evaluation for sudden, patchy, painful, inflamed, draining, scar-like, or persistent hair loss.