One good indicator of scarring alopecia is a ragged edge around the patch, but since irritated patches don't always form, a small biopsy is usually performed to detect inflammatory cells around your hair follicles that may indicate scarring alopecia.
Hair loss or thinning: A damaged hair follicle will be unable to create a strong piece of hair. Consequently, hair will become thin, brittle, and weak. You might notice that it's breaking more frequently than it would or altogether falling out. Breakage can be a direct result of this.
Anti-inflammatory medication is the most common treatment for most forms of scarring alopecia. Anti-inflammatory medication fights the inflammatory cells causing hair follicle destruction. You might take a pill, such as hydroxychloroquine, or receive a corticosteroid injection, such as triamcinolone acetonide.
Noticeable hair loss: Center of the scalp
The first sign is usually noticeable hair loss in the center of the scalp. This is why you see the word “central” in the name. Instead of developing one patch in the center of the scalp, a few people with CCCA develop scattered patches of hair loss on their scalp.
At first it may look like small pimples around the tiny pockets from where each hair grows (hair follicles). The condition can be itchy, sore and embarrassing. The infection can spread and turn into crusty sores. Mild folliculitis will likely heal without scarring in a few days with basic self-care.
What Does Scarring Alopecia Look Like? This form of hair loss looks like scarred skin surface where your hair used to be. The surface of the skin will look less or more pigmented, shiny, and smooth. And of course completely bald.
Once a hair follicle has been destroyed, it is replaced by scar tissue. This is why hair loss can be permanent. You can tell when scarring develops by looking at your scalp. After many hair follicles develop scars, you'll have a bald area that feels smooth to the touch.
Miniaturised or damaged hair follicles can sometimes be treated with medication such as Minoxidil or Finasteride, as well as other effective therapies (such as PRP treatment for hair or low-level laser therapy). But once a hair follicle is dead, there is nothing you can do to restore its function.
Hair care practices: hair straightening using hot combs (straighteners) and chemical relaxers (lotion or cream to alter the hair texture), tight hairstyles, braids and weaves have all been suggested as increasing the risk of developing CCCA; however, not all studies have found this link.
Generally, cicatricial alopecia is caused by inflammation, which damages the hair follicle. Damage can also stem from a trauma such as a burn or serious infection. The inflammation can involve different types of cells, including lymphocytes, natural killer cells, or several cell types.
There is no way to "test" if your hair follicles are active. One obvious way to tell is if you see hairs grow. If you notice no hair growth for 6 to 12 months then it probably is a "dead" follicle. Hair loss due to stress will be diffuse.
Hair follicle damage from DHT is largely irreversible, meaning it's important to act quickly if you start to experience this form of hair loss. We've discussed the effects of this hormone on your hair in more detail in our full guide to DHT and male pattern baldness.
Typically, dead hair follicles lead to a smooth patch of bald skin on the scalp – it typically will not look like general hair thinning. Doctors and hair specialists can get a look at your hair follicles by using a microscope.
Affected areas of the scalp may show little signs of inflammation, or have redness, scaling, increased or decreased pigmentation, pustules, or draining sinuses. Scarring hair loss occurs in otherwise healthy people of all ages and is seen worldwide.
The emergence of hair, including peach fuzz, along the hairline is often a clear sign of new growth. These delicate, soft hairs may be an early stage of more substantial hair growth, reflecting a responsive and healthy scalp.
Scabs on the scalp can emerge due to folliculitis, dermatitis, psoriasis or an allergic reaction to chemical products, like hair dye or or hair treatments. It is rare for scabs to form due to severe health conditions, like skin cancer.
The micro injuries created by the derma roller revive dormant follicles with new hair growing during the wound healing process as it triggers cellular turnover to deliver hair growth results. A derma roller can be used almost anywhere on the body, including the scalp and beard area.
Moderately damaged hair may start to return to its “usual self” in two to three months after using heat with caution & twice-weekly treatments, especially if you use treatments & ingredients such as jojoba oil that are specifically targeted at rebuilding your hair's protein & restoring its lipids.