Scarring alopecia is a condition that leads to irreversible hair loss. Hair follicles are replaced by fibrous connective tissue and hyalinized collagen. This disorder was first described in medicine only about twenty years ago. Since then, many cases have been documented, and the disease remains quite difficult to treat. Scarring alopecia can result from various causes and may be a consequence of serious systemic diseases or congenital defects. It is a very rarely diagnosed type of alopecia that not only causes hair loss but also inflammation of the scalp. Hair follicles are permanently damaged, which means irreversible baldness in the affected areas. It is worth taking a closer look at the causes, symptoms, and treatment of this rare condition.
Scarring alopecia – causes
Scarring alopecia occurs as a result of permanent damage to hair follicles. Hair can no longer grow, which means permanent loss. The causes of scarring alopecia are many and are divided into primary and secondary factors. It can also be associated with the presence of serious diseases.
Genetic predisposition
When the disease occurs at a young age, it may be linked to serious autoimmune conditions. The immune system reacts abnormally, attacking the body’s own tissues. This form of the disease develops due to hereditary factors. Conditions that may influence the development of scarring alopecia include:
- Darier’s disease,
- Epidermolysis bullosa,
- Congenital skin hypoplasia,
- Focal cartilage hypoplasia.
Congenital scarring alopecia may also be accompanied by other developmental defects, such as congenital heart anomalies or spina bifida. Pathologies related to scarring may affect not only the scalp but also other parts of the body. Cartilage hypoplasia can lead to skin atrophy in the affected area.
Irritation, injuries, and infections
This type of alopecia may be a complication of localized bacterial, fungal, or viral infections. Examples include shingles, boils, or infections caused by dermatophytes. Infections trigger inflammation that involves hair follicles. As immune cells attack, they also damage healthy tissues, leading to scar formation. Because scars are irreversible, hair regeneration is impossible.
Physical factors are also a common cause. The skin’s response to injury is similar to scarring in other parts of the body. A scar on the scalp is more visible because hair cannot grow on it. Physical causes include second- and third-degree burns, frostbite, chemical burns, electrical injuries, and various types of trauma.
The impact of autoimmune diseases
Inflammation on the skin may result from abnormal immune reactions – autoimmunity. In this case, the immune system recognizes its own tissues as foreign and attacks them. This leads to inflammation and tissue destruction. Causes of autoimmunity include sarcoidosis, lichen sclerosus, lupus erythematosus, and scleroderma.
Scarring alopecia and lupus
Scarring alopecia associated with lupus, also known as scalp scarring, is a serious and often irreversible condition that may result in permanent hair loss. Lupus is an autoimmune disease in which the immune system attacks the body’s own cells and tissues, including the skin.
In scarring alopecia related to lupus, the scalp becomes red, inflamed, and damaged, destroying hair follicles. As the skin heals, scar tissue forms, preventing hair regrowth and leading to permanent baldness.
