Possible signs
- smooth, shiny hairless skin
- fewer follicular openings
- pain, burning or itch
- redness, scale, pustules or crusts
Hair dermatology · São Mateus, Espírito Santo
Scarring alopecia explained
Scarring alopecia describes diseases in which inflammation or destruction can replace the follicle with scar tissue. Recognising activity early is essential to preserve remaining hair.
Dermatology care
Hair loss deserves diagnosis, not random trial and error
Lichen planopilaris, frontal fibrosing alopecia and folliculitis decalvans are examples. Each has different signs and treatment.
- Clinical examination and trichoscopy are fundamental. Many cases require a biopsy of an active area to define the subtype and guide treatment.
- A clear care plan with follow-up of symptoms and density.
- Care for patients in São Mateus and the Northern Espírito Santo region.
Important: this page is educational and does not replace a consultation, diagnosis or prescription.
Possible presentation
Signs that deserve attention
What may be involved
Causes vary by subtype and may involve autoimmunity, perifollicular inflammation, neutrophils, associated infection or prolonged traction.
Appearance alone cannot confirm the type of alopecia. Pattern, timing and symptoms change the investigation.
Evaluation
How diagnosis is built
1
Medical history
Onset, speed, triggers, illness, medicines, styling habits and family history are reviewed.
2
Examination and trichoscopy
Clinical examination and trichoscopy are fundamental. Many cases require a biopsy of an active area to define the subtype and guide treatment.
3
Individual plan
The type and activity of alopecia, together with general health, determine whether tests, biopsy, treatment or monitoring are appropriate.
Care
Treatment depends on the cause
Treatment aims to control inflammation and prevent new scarring. Medicines and procedures are selected according to cause, activity, extent and overall health.
Address the origin
Correct or control an identifiable trigger whenever possible.
Protect follicles
Reduce inflammation, traction or progression to protect viable follicles.
Follow progress
Compare symptoms, photographs and density over time without promising the same result for everyone.
When to seek an earlier assessment
Hair loss with pain, burning, pustules, scale, perifollicular redness or eyebrow loss should be assessed without waiting for progression.
FAQ · common questions
Questions about scarring alopecia
01Can scarring alopecia be cured?
Some subtypes enter remission, but established scar tissue usually cannot produce hair. The goal is to control activity and preserve remaining follicles.
02Is it the same as alopecia areata?
No. Alopecia areata generally preserves follicles, while scarring forms can destroy them. Examination differentiates them.
03Is biopsy always required?
Not always, but it is often recommended when the subtype is unclear or activity needs confirmation.
04Can I have a transplant?
Only selected stable cases may be considered after inflammation is controlled; it is not the first diagnostic step.
05Can I wait to see if it improves?
Waiting without assessment may allow permanent loss. Inflammatory symptoms justify early review.
References
Information based on medical sources
- DermNet – Hair loss: scarring causes
- Brazilian Society of Dermatology
- American Academy of Dermatology Association – Hair loss
Educational content reviewed for patient communication. It does not replace a medical consultation, diagnosis or prescription.