Scarring Alopecias (Cicatricial Alopecias) Treatment in Hyderabad

Are you noticing areas of hair loss where the scalp skin appears shiny, smooth, inflamed, or scarred? This could indicate a Scarring Alopecia (also known as Cicatricial Alopecia), a group of rare disorders where hair follicles are destroyed and replaced by scar tissue, leading to permanent hair loss. Early diagnosis and aggressive treatment are crucial to halt the progression and preserve remaining hair follicles. At Dr. Nishita’s Clinic in Hyderabad, we specialise in diagnosing and managing these complex conditions.

Understanding Scarring Alopecias

In Scarring Alopecias, inflammation targets and permanently destroys the hair follicle stem cells. Once the follicle is destroyed and replaced by scar tissue, hair cannot regrow in that spot. These conditions are classified based on the primary type of inflammatory cells involved (lymphocytic, neutrophilic, or mixed).

  • Mechanism: The exact cause of most scarring alopecias is poorly understood, but it involves an inflammatory process directed at the hair follicle.
  • Irreversible Hair Loss: The hallmark is permanent destruction of hair follicles.
  • Symptoms: May include itching, burning, pain, tenderness, redness, scaling, pustules, or a “boggy” scalp, along with progressive hair loss. Some forms are asymptomatic initially.

Common Types of Scarring Alopecias We Address

  • Lichen Planopilaris (LPP): Lymphocytic inflammation; often causes itching, pain, redness around follicles, and perifollicular scaling. Typically affects the crown and vertex.
    • Frontal Fibrosing Alopecia (FFA): A variant of LPP, causing progressive recession of the frontal hairline and often eyebrows.
  • Central Centrifugal Cicatricial Alopecia (CCCA): Begins in the central scalp (crown) and spreads outwards. Common in women of African descent, may be linked to certain hair care practices.
  • Dissecting Cellulitis of the Scalp: Neutrophilic inflammation; forms deep, painful nodules, abscesses, and interconnecting sinus tracts leading to scarring.
  • Folliculitis Decalvans: Neutrophilic inflammation; presents with recurrent pustules, crusting, and tufted hairs (multiple hairs emerging from a single scarred opening).
  • Pseudopelade of Brocq: End-stage of various scarring alopecias, characterised by smooth, irregular, “moth-eaten” patches of hair loss.

Our Tailored Approach to Scarring Alopecias in Hyderabad

Early and accurate diagnosis is paramount:

Looking for specific signs of inflammation, follicular changes, and scarring patterns.

Essential for confirming the diagnosis, identifying the type of scarring alopecia, and assessing the degree of inflammation and fibrosis. One or two small punch biopsies are typically taken under local anaesthesia.

Aimed at reducing inflammation, stopping disease progression, and relieving symptoms. Treatment is often long-term.

The primary goal is to prevent further hair follicle destruction. Regrowth in scarred areas is generally not possible, but some recovery can occur in inflamed but not yet fully scarred follicles.

Often involves a combination of topical and systemic therapies.

Advanced Treatments for Scarring Alopecias at Dr. Nishita’s Clinic

Treatment focuses on controlling inflammation and halting progression:

Potent anti-inflammatory creams, lotions, or solutions to reduce scalp inflammation.

Injecting steroids directly into inflamed areas of the scalp to deliver medication precisely.

Used for their anti-inflammatory properties in certain types like Folliculitis Decalvans or LPP.

* Hydroxychloroquine (antimalarial with immunomodulatory effects) for LPP, FFA. * Corticosteroids (oral) for aggressive or rapidly progressing cases (short-term). * Methotrexate, Cyclosporine, Mycophenolate Mofetil for more severe or resistant cases.

Can be helpful in some neutrophilic scarring alopecias.

Not usually an option for active scarring alopecia, as the transplanted follicles may also be destroyed. May be considered in very rare, completely quiescent (burnt-out) disease for small areas, with high risk of failure.

Gentle shampoos, avoiding harsh treatments.

Why Choose Dr. Nishita’s Clinic for Scarring Alopecias?

  • Specialist in Complex Hair Disorders: Dr. Nishita’s expertise is crucial for diagnosing and managing these challenging conditions.
  • Essential Diagnostic Capabilities: Including trichoscopy and the ability to perform and interpret scalp biopsies.
  • Evidence-Based Treatment Protocols: Utilising proven medical therapies to control disease activity.
  • Long-Term Management Focus: Scarring alopecias often require ongoing care and monitoring.
  • Patient-Centric Approach: Providing support and realistic expectations for these chronic conditions.

Frequently Asked Questions (FAQs)

Unfortunately, once a hair follicle is destroyed and replaced by scar tissue, hair cannot regrow from that specific follicle. Treatment aims to save remaining follicles and stop the disease from spreading.

Diagnosis is based on clinical examination, trichoscopy, and importantly, a scalp biopsy for histopathological analysis.

Many scarring alopecias are chronic and may require long-term treatment to maintain remission or control activity. The goal is to stop progression.

No, these are relatively rare conditions compared to non-scarring hair loss like androgenetic alopecia or telogen effluvium.

Early Diagnosis is Key: Book Your Consultation

If you suspect you have a scarring alopecia, prompt evaluation by a dermatologist specialising in hair disorders is critical. Schedule a consultation with Dr. Nishita for an accurate diagnosis and management plan.

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Visit us in Banjara Hills, Hyderabad
Call or WhatsApp: +91 93812 19187
Monday to Saturday | 10:00 AM – 7:00 PM

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