Cicatricial Alopecia: Diagnosis and Treatment Overview

May 2010 in “ Journal of the Dermatology Nurses' Association ”

Jennifer Fu, Vera H. Price

cicatricial alopecia scarring alopecia hair follicles scalp biopsy hydroxychloroquine doxycycline mycophenolate mofetil cyclosporine pioglitazone intralesional triamcinolone acetonide topical treatments antimicrobial agents Plaquenil Vibramycin CellCept Neoral Actos Kenalog

TLDR Cicatricial alopecia causes permanent hair loss and is treated to relieve symptoms and stop progression.

Cicatricial alopecia, or scarring alopecia, was a condition characterized by permanent hair loss due to inflammatory destruction of hair follicles, classified into lymphocytic and neutrophilic groups. Diagnosis required a scalp biopsy, and treatment focused on symptom relief and halting progression, as hair regrowth was generally not possible. First-line treatments included hydroxychloroquine and doxycycline, with second-line options like mycophenolate mofetil and cyclosporine if needed. Pioglitazone showed promise in resistant cases, and adjuvant therapies included intralesional triamcinolone acetonide and topical treatments. For neutrophilic types, antimicrobial agents were essential. The condition did not affect general health and was neither hereditary nor contagious.

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Research cited in this study

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research Efficacy and Safety of Mycophenolate Mofetil for Lichen Planopilaris

66 citations, January 2010 in “Journal of The American Academy of Dermatology”

Mycophenolate mofetil was effective for most patients in treating scarring hair loss, but some had side effects.

research Lichen Planopilaris Treated With a Peroxisome Proliferator-Activated Receptor Gamma Agonist

105 citations, December 2009 in “Archives of dermatology”

A specific drug can help treat Lichen Planopilaris, a condition causing permanent hair loss.

research The Medical Treatment of Cicatricial Alopecia

46 citations, March 2006 in “Seminars in Cutaneous Medicine and Surgery”

Current treatments for cicatricial alopecia can manage symptoms but don't stop hair loss or the disease.

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community If You Have DUPA, PLEASE READ THIS: Everyone Should Be Scalp Biopsied

in Research 830 upvotes 7 months ago

Scalp biopsies are crucial for diagnosing hair loss conditions like Diffuse Unpatterned Alopecia (DUPA) and retrograde hair loss, as treatments like finasteride and dutasteride may not be effective if other conditions are present. Combining PPAR-GAMMA agonists with retinoids could improve treatments for conditions like Lichen Planopilaris.

community Dutasteride Isn't Working? Get a Scalp Biopsy NOW

in Finasteride/Dutasteride 19 upvotes 1 month ago

Dutasteride may not be effective for everyone due to underlying issues, suggesting scalp biopsies for further diagnosis. Users discuss using higher doses of dutasteride, topical treatments, minoxidil, and pyrilutamide for hair loss management.

community I am a dermatologist with a clinical interest in alopecia. AMA

in Will treatment work for me? 2 years ago

In this conversation, 4990 discussed various treatments for hair loss, including oral minoxidil, PRP, transplan, Jak inhibitors, Dutasteride, Finasteride, Olumiant, Ketoconazole, RU58841, microneedling, baricitinib, and CCCA. They recommended scalp biopsies in unclear cases of DUPA, twice weekly to twice daily shampooing for topical minoxidil users, and two sessions spaced one month apart with follow up at month three to determine the effectiveness of PRP treatment.

community lost my hair in a single year of treatment at 20 years old

in Finasteride/Dutasteride 89 upvotes 8 months ago

A 20-year-old lost significant hair after one year of treatment, using minoxidil, finasteride, and later dutasteride. They are considering adding RU58841 but are advised to return to finasteride and minoxidil for a year before deciding.

community scarring alopecia awareness in this community

in Chat 33 upvotes 2 years ago

Lichen Planopilaris (LPP), a form of permanent hair loss, which can be mistaken for seborrheic dermatitis and is characterized by scalp itching, burning, redness, and dandruff. Treatment options discussed include steroidal creams, finasteride, minoxidil, and RU58841.

community Losing Hair on Dutasteride? You might have LPP

in Research/Science 98 upvotes 1 month ago

Men with hair loss might have lichen planopilaris (LPP), which can mimic androgenetic alopecia, leading to misdiagnosis and ineffective treatment with finasteride or dutasteride. Proper diagnosis, including biopsies, is crucial to distinguish between androgenetic alopecia and conditions like LPP.