Cicatricial Alopecia: Overview and Treatment Options

The document from October 31, 2018, provides an overview of cicatricial alopecia, a permanent hair loss condition due to the destruction of hair follicles and replacement with scar tissue. It distinguishes between primary cicatricial alopecia, which is an inflammatory condition targeting hair follicles, and secondary cicatricial alopecia, which results from nonspecific skin damage. Primary cicatricial alopecia is further classified based on the type of inflammatory cells involved. Treatments include immunosuppressive agents for lymphocyte-predominant lesions and antimicrobials or dapsone for neutrophil-predominant lesions, with autologous hair transplantation recommended for stable cases. The document notes a lack of consensus on treatment efficacy, with clinical improvement not fully supported by evidence-based trials. It also mentions that minoxidil may have antifibrotic effects in early stages of scarring alopecia, but its effectiveness varies among individuals. Hair transplantation techniques like FUE are considered for hair replacement, with outcomes depending on scalp preparation and post-surgery care. The document concludes that while various treatments have been attempted, their efficacy is not well-supported by evidence, and hair transplantation has shown more predictable and satisfactory results, though further research is needed.