Cicatricial Alopecias: Diagnosis and Treatment Complexities

July 2012 in “ Springer eBooks ”

Yolanda M. Lenzy, Amy J. McMichael

TLDR The document concludes that more research is needed to better understand and treat scarring hair loss conditions.

The document from 2012 addresses the complexity of diagnosing and treating cicatricial alopecias, a group of disorders characterized by scarring hair loss. It outlines the North American Hair Research Society's classification of primary cicatricial alopecias and discusses the clinical features and treatment options for specific types such as central centrifugal cicatricial alopecia (CCCA) and lichen planopilaris (LPP). Treatments range from topical and intralesional steroids to systemic agents like hydroxychloroquine, methotrexate, cyclosporine, and mycophenolate mofetil, with minoxidil suggested as an adjuvant therapy. Hair transplantation is considered for stable disease. The document also addresses the treatment of related conditions such as chronic cutaneous lupus erythematosus (DLE), dissecting cellulitis of the scalp (DCS), and folliculitis decalvans (FD), recommending a therapeutic ladder approach. It concludes with a call for more research to improve the understanding and management of these challenging conditions.

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Research cited in this study

16 / 16 results

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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 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 86 upvotes 8 months ago

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community Losing Hair on Dutasteride? You might have LPP

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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.

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community Totally confused by doctors opinions, would appreciate some clarity

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