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.

View this study on link.springer.com →

Discuss this study in the Community →

Research cited in this study

16 / 16 results

research Secondary Cicatricial and Other Permanent Alopecias

20 citations, July 2008 in “Dermatologic Therapy”

The document says that treating the root cause of hair follicle damage is crucial to prevent permanent hair loss, and treatment options vary.

research Diagnosis and Management of Primary Cicatricial Alopecia: Part II

32 citations, March 2008 in “SKINmed Dermatology for the Clinician”

Accurate diagnosis and tailored treatment are crucial for managing complex hair loss conditions.

research Diagnosis and Management of Primary Cicatricial Alopecia: Part I

42 citations, January 2008 in “SKINmed/Skinmed”

The article explains how to diagnose and manage certain types of scarring hair loss.

research A Case-Series of 29 Patients with Lichen Planopilaris: The Cleveland Clinic Foundation Experience on Evaluation, Diagnosis, and Treatment

113 citations, May 2007 in “Journal of the American Academy of Dermatology”

The study found that steroids and tetracycline helped treat active Lichen planopilaris, and hair transplants were good for later stages.

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.

research Female Pattern Hair Loss and Its Relationship to Permanent/Cicatricial Alopecia: A New Perspective

73 citations, November 2005 in “Journal of Investigative Dermatology Symposium Proceedings”

Some women with common hair loss may develop permanent hair loss.

research Hair Loss: Is There a Relationship with Hair Care Practices in Nigeria?

57 citations, September 2005 in “International Journal of Dermatology”

Frequent use of chemical hair relaxants is linked to increased scarring hair loss in Nigerian women.

research Frontal Fibrosing Alopecia in Postmenopausal Women

179 citations, December 2004 in “Journal of The American Academy of Dermatology”

Some postmenopausal women with frontal fibrosing alopecia stopped losing hair with finasteride treatment, hinting at a possible hormonal cause.

research Medical and Surgical Therapies for Alopecias in Black Women

105 citations, April 2004 in “Dermatologic Therapy”

The document concludes that proper diagnosis and a combination of medical, hair-care, and surgical treatments are important for managing alopecia in black women.

research Hair and Scalp Disorders in Ethnic Populations

55 citations, October 2003 in “Dermatologic Clinics”

Different hair care practices and conditions affect African American hair and scalp health, requiring specialized knowledge for treatment.

research Tinea Capitis in Adult Women Masquerading as Bacterial Pyoderma

32 citations, August 2003 in “Journal of the American Academy of Dermatology”

Tinea capitis can be misdiagnosed as bacterial infection in adult women but is treatable with antifungal medication.

research Ethnic Hair Update: Past and Present

73 citations, June 2003 in “Journal of the American Academy of Dermatology”

Dermatologists need to understand African American hair-care practices to better treat their hair and scalp disorders.

research Use of an 800-nm Pulsed-Diode Laser in the Treatment of Recalcitrant Dissecting Cellulitis of the Scalp

51 citations, October 2002 in “Archives of dermatology”

The document does not conclude the effectiveness of the 800-nm pulsed-diode laser for treating scalp cellulitis.

research Lichen Planopilaris Treated With Thalidomide

37 citations, December 2001 in “Journal of the American Academy of Dermatology”

Thalidomide significantly improved hair regrowth in a woman with lichen planopilaris.

research Fibrosing Alopecia in a Pattern Distribution

158 citations, February 2000 in “Archives of dermatology”

Some people with pattern hair loss may also have scalp inflammation and scarring similar to lichen planopilaris.

research Postmenopausal Frontal Fibrosing Alopecia: A Frontal Variant of Lichen Planopilaris

329 citations, January 1997 in “Journal of the American Academy of Dermatology”

Frontal fibrosing alopecia is a hair loss condition in postmenopausal women, similar to lichen planopilaris, with ineffective treatments.

Related Community Posts Join

6 / 17 results

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

in Research 830 upvotes 8 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 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 91 upvotes 9 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 Losing Hair on Dutasteride? You might have LPP

in Research/Science 99 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.

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

in Finasteride/Dutasteride 19 upvotes 2 months 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 Totally confused by doctors opinions, would appreciate some clarity

in Treatment 1 upvotes 4 months ago

The user is experiencing hair loss and confusion over conflicting medical advice, with treatments including minoxidil, finasteride, and topical corticosteroids. They are unsure about the necessity of a biopsy and the timing of using minoxidil, while also considering the impact of potential androgenetic alopecia and telogen effluvium.

Related Research

9 / 9 results

research Hair and Nail Conditions: Alopecia Evaluation

1 citations, June 2022 in “PubMed”

Alopecia causes hair loss and should be treated early, especially scarring types where hair cannot regrow.

research Common Causes of Hair Loss: Clinical Manifestations, Trichoscopy, and Therapy

47 citations, December 2020 in “Journal of the European Academy of Dermatology and Venereology”

The document concludes that understanding and treating hair loss requires recognizing its various types and using appropriate diagnostic tools and treatments.

research What’s New in Hair Loss

5 citations, March 2019 in “Dermatologic Clinics”

New treatments for hair loss show promise, but require more research on long-term effects and proper dosing.

research Hair Disorders

August 2018 in “Oxford University Press eBooks”

The document's conclusion cannot be provided because the document cannot be parsed.

research Disorders of Hair

July 2013 in “DeckerMed Family Medicine”

The document's conclusion cannot be provided because the document is not readable or understandable.

research Cicatricial Alopecias: Diagnosis and Treatment Complexities

1 citations, July 2012 in “Springer eBooks”

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

research Alopecia: Evaluation and Treatment

76 citations, July 2011 in “Clinical, Cosmetic and Investigational Dermatology”

The document concludes that proper diagnosis and FDA-approved treatments for different types of hair loss exist, but treatments for severe cases often fail and future improvements may focus on hair follicle stem cells.

research Topical and Intralesional Therapies for Alopecia Areata

36 citations, May 2011 in “Dermatologic therapy”

No treatments fully cure or prevent alopecia areata; some help but have side effects or need more research.

research Hair Diseases

28 citations, September 1998 in “Medical Clinics of North America”

Most hair loss can be diagnosed with patient history and physical exam, and a few common types make up most cases.