Cicatricial Marginal Alopecia: Is It All Traction?

September 2008 in “ British Journal of Dermatology ”

Lynne J. Goldberg

cicatricial marginal alopecia CMA scarring hair loss traction alopecia hair follicles sebaceous glands follicular loss stem cell depletion scarring alopecia

TLDR Traction may not be the only cause of cicatricial marginal alopecia.

In the 2009 study, Dr. Lynne J. Goldberg evaluated 15 patients with cicatricial marginal alopecia (CMA), a type of scarring hair loss at the scalp margin. The study, which reviewed biopsies from 1999 to 2006, found that not all patients had a history of hair care practices leading to traction alopecia, with six denying such practices and three having an unknown hair care history. Histological analysis showed a loss of hair follicles and retention of sebaceous glands, with an average of 7.8 hair follicles per 4-mm punch biopsy, significantly lower than the normal range of 21 to 38. The study concluded that traction may not be the only cause of CMA and highlighted the need for further research into the mechanisms of follicular loss and the role of stem cell depletion in scarring alopecia. Clinicians were advised to consider CMA in cases of band-like hair loss at the scalp periphery, even without a history of traction alopecia.

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