Rely on Clinical Experience to Guide Treatment Selection for Primary Cicatricial Alopecias

The document from December 2012 addresses the difficulties in diagnosing and treating primary cicatricial alopecias, which are a group of conditions causing irreversible hair loss and account for 3-7% of hair loss consultations. Due to the lack of distinctive features and molecular markers, treatment is challenging and relies heavily on clinical experience. The article highlights the necessity of early intervention to mitigate the progression of inflammation and scarring, but notes that hair regrowth in scarred areas is unlikely and treatment often fails or relapses. A range of pharmacological treatments are recommended based on a combination of literature review, expert opinion, and personal experience, with surgical options considered for some cases. The treatments are categorized into first-line, second-line, and third-line options, with the selection influenced by potential adverse effects and practical considerations. The document summarizes the characteristics and management strategies for primary cicatricial alopecias as reviewed by Rongioletti and Christana.