Follicular Streamers (Stelae) in Scarring and Non-Scarring Alopecia

In the 2008 study, researchers examined follicular streamers in 22 non-scarring alopecia cases and 22 scarring alopecia cases. They found that streamers were more prevalent in non-scarring alopecia, with 61 streamers observed in these cases compared to 13 in scarring alopecia. The majority of streamers were associated with catagen/telogen follicles, and accurate follicular counts for diagnosis should follow streamers from deeper levels to the follicular unit level. The study highlighted the diagnostic importance of streamers, as they indicate viable hairs unless fibrosed, and emphasized that streamers should be differentiated from follicular scars to accurately diagnose and understand the nature of hair loss.