Management of Primary Cicatricial Alopecias: Options for Treatment

July 2008 in “ British Journal of Dermatology ”

Matthew Harries, Rodney Sinclair, S. Macdonald-Hull, David Whiting, C.E.M. Griffiths, Ralf Paus

TLDR There are many treatments for permanent hair loss disorders, but their effectiveness varies and there's no clear best option.

The 15-year-old review article "Management of primary cicatricial alopecias: options for treatment" discussed the challenges and treatment options for primary cicatricial alopecias (PCAs), disorders causing permanent hair loss. The authors noted that PCAs are poorly understood and characterized by the replacement of follicular structures with scar-like fibrous tissue. The aim of treatment was to reduce symptoms and slow or stop the progression of the scarring process. Various treatments were discussed, including potent topical corticosteroids, intralesional triamcinolone acetonide, antimalarials, oral retinoids, thalidomide, griseofulvin, mycophenolate mofetil, low molecular weight heparin, and excimer laser. The effectiveness of these treatments varied, with some showing marked improvement in some patients, while others showed no response or even deterioration. The authors concluded that the overall level of evidence to support one form of treatment over another was low, and treatment preference was often based on the physician's personal experience, expected adverse effects, and pragmatic considerations.

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