Cicatricial Alopecia (Scarring Alopecia) Post Series: Two
06 / 23 / 16

Cicatricial Alopecia (Scarring Alopecia) Post Series: Two

What causes it?

In the last post on cicatricial alopecia, I shared information from the Cicatricial Alopecia Research Foundation or CARF, which is an excellent resource site for those suffering from one of these rare disorders, and I encourage you to go to their website:

With many patients in my practice suffering from a primary cicatricial alopecias disorder, today's blog post continues with further general information to shed stronger light on this family of diseases.

In the last blog we answered the questions:

  • What is cicatricial alopecia?
  • Are there different kinds of cicatricial alopecia?

Today, two more questions will be answered.

What causes cicatricial alopecia?

According to CARF, even though causes of the various cicatricial alopecias are poorly recognized, we do know that inflammation centered on the hair follicle plays a major role in all primary cicatricial alopecias. Usually, the upper part of the follicle, which houses stem cells and sebaceous glands (oil glands), is targeted. If these stem cells and sebaceous glands become destroyed, there is zero possibility for regeneration of that hair follicle and permanent hair loss ensues.

So what causes this inflammation? CARF says new research suggests an essential "master regulator" preservation of hair follicle cells, stem cells, and sebaceous glands can stop working. This "master regulator" is called the peroxisome proliferator-activated receptor gamma, or PPAR gamma. When these PPAR gamma preservation levels drop, the process towards inflammation begins. The sebaceous gland dysfunctions, which causes abnormal processing and buildup of “toxic” lipids, and this buildup of lipids triggers the inflammation that eventually ruins the hair follicle.

Who is affected by cicatricial alopecia?

Due to the lack of epidemiologic studies performed to determine the percentage of cicatricial alopecias, sufficient information is pending, but overall, the Cicatricial Alopecia Research Foundation states that this family of disorders is not common.

According to CARF, this is what we do know:

  • Cicatricial alopecias affect both men and women of all ages, can manifest during the teenage years, but seldom seen in children.
  • Although there are a few reports of cicatricial alopecia occurring within a family, the majority of cicatricial alopecia patients have no family history of a similar condition.
  • Central centrifugal cicatricial alopecia most often affects women of African ancestry, and can also occur within several family members.
  • Frontal fibrosing alopecia most often affects post-menopausal women, but can also occur in young women and men.
  • Even though having more than one type of hair loss condition is possible, non-scarring hair loss situations do not transform into scarring hair loss alopecias.

So are cicatricial alopecias associated with other illnesses, and how are cicatricial alopecias diagnosed?

This topic is discussed in the next blog post in my series on cicatricial alopecias.

Dr. Arthur Gray offers a full range of diagnostic options as well as surgical and medical treatments for hair loss. If you are suffering from hair loss and looking for answers, contact Dr. Gray today to schedule a one-on-one consultation.