Alopecia Cicatricata

Last updated: February 8, 2026Reviewed date: February 8, 2026Reading time: 12 min read
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Alopecia Cicatricata
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Alopecia cicatricata (also known as cicatricial alopecia or scarring alopecia) is a type of hair loss condition characterized by the destruction of hair follicles and the replacement of these follicles with scar tissue. This type of hair loss is permanent and can result in complete...

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Article Summary

Alopecia cicatricata (also known as cicatricial alopecia or scarring alopecia) is a type of hair loss condition characterized by the destruction of hair follicles and the replacement of these follicles with scar tissue. This type of hair loss is permanent and can result in complete baldness of the affected area. There are several different types of alopecia cicatricata, including: Central centrifugal cicatricial alopecia (CCCA): This...

Key Takeaways

  • This article explains Causes in simple medical language.
  • This article explains Symptoms in simple medical language.
  • This article explains Diagnosis in simple medical language.
  • This article explains Treatment in simple medical language.
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Definition

Alopecia cicatricata (also known as cicatricial alopecia or scarring alopecia) is a type of hair loss condition characterized by the destruction of hair follicles and the replacement of these follicles with scar tissue. This type of hair loss is permanent and can result in complete baldness of the affected area.

There are several different types of alopecia cicatricata, including:

  1. Central centrifugal cicatricial alopecia (CCCA): This is the most common type of cicatricial alopecia, affecting mainly African American women. It typically starts as a patch of hair loss in the center of the scalp and spreads outwards, leading to the formation of a circular bald patch.
  2. Folliculitis decalvans: This type of cicatricial alopecia is characterized by the infection, or irritation, often causing pain, swelling, heat, or redness. সহজ বাংলা: শরীরের প্রদাহ; ব্যথা, ফোলা বা লালভাব হতে পারে।" data-rx-term="inflammation" data-rx-definition="Inflammation is the body’s response to injury, infection, or irritation, often causing pain, swelling, heat, or redness. সহজ বাংলা: শরীরের প্রদাহ; ব্যথা, ফোলা বা লালভাব হতে পারে।">inflammation and destruction of hair follicles, leading to scarring and permanent hair loss. It often begins as small, red, painful pimple-like eruptions around hair follicles and can progress to widespread baldness.
  3. Lichen planopilaris (LPP): This type of cicatricial alopecia affects mainly women and causes infection, or irritation, often causing pain, swelling, heat, or redness. সহজ বাংলা: শরীরের প্রদাহ; ব্যথা, ফোলা বা লালভাব হতে পারে।" data-rx-term="inflammation" data-rx-definition="Inflammation is the body’s response to injury, infection, or irritation, often causing pain, swelling, heat, or redness. সহজ বাংলা: শরীরের প্রদাহ; ব্যথা, ফোলা বা লালভাব হতে পারে।">inflammation and destruction of hair follicles, leading to scarring and permanent hair loss. It often presents as patches of hair loss, usually on the crown of the scalp, and can be associated with itching and burning sensations.
  4. Frontal fibrosing alopecia (FFA): This type of cicatricial alopecia affects mainly postmenopausal women and is characterized by the progressive hair loss and scarring of the frontal hairline, leading to a distinctive “peaked” appearance.
  5. Discoid lupus erythematosus (DLE): This is a type of autoimmune disorder that can cause scarring and permanent hair loss. It often presents as coin-shaped, red, scaly patches of hair loss, most commonly on the scalp, but also on other areas of the body.
  6. Traction alopecia: This type of cicatricial alopecia is caused by tight hairstyles that pull on hair follicles, leading to scarring and permanent hair loss. It is most commonly seen in people who wear tight braids, cornrows, or weaves.

Causes

The exact cause of alopecia cicatrisata is unknown, but there are several factors that are believed to contribute to its development.

  1. Genetics: There is evidence that genetics play a role in the development of alopecia cicatrisata. Individuals who have a family history of autoimmune conditions or alopecia are more likely to develop the condition.
  2. Immune system dysfunction: Alopecia cicatrisata is an autoimmune condition, meaning that the immune system attacks healthy hair follicles, leading to hair loss and scarring. In some cases, the immune system mistakenly identifies hair follicles as foreign invaders and attacks them.
  3. Hormonal factors: Hormonal imbalances, such as those seen in conditions like polycystic ovary syndrome (PCOS) or thyroid gland makes too little hormone. সহজ বাংলা: থাইরয়েড হরমোন কম।" data-rx-term="hypothyroidism" data-rx-definition="Hypothyroidism means the thyroid gland makes too little hormone. সহজ বাংলা: থাইরয়েড হরমোন কম।">hypothyroidism, have been linked to the development of alopecia cicatrisata. These imbalances can cause changes in the growth and maintenance of hair follicles, leading to hair loss.
  4. infection, or irritation, often causing pain, swelling, heat, or redness. সহজ বাংলা: শরীরের প্রদাহ; ব্যথা, ফোলা বা লালভাব হতে পারে।" data-rx-term="inflammation" data-rx-definition="Inflammation is the body’s response to injury, infection, or irritation, often causing pain, swelling, heat, or redness. সহজ বাংলা: শরীরের প্রদাহ; ব্যথা, ফোলা বা লালভাব হতে পারে।">Inflammation: Chronic inflammation can also contribute to the development of alopecia cicatrisata. Inflammation can damage hair follicles and lead to scarring, resulting in permanent hair loss.
  5. Trauma: Physical trauma to the scalp, such as from tight hairstyles or chemical treatments, can also contribute to the development of alopecia cicatrisata. Trauma can cause infection, or irritation, often causing pain, swelling, heat, or redness. সহজ বাংলা: শরীরের প্রদাহ; ব্যথা, ফোলা বা লালভাব হতে পারে।" data-rx-term="inflammation" data-rx-definition="Inflammation is the body’s response to injury, infection, or irritation, often causing pain, swelling, heat, or redness. সহজ বাংলা: শরীরের প্রদাহ; ব্যথা, ফোলা বা লালভাব হতে পারে।">inflammation and scarring, leading to permanent hair loss.
  6. Infections: Certain infections, such as fungal infections of the scalp, can also contribute to the development of alopecia cicatrisata. These infections can cause infection, or irritation, often causing pain, swelling, heat, or redness. সহজ বাংলা: শরীরের প্রদাহ; ব্যথা, ফোলা বা লালভাব হতে পারে।" data-rx-term="inflammation" data-rx-definition="Inflammation is the body’s response to injury, infection, or irritation, often causing pain, swelling, heat, or redness. সহজ বাংলা: শরীরের প্রদাহ; ব্যথা, ফোলা বা লালভাব হতে পারে।">inflammation and scarring, leading to permanent hair loss.
  7. Medications: Certain medications, such as those used to treat cancer, can also contribute to the development of alopecia cicatrisata. These medications can cause hair loss and scarring, leading to permanent hair loss.
  8. Age: Alopecia cicatrisata can occur at any age, but it is most common in individuals over the age of 40. As individuals age, their hair follicles may become less resilient, making them more susceptible to damage and scarring.

The exact mechanisms by which these factors contribute to the development of alopecia cicatrisata are not well understood. However, it is believed that a combination of genetic and environmental factors interact to trigger the immune system to attack hair follicles, leading to scarring and permanent hair loss.

Symptoms

This condition is considered a chronic autoimmune disorder, which means that the immune system mistakenly attacks healthy tissues in the body, including the hair follicles. In this case, the immune system attacks the hair follicles, causing infection, or irritation, often causing pain, swelling, heat, or redness. সহজ বাংলা: শরীরের প্রদাহ; ব্যথা, ফোলা বা লালভাব হতে পারে।" data-rx-term="inflammation" data-rx-definition="Inflammation is the body’s response to injury, infection, or irritation, often causing pain, swelling, heat, or redness. সহজ বাংলা: শরীরের প্রদাহ; ব্যথা, ফোলা বা লালভাব হতে পারে।">inflammation and scarring, leading to permanent hair loss.

The following are the main symptoms of alopecia cicatrisata:

  1. Hair loss: The primary symptom of alopecia cicatrisata is hair loss, which typically starts as small, circular patches of hair loss on the scalp. Over time, these patches can become larger and merge with each other, resulting in extensive hair loss. The hair loss is usually permanent and the hair follicles are destroyed, so the hair will not regrow in the affected areas.
  2. Scalp itching: Some people with alopecia cicatrisata experience itching on the scalp, which can be mild to severe in nature. This itching can be accompanied by redness, scaling, and soreness.
  3. Scalp scaling: Some people with alopecia cicatrisata experience scaling on the scalp, which can be accompanied by itching and redness. The scaling is a result of the immune system attacking the hair follicles, causing infection, or irritation, often causing pain, swelling, heat, or redness. সহজ বাংলা: শরীরের প্রদাহ; ব্যথা, ফোলা বা লালভাব হতে পারে।" data-rx-term="inflammation" data-rx-definition="Inflammation is the body’s response to injury, infection, or irritation, often causing pain, swelling, heat, or redness. সহজ বাংলা: শরীরের প্রদাহ; ব্যথা, ফোলা বা লালভাব হতে পারে।">inflammation and scarring.
  4. Scalp redness: People with alopecia cicatrisata may experience redness on the scalp, which can be accompanied by itching and scaling. The redness is a result of the inflammation caused by the immune system attacking the hair follicles.
  5. Nail changes: Some people with alopecia cicatrisata experience changes in their nails, such as ridging, pitting, or brittle nails. These changes can be a sign of a more widespread autoimmune condition.
  6. Eyebrow and eyelash loss: In some cases, people with alopecia cicatrisata may also experience hair loss in other areas of the body, such as the eyebrows and eyelashes. This can result in a loss of facial hair and a more noticeable bald spot on the scalp.
  7. Pain: In some cases, people with alopecia cicatrisata may experience pain in the affected areas. This pain can be a result of the inflammation caused by the immune system attacking the hair follicles.

It is important to note that not all people with alopecia cicatrisata will experience all of these symptoms, and the symptoms can vary in severity from person to person.

Diagnosis

Diagnosis of alopecia cicatrisata typically involves a combination of clinical examination and laboratory tests. The following is a list of the most common diagnostic procedures and tests used to identify and evaluate the condition:

  1. Clinical Examination: A dermatologist will typically start by conducting a thorough physical examination of the scalp, including examination of the skin, hair, and hair follicles. They will look for signs of inflammation, scarring, and any other physical abnormalities that may suggest the presence of alopecia cicatrisata.
  2. Trichoscopy: Trichoscopy is a non-invasive diagnostic tool that allows the dermatologist to examine the hair and scalp using a specialized microscope called a dermatoscope. This test allows the dermatologist to see the hair shafts, follicles, and surrounding skin in great detail, helping to identify any signs of hair loss or damage.
  3. Scalp Biopsy: A scalp biopsy is a procedure in which a small piece of skin and hair is removed from the scalp and examined under a microscope. This test can provide important information about the extent and severity of hair follicle damage and is often used to confirm a diagnosis of alopecia cicatrisata.
  4. Blood Tests: Blood tests can be used to look for underlying autoimmune diseases or infections that may be contributing to the hair loss. Tests may include complete blood count (CBC), erythrocyte sedimentation rate (ESR), antinuclear antibody (ANA) test, and other autoimmune markers.
  5. Skin Tests: Skin tests, such as a skin punch biopsy or a skin scraping test, may be performed to identify any underlying skin conditions that may be contributing to the hair loss.
  6. Imaging Tests: Imaging tests, such as CT scans or MRI, may be used to identify any underlying conditions or abnormalities in the scalp or neck that may be causing the hair loss.

Once a diagnosis of alopecia cicatrisata has been confirmed, the dermatologist will work with the patient to develop a treatment plan. This may involve a combination of medical, surgical, and cosmetic treatments.

Medical treatments for alopecia cicatrisata may include the use of topical or oral medications, such as corticosteroids, to reduce inflammation and promote hair growth. Topical minoxidil may also be used to stimulate hair growth.

Treatment

While there is no cure for alopecia cicatrisata, there are several treatments that can help to manage the symptoms and slow the progression of the condition.

  1. Topical Minoxidil: Minoxidil is a medication that is applied directly to the scalp. It is believed to work by increasing blood flow to the hair follicles and by preventing the progression of hair loss. Minoxidil is available over-the-counter in a 2% or 5% solution. Higher strengths are available by prescription. Topical Minoxidil is a safe and effective treatment for alopecia cicatrisata, and it has been shown to slow the progression of hair loss and promote new hair growth in some cases.
  2. Corticosteroids: Corticosteroids are medications that are used to reduce inflammation. They are often used to treat autoimmune conditions, including alopecia cicatrisata. Corticosteroids can be applied topically to the scalp, or they can be taken orally or as an injection. Topical corticosteroids are often used to treat mild cases of alopecia cicatrisata, while more severe cases may require oral or injected corticosteroids. Corticosteroids can be effective in reducing the inflammation and slowing the progression of hair loss, but they can also have side effects, including thinning of the skin, acne, and weight gain.
  3. Topical Anthralin: Anthralin is a medication that is applied directly to the scalp. It is believed to work by suppressing the immune system and reducing inflammation. Anthralin is a safe and effective treatment for alopecia cicatrisata, and it has been shown to slow the progression of hair loss and promote new hair growth in some cases.
  4. Topical Calcineurin Inhibitors: Calcineurin inhibitors are medications that are used to suppress the immune system. They are often used to treat autoimmune conditions, including alopecia cicatrisata. Topical calcineurin inhibitors are applied directly to the scalp, and they have been shown to be effective in reducing inflammation and slowing the progression of hair loss.
  5. Immune Therapy: Immune therapy involves altering the immune system in order to reduce its attack on the hair follicles. This can be achieved through the use of immunosuppressive medications or immunomodulatory agents. Immune therapy is often used in severe cases of alopecia cicatrisata that are unresponsive to other treatments. It is a relatively new and experimental treatment, and more research is needed to determine its effectiveness and safety.
  6. Hair transplantation: Hair transplantation is a surgical procedure that involves transplanting hair follicles from one area of the scalp to another. This can be an effective treatment for alopecia cicatrisata in cases where there are areas of the scalp with healthy hair growth. Hair transplantation is a permanent solution to hair loss, and it can result in natural-looking hair growth.
  7. Wigs and hairpieces: Wigs and hairpieces can be used to cover the areas of the scalp affected by alopecia cicatrisata. This can be a good option for those who do not want to undergo surgical procedures or who do not respond.
  8. Immunosuppressive drugs – Immunosuppressive drugs are medications that suppress the immune system. They are sometimes used to treat alopecia cicatrisata, as they can help slow down the progression of hair loss. The most commonly prescribed immunosuppressive drugs for alopecia cicatrisata are methotrexate, azathioprine, and cyclosporine.
  9. Platelet-rich plasma (PRP) – Platelet-rich plasma (PRP) is a treatment that involves injecting a concentrated mixture of platelets and plasma into the scalp. The platelets contain growth factors that can help promote hair growth and slow down the progression of hair loss. PRP is thought to work by stimulating the hair follicles and promoting the growth of new hair
  10. Wigs and hairpieces – Wigs and hairpieces can be a good option for those with alopecia cicatrisata who want to cover up their hair loss. Wigs and hairpieces are available in a variety of styles and colors, and they can be a good alternative to hair transplantation.
  11. Hair transplantation – Hair transplantation is a surgical procedure that involves transplanting hair from one part of the scalp to another. Hair transplantation can be a good option for those with alopecia cicatrisata who want to restore their hairline or improve the appearance of their scalp. However, hair transplantation is a complex and expensive procedure, and it is not suitable for everyone.
  12. Scalp micro pigmentation – Scalp micro pigmentation is a cosmetic procedure that involves tattooing the scalp with a pigment that resembles the color of hair. Scalp micro-pigmentation can be a good option for those with alopecia cicatrisata who want to improve the appearance of their scalp.

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Doctor visit helper

Prepare before seeing a doctor

A simple rural-patient checklist to help you explain symptoms clearly, ask better questions, and avoid unsafe self-treatment.

Safety note: This is not a prescription or diagnosis. For severe symptoms, pregnancy danger signs, children with serious illness, chest pain, breathing difficulty, stroke-like weakness, or major injury, seek urgent care.

Which doctor may help?

Start with a registered doctor or the nearest qualified health center.

What to tell the doctor

  • Write when the problem started and how it changed.
  • Bring old prescriptions, investigation reports, and current medicines.
  • Write allergies, pregnancy status, diabetes, kidney/liver disease, and major past illnesses.
  • Bring one family member if the patient is weak, elderly, confused, or a child.

Questions to ask

  • What is the most likely cause of my symptoms?
  • Which danger signs mean I should go to hospital quickly?
  • Which tests are necessary now, and which can wait?
  • How should I take medicines safely and what side effects should I watch for?
  • When should I come for follow-up?

Tests to discuss

  • Vital signs: temperature, pulse, blood pressure, oxygen saturation
  • Basic physical examination by a clinician
  • CBC, urine test, blood sugar, or imaging only when clinically needed

Avoid these mistakes

  • Do not use antibiotics, steroid tablets/injections, or strong painkillers without proper medical advice.
  • Do not hide pregnancy, kidney disease, ulcer, allergy, or blood thinner use.
  • Do not delay emergency care when danger signs are present.

Medicine safety and first-aid guide

This section is for patient education only. It does not replace a doctor, pharmacist, or emergency care.

Safe first steps

  • Avoid heavy lifting, sudden bending, and prolonged bed rest.
  • Use comfortable posture and gentle movement as tolerated.
  • Discuss physiotherapy, X-ray, or MRI only when clinically needed.

OTC medicine safety

  • For mild back pain, pain-relief medicine may be discussed with a doctor or pharmacist.
  • Avoid repeated painkiller use if you have kidney disease, stomach ulcer, uncontrolled blood pressure, or are taking blood thinners.

Avoid these mistakes

  • Do not start antibiotics without a proper medical decision.
  • Do not use steroid tablets or injections casually for quick relief.
  • Do not delay emergency care because of home remedies.

Get urgent help if

  • Back pain with leg weakness, numbness around private area, loss of urine/stool control, fever, cancer history, or major injury needs urgent care.
Medicine names, dose, and timing must be decided by a qualified clinician or pharmacist after checking age, pregnancy, allergy, other diseases, and current medicines.

For rural patients and family caregivers

Patient health record and symptom diary

Write your symptoms, medicines already taken, test results, and questions before visiting a doctor. This note stays on your device unless you print or copy it.

Doctor to discuss: Doctor / qualified healthcare provider
Tests to discuss with doctor
  • Basic vital signs: temperature, pulse, blood pressure, oxygen level if needed
  • Relevant blood, urine, imaging, or specialist tests only after clinical assessment
Questions to ask
  • What is the most likely cause of my symptoms?
  • Which warning signs mean I should go to emergency care?
  • Which tests are really needed now?
  • Which medicines are safe for my age, pregnancy status, allergy, kidney/liver/stomach condition, and current medicines?

Emergency warning signs such as chest pain, severe breathing difficulty, sudden weakness, confusion, severe dehydration, major injury, or loss of bladder/bowel control need urgent medical care. Do not wait for online information.

Safe pathway to proper treatment

Care roadmap for: Alopecia Cicatricata

Use this simple roadmap to understand the next safe steps. It is educational and does not replace examination by a doctor.

Go to emergency care if you notice:
  • Severe or rapidly worsening symptoms
  • Breathing difficulty, chest pain, fainting, confusion, severe weakness, major injury, or severe dehydration
Doctor / service to discuss: Qualified healthcare provider; specialist depends on symptoms and examination.
  1. Step 1

    Check danger signs first

    If danger signs are present, seek emergency care and do not wait for online information.

  2. Step 2

    Record the symptom story

    Write when symptoms started, severity, medicines already taken, allergies, pregnancy status, and test results.

  3. Step 3

    Visit a qualified clinician

    A doctor, nurse, or qualified healthcare provider can examine you and decide which tests or treatment are needed.

  4. Step 4

    Do only useful tests

    Do tests after clinical assessment. Avoid unnecessary tests, random antibiotics, or repeated medicines without diagnosis.

  5. Step 5

    Follow up and return early if worse

    If symptoms worsen, new warning signs appear, or treatment is not helping, return for review quickly.

Rural patient practical tips
  • Take a written symptom diary and all previous prescriptions/test reports.
  • Do not hide medicines already taken, even herbal or over-the-counter medicines.
  • Ask which warning signs mean urgent referral to hospital.

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Alopecia Antibody Deficiency

Alopecia antibody deficiency is a rare condition where a person has significant hair loss (usually alopecia…

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Alopecia areata

Alopecia areata is a form of alopecia that impacts hair follicles, nails, and rarely, the retinal…

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Alopecia Areata

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