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Causes and Treatment of Scarring Hair Loss

Causes and Treatment of Scarring Hair Loss

The days of ponytails as a classic gym-only style are long gone. Now, ultra-tight, slick ponytails have become a staple on the red carpet. The tight ponytail is well known for its Croydon facelift effect, stretching the skin back for an instant cheekbone-enhancing look that women have been swearing by for decades now.

Unfortunately, tight ponytail trend can actually be bad for you. It can lead to scarring hair loss or cicatricial alopecia. Some styling and grooming practices, at the salon, such as hair rebonding, coloring, straightening or perming, can also cause scarring hair loss.

Also Read: Hairstyles Likely to Cause Hair Loss or Thinning Hair

Scarring hair loss can also be caused due to many skin condition – when the skin gets scarred, hair follicles in the skin are replaced by scar tissue permanently resulting in bald spots. Hair loss over such area is permanent and irreversible. No treatment can ‘nurse’ these hair follicles to grow.

Scarring hair loss can affect both men and women and people across all ages. In some cases, it forms slowly; in other instances, it may appear instantaneously, following a scalp injury.


  • Hair loss, after salon and other cosmetic procedures
  • Hair loss, after scalp injury or damage
  • Itching, burning, pain and tenderness of the scalp before a bald patch appears
  • Redness in the affected area; there may also be pustules
  • Skin loses its texture and shine in the affected area
  • Skin in affected area may be hard to touch, or may be discolored.


The condition typically occurs when the hair follicle is destroyed and is replaced with scar tissue.

Put simply, just about any injury, or infection, of the scalp can lead to a scar and cause scarring hair loss. In like manner, scarring hair loss can be triggered by the use of chemical relaxers, perms and hair color that contains bleach.

Also Read: The 'bald' truth ladies - you can control your hair fall by knowing what causes it

Triggering factors

Some skin conditions that can trigger scarring hair loss are as follows —

  • Lichen planopilaris. This condition is marked by purplish, raised, itchy, flat-topped lesions that heal with a scar
  • DLE (discoid lupus erythematosus). This is marked by irregular patches of hyperpigmented (dark) and hypopigmented (pale; white) skin, along with redness, scales, scarring and hair follicles devoid of hair
  • Raised, spongy lesions on the scalp with pus discharge — these are formed in response to a fungal infection of the hair follicle.

Scarring alopecia may also result as a ‘secondary’ response to any of the following —

  • Acne (pimples) is not just the prime distressing ‘preserve’ of your face. A variant of acne can affect your scalp. This is more common on the back of the scalp
  • Injury to the scalp
  • Parlour burns — from hair dyes and chemicals used on the scalp, or severe local burns from heating instruments in the parlour. This is quite common; it is also easily avoidable.


Your trichologist will examine your scalp to check for any scarring. A ‘hair pull test’ may be performed to see how easily your hair gets uprooted in the affected area. In rare cases, a biopsy may be performed to confirm the diagnosis.

Hair Loss Treatment

Hair fall treatment outcomes are determined by the reduction, or disappearance of scalp symptoms such as itching, burning, pain or tenderness. Results are also evaluated by improvement in scalp inflammation, such as decreased redness, scaling or pustules, and by reduced hair loss.

Medical treatment for hair fall control cannot help one to regain hair in scarring alopecia. However, it may be possible to treat or control further deterioration. It is, therefore, important to begin hair fall treatment as early as possible — to control the inflammatory process — although the progression of scarring hair loss is erratic. In some cases, progression is slow; in others, progression can be rapid and widespread. Most often, there is sufficient hair remaining to cover the affected scalp areas.


Self-help Tips

• Avoid the use blow dryers and hair irons, or use them with extreme care; evade any kind of accidental contact with the scalp

• Counseling may be required in certain cases — for recognition and acceptance of permanent hair loss and hair fall treatment required

• Do a patch test, before using hair products. Apply a small quantity of the product on a small patch of your skin, preferably behind ears, or nape of neck, or inner side of the elbow. Wait for 15 minutes and then wash off. Watch for signs of inflammation or allergy, such as redness, itching or rash

• Consult a trichologist immediately, if you notice any ‘tell-tale’ sign or symptom of scarring hair loss.

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