Alopecia, or hair loss, occurs for diverse reasons including genetics, hormonal imbalances, nutrient deficiencies, skin disorders and stress. Scarring alopecia, also known as cicatricial alopecia, is the loss of hair due to the scarring of the scalp. Like androgenetic alopecia, or pattern/common baldness, scarring is the only other type of permanent hair loss. It is generally caused by burns or disorders that kill hair follicles and replace them with scar tissue.
Second Degree Burns
The dermis is the second layer of the skin, which contains the hair follicles responsible for hair growth. Any destruction of these follicles that results in the replacement of scar tissue will cause permanent hair loss. Scalp-burns due to extended use of dangerous hair chemicals, fire, excessive radiation or heated metal can trigger this type of scarring.
Lichen Planopilaris
Lichen planopilaris, a variant of the skin disease lichen planus, appears on the scalp. Its origin is unknown, but it is speculated to be a reaction to stress, infection, genetics or an autoimmune syndrome. It usually affects middle-aged adults, presenting as inflammation and patchy balding, and can lead to scarring if left untreated.
Lupus Erythematosus
Better known as lupus, this genetically-linked skin disease causes inflammation of the skin, especially on the neck and face. As inflammation spreads across the scalp, if left untreated, scarring will result, causing permanent hair loss. Usually, UV rays from the sun can exacerbate the effects of lupus and accelerate hair loss. Also, red patches or bumps may appear prior to the scarring.
Recurring Fungal or Bacterial Infections
Any scalp infection that is left untreated long enough can permanently damage hair stem cells and sebaceous (oil) glands at the second layer of the skin, resulting in scarring alopecia. Common forms of infection include ringworm, which can usually be treated easily without permanent scarring, and yeast-like fungal infections that spread at random. Most fungal and bacterial infections start off as small as a pimple before becoming inflamed and spreading.
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