When inflammation of the hair follicles occurs due to infection it can lead to scarring alopecia. It is easy to identify a case of severe scarring alopecia because there will be rough patches on the surface of the scalp made up of small blood vessels and connective tissue. Scaring alopecia can have many causes some of these causes and different types of scarring alopecia are discussed below.

Scarring Alopecia caused by Discoid lupus erythematosus

Discoid Lupus Erythematosus is a diffuse connective tissue disease which can result in hair loss on the scalp. In Discoid Lupus Erythematosis lesions occur a round scaling papules 5 to 10 mm across with follicular plugging. There may or may not be scaling. Eventually the skin becomes smooth atrophic and scarred. Lupus is a photosensitive disease therefore exposure to sunlight should be minimised. Topical cortocosteroid ointments such as triamcinolone acetonide may be helpful in the treatment of small lesions. Also anti malarial drugs such as hydroxychloroquine are useful in the management of discoid lupus erythematosis.

Lichen Planus

Lichen planus is a rather uncommon skin disease that effects about 1 percent of the population. Lichen Planus is a inflammatory disease that strikes primarily the skin and mucous membranes. It usually starts as an itchy patch on the front of the wrists and forearms. the sides of the legs and ankles and lower back. In rare cases lichen planus can effect the scalp and other hairy areas this is called lichen planopilaris. It appears on the scalp as raised reddish-purple areas that look like lichen on a rock, or as an area of alopecia with follicle plugging which usually clears up. Steroid lotions are used to relieve itchiness, antimalarial drugs may reduce inflammation.

Pseudopelade of Brocq

Pseudopelade of brocq is a rare scarring alopecia which has no potential for regrowth. I usually affect middle aged people.

Aplasia cutis congenita

Aplasia cutis congenita is a rare disorder that often results as a small blistered atrophied area usually in the midline of the scalp and present from birth. In most cases the problem heals itself however in larger areas it may be associated with underlying developmental disorders.

Congenital atrichia

Congenital atrichia occurs when a baby is born without hair follicles in certain areas. This can be quite common and usually only occurs in a few spots which are easy to cover.