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Primary cicatricial or scarring alopecia is a type of alopecia characterized by a destruction of hair follicles, and permanent hair loss. Why this happens isn’t entirely understood, but like alopecia areata, the cause is thought to involve the auto-immune system.

Distinguishing primary scarring alopecia from other types of alopecia, such as alopecia areata, can initially be difficult. Because primary cicatricial alopecia causes hair follicles to fill up with skin cells, areas of the skin on your scalp can be especially smooth and shiny. Further confusion can arise as there are often a few hairs interspersed throughout the affected area. And unlike alopecia areata, scarring alopecia often causes visible scalp inflammation and in certain cases, tufting of the hair, severe scaling and pustules. Treatment of small areas of cicatricial alopecia can be quite effective.

However, these conditions are notoriously difficult to control. If the problem is persistent, certain oral medications may help bring about remission. If you have secondary scarring alopecia caused by an accident or radiotherapy, methods of hair restoration can also help. These involve either hair transplants or surgery on the affected areas.

However, treatment of larger areas is more difficult and often requires the use of tissue expansion of the unaffected scalp, similar to the method used in breast reconstruction.

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