Ask Dr. Wendel: Do I Suffer from Alopecia Areata or Scarring Alopecia?

Today’s “Ask Dr. Wendel” blog post will give an overview of the two most common diseases that can cause thinning and loss. Here are some of the major differences between Scarring Alopecia and Alopecia Areata:

During my 10+ years of experience in treating women with hair loss conditions, I have met with many patients who specifically ask me about the hair loss disease known as Alopecia. Today’s “Ask Dr. Wendel” blog post will give an overview of the two most common diseases that can cause thinning and loss. Here are some of the major differences between Scarring Alopecia and Alopecia Areata:

Scarring Alopecia, also known as Cicatricial Alopecia, is a rare hair disorder that leads to the destruction of hair follicles. It can progress very slowly with gradual hair loss and no symptoms at all or it can progress rapidly with tingling, burning, or itching at the scalp. It is caused by inflammation at the upper part of the hair follicles where the stem cells and oil gland are located. If this part of the hair follicle is destroyed, unfortunately, there is no possibility for regeneration of the follicle with treatments such as Platelet Rich Plasma (PRP) Therapy. The inflammation that I see on the scalps of women with Scarring Alopecia can actually be caused by aggressive hair care practices such as frequent chemical treatments like relaxers, perms, and hair dyes. Excessive heat or chronic tension on the hair follicle from braids, extensions, weaves, or curlers may also contribute to follicle inflammation. All women are at risk for hair loss but women with curly hair who regularly relax it straight, either at home or in the salon, are especially at risk for Scarring Alopecia. The process of relaxing the hair usually involves applying harsh chemicals, which make you at greater risk for burning your scalp if not done properly (e.g., without using a scalp protector/base or the right tools) or if done too frequently.

On the other hand, Alopecia Areata is much more common…it’s an autoimmune skin disease where the immune system mistakenly attacks hair follicles. Typically, women with Alopecia Areata lose their hair rapidly and in circular or oval patches and the onset often occurs in childhood. There are two different types of Alopecia Areata: Alopecia Totalis and Alopecia Universalis. Totalis is the loss of all of the head’s hair while Universalis is the loss of all hair on the scalp and body. The cause of Alopecia Areata is unknown but it is believed to be tied to a genetic disposition. The good news is that this condition is not always permanent! Hair follicles remain alive and are able to resume normal hair production either on their own or with the help of treatments like PRP.

Whether you or somebody you love has either types of Alopecia, there are options out there that are worth exploring. Learn more about the causes of hair loss in women or you are always welcome to contact us for a consultation with our experienced and empathetic all-female medical team.

Posted by Mary Wendel, M.D

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