There are many types of scarring alopecia, including Lichen Planopilaris (LPP), Frontal Fibrosing Alopecia (FFA), Central Centrifugal Cicatricial Alopecia (CCCA), and Folliculitis Decalvans. These conditions can progress silently or rapidly, and early intervention is critical to prevent permanent loss.
Autoimmune activity– The immune system attacks healthy follicles
Chronic inflammation – From infections, trauma, or systemic conditions
Hormonal shifts – Especially in postmenopausal women (e.g., FFA)
Chronic stress or trauma – High cortisol can modulate immune responses
Genetics – Some types (like CCCA) may be more common in specific populations
Scalp infections – Deep bacterial or fungal infections can cause follicle damage
Delayed diagnosis or mismanagement – Increases risk of irreversible loss
Don't worry, we can help!
Patches of shiny, smooth scalp with no visible follicles
Redness, scaling, or pustules around the hairline or crown
Burning, itching, or pain in the affected area
Hair breakage that worsens over time
Sudden onset or slow progression depending on subtype
Early diagnosis is essential. A professional may perform:
Trichoscopic (scalp microscope) examination for signs of inflammation or follicle dropout
Scalp biopsy to confirm presence of scar tissue and identify type
Functional blood testing to assess autoimmune patterns, inflammation, nutrient status, and liver/gut health
Medical history review and symptom tracking
Referral to a dermatologist is often required to confirm the diagnosis and rule out similar conditions.
Anti-inflammatory diet rich in whole foods, antioxidants, and essential fats
Eliminate triggers (e.g., processed foods, environmental toxins)
Reduce stress load with sleep support, breathwork, and adrenal adaptogens
Topical anti-inflammatory agents: natural (turmeric, green tea extract) or prescribed (clobetasol, tacrolimus)
Microneedling to trigger follicle stimulation
Ozone therapy to reduce microbial load and oxygenate the scalp
Microneedling or PRP (only if active inflammation has subsided)
Functional nutrients: vitamin D, zinc, biotin, quercetin, omega-3s
Gut-healing protocol (if bioscans show leaky gut, dysbiosis, or candida)
Scalp detox with Iridium Green Shampoo and Cell Food Drops
That’s okay—your curiosity still matters! If you have a question about hair or scalp health but aren’t ready to move forward with a consultation, feel free to send it our way. We may feature it in an upcoming blog post or use it as a topic in a future live session—because chances are, someone else is wondering the same thing too.
We regularly share content on this topic through both video and written posts. Use the search bar to find answers to the specific questions you're looking for.
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Scarring alopecia, or Alopecia Cicatricial, is a permanent form of hair loss caused by inflammation that destroys hair follicles and replaces them with scar tissue. In this post, we explore the causes... ...more
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"I was misdiagnosed for two years and lost so much hair before finding out it was Lichen Planopilaris. Working with a team that focused on gut health, inflammation, and gentle scalp support made all the difference."
– Client, Age 52
Real Stories. Real Experiences.
Alopecia Areata can be unpredictable, but you don’t have to face it alone. This community was built to support and uplift — real people with real experiences, just like yours. We’re here to listen, share, and grow together.
We’ve gathered the most insightful, supportive, and educational videos on Cicatricial Alopecia so you don’t have to search alone. Learn the science. Hear real experiences. Feel less alone.
This playlist was designed to help you feel empowered and informed every step of the way.
Scarring Alopecia refers to a group of rare disorders that permanently destroy hair follicles, replacing them with scar tissue. Unlike non-scarring forms of hair loss, once a follicle is damaged by inflammation and replaced with fibrosis, hair cannot grow back. Early diagnosis is crucial, which is why we at The Hair Wire encourage people to pay attention to subtle symptoms—not just visible loss.
The exact cause can vary depending on the subtype (like Lichen Planopilaris, Frontal Fibrosing Alopecia, or Central Centrifugal Cicatricial Alopecia). It often involves inflammation, autoimmune responses, and environmental triggers. Research in epigenetics suggests a link between immune activity, hormonal shifts, and external stressors, which may explain why onset often coincides with lifestyle disruptions.
Most types of hair loss (like Telogen Effluvium or Alopecia Areata) are non-scarring, meaning the follicle remains intact and capable of regrowth. In scarring alopecia, the follicle is permanently destroyed, often starting with subtle symptoms like burning, tenderness, flaking, or redness—well before actual hair loss is visible. That’s why early awareness and intervention matter.
Once scarring occurs, it’s permanent. However, with early diagnosis and a tailored treatment plan, progression can be slowed or even halted. At The Hair Wire, we emphasize early detection, lifestyle mapping, and collaboration with dermatologists and trichologists to manage the condition proactively and preserve as much healthy follicular tissue as possible.
- Burning, itching, or tenderness of the scalp
- Redness or inflammation around the follicle
- Pustules or scaling
- Shiny, smooth areas where hair once grew
These signs are often overlooked or misdiagnosed as dermatitis or dandruff. At The Hair Wire, we teach professionals to read the signs early—to prevent permanent damage through informed care.
There’s no universal cure, but treatment focuses on controlling inflammation and halting further follicle destruction. Options may include:
Topical and oral corticosteroids
- Anti-inflammatory antibiotics
- ImmunomodulatorsLow-level light therapy (in some cases)
Lifestyle factors like reducing stress, managing inflammation through diet, and gentle scalp care also play a supporting role.
While not a direct cause, stress, diet, hormonal imbalances, and inflammation can exacerbate autoimmune activity and disrupt immune regulation. Through an epigenetic lens, we see that what you eat, how you rest, and how you manage emotional stress can all influence the body’s immune landscape. That’s why we advocate for integrative care on The Hair Wire—treating the person, not just the symptom.
There can be a genetic predisposition, especially in forms like Central Centrifugal Cicatricial Alopecia (CCCA), which predominantly affects Black women. However, lifestyle, hormonal health, and environmental triggers play significant roles in whether these genes “switch on.” This is why education and early intervention matter—even for those with family history but no symptoms yet.
Diagnosis typically requires:
- Trichoscopic (scalp microscope) examination
- Detailed health and lifestyle intake
- Scalp biopsy to confirm inflammation and scarring
Our approach at The Hair Wire includes empowering both professionals and clients to ask the right questions, understand the language of the scalp, and seek biopsy referrals when red flags appear.
- Don’t wait. Book an assessment with a trichologist or dermatologist familiar with hair loss.
- Track your symptoms, including pain, redness, and shedding patterns.
- Avoid aggressive styling or chemical treatments.
- Request a biopsy if inflammation is present.
And most importantly—get informed. You’re not alone, and there is a path forward. Education is the first step to reclaiming agency, and The Hair Wire is here to walk with you—through clinical clarity and compassionate care.
Our mission is to raise the standard — reigniting the heart of this industry with integrity, purpose, and connection. We’re also committed to bridging the gap between cosmetology, dermatology, and general practice, creating a more collaborative and informed approach to hair and scalp health.
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