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Scarring Alopecia - Why is it Challenging to Diagnose in Early Stages?

It's hard to imagine that there are over 100 reasons to lose hair.

Some types of hair loss appear very distinctive - and so it's quite easy to identify the cause. Most people recognize that a man who is balding at the top of the scalp has genetic hair loss. Similarly, most people know that a woman who loses hair a few months after delivery of a baby has a temporary hair shedding problem related to hormonal changes after pregnancy.

Are all hair loss conditions so straightforward to diagnose?

Some types of hair loss conditions are more challenging to diagnose than others. Certainly this is the case for a group of hair conditions known as scarring hair loss conditions or "scarring alopecias."  In the very earliest stages of scarring alopecia, patients can have a pattern of hair loss that looks just like genetic hair loss or age-related hair loss.  It's for this reason that patients are often surprised to learn their diagnosis.

"I thought I was losing hair for the same reason my father lost hair," many patients say.

What are scarring alopecias?

Scarring alopecias are a group of hair conditions that cause the body to form scars around the hair follicles. This causes the hairs to be permanently damaged and if the process continues - it also causes the hair follicles to be permanently lost.   In the early stages of the condition, individuals may have hair shedding, as well as scalp symptoms like itching, burning or pain.  It requires a physician who is knowledgable about these conditions to 'catch' the diagnosis and this stage.  If the condition continues untreated, areas of scarring and permament hair loss may develop. It's at this stage that scarring alopecia is more easily diagnosed.

The goal of diagnosis is to try to catch these conditions at the earliest possible stages.

A New Sunnybrook Video on Scarring Alopecia

Every week, Monica Matys of Sunnybrook Hospital produces a video blog and posts it on the Sunnybrook Medical Centre website. These blogs provide incredible insights into various health conditions and what patients experience.  In January 2012, Monica produced a segment specifically on scarring alopecia.  As with previous videos that Monica has produced, we've been getting a lot of positive feedback.   I've posted Monica's video below and provided a link to her blog on scarring alopecia.



Dr. Jeff Donovan is a Canadian and US board certified dermatologist specializing exclusively in hair loss. To schedule a consultation, please call the Vancouver office at 604.283.9299



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