The Two Types of Inactive Scarring Alopecia: Is my Scarring Alopecia really Burnt Out?

Burnt out Inactive Scarring Alopecia vs Treatment Induced Inactive Scarring Alopecia vs

Scarring alopecias are hair loss conditions with the potential to cause permanent hair loss.
The first step in treating scarring alopecia is to convert it from an “active” form to an “inactive” form.
There are two types of “inactive” scarring alopecia and some confusion exists between the two forms.

Type 1: Treatment Induced Inactive Scarring Alopecia

The first type of inactive scarring alopecia is what I call treatment induced inactive scarring alopecia whereby the scarring alopecia becomes quiet due to the proper treatment being used. The disease is quiet because the treatment made it quiet. In this situation any reduction, stopping or tapering of the treatment leads to a resumption of disease activity again.

Type 2 : Burnt Out Inactive Scarring Alopecia

The second type of inactive scarring alopecia is what is called “burnt out” inactive scarring alopecia. This type of scarring alopecia is generally only reached after prolonged period of treatment. (Sometimes the disease itself may become quiet and burnt out due to its natural course). In the case of burnt out inactive scarring alopecia, treatments can be tapered, reduced and eventually stopped without any resumption of disease activity.

Do I have Burnt Out or Treatment Induced Inactive Scarring Alopecia?

A knowledgable hair specialist can guide whether a scarring alopecia is burnt out or simply inactive from treatment. Generally speaking, if a patient with scarring alopecia has exactly the same number of hairs on their head, eyebrows, eyelashes and body as they did 2 years ago, there is a good chance they have one of the forms of inactive scarring alopecia. If it’s the treatment that is keeping it so quiet then it’s probably treatment induced inactive scarring alopecia rather than burnt out disease. If the patient or his/her practitioner thinks all hair loss medications can be stopped and there is zero chance of any hair loss occurring over the next two years, then we may be dealing with burnt out scarring alopecia.

FURTHER READING:

[1] “Burnt out Inactive Scarring

[2] “Burnt Out vs Stable/inactive LPP: Not Quite the Same”