National Scarring Alopecia Awareness Month (Day 27, Myth 12): Do Blood Test Results Help Point to the Cause of Scarring Alopecia ?

Blood Tests Do Not Point to Root Cause Of Scarring Alopecia

Blood tests do not reveal the precise root cause of a scarring alopecia. Nor do scalp biopsies or do the fanciest or most sophisticated trichoscope cameras. None of these give sufficient insight into the cause of scarring alopecia. We don’t know the cause of most primary scarring alopecias.

Blood tests, biopsies and trichoscopy is important to help us reach certain conclusions as to the diagnosis or to identify associated conditions. However, they do no help us with the question “What caused this all in the first place?”

I would like to point out that blood tests may not necessarily be normal in all patients with scarring alopecias. In fact, blood tests do occasionally turn up with abnormal results. For the most part, however, these abnormal tests results refect something associated with the disease process, not any direct clue to what actually causes the disease.

For example, patients with central centrifugal cicatricial alopecia (CCCA) have a higher chance of being diagnosed with diabetes, so testing blood sugars makes sense in most patients with CCCA. Patients with lichen planopilaris and frontal fibrosing alopecia have a higher chance of various hormone related issues so testing androgen hormones, estrogen hormones, and thyroid hormones makes sense for many patients. In scalp discoid lupus, one must obtain blood tests in order to screen for systemic lupus erythematosus so various auto antibodies including the antinuclear antibody (ANA) are appropriate to order.

It’s common to feel that blood tests help uncover the root cause of a scarring alopecia. They don’t. However, blood tests are still essential to order for most patients with scarring alopecia in order to uncover various conditions that are now understood to be linked.