There are many different forms of hair loss. We broadly classify hair loss into the "scarring" forms and the "non-scarring" forms. Patients with scarring forms (also called scarring alopecia) may experience hair loss accompanied by symptoms such as itching, burning or even scalp tenderness/bruising. Some patients, however are completely asymptomatic.
The hallmark of all scarring alopecias is the loss of the follicular openings or "pores" when examined up close. Rather these areas are replaced by scar tissue - as shown here in this photo of a patient with a scarring alopecia known as lichen planopilaris (LPP).
This article was written by Dr. Jeff Donovan, a Canadian and US board certified dermatologist specializing exclusively in hair loss.
The Clevland clinic performed a new study that showed that hormone abnormalities can be common in lichen planopilaris (LPP) and frontal fibrosing alopecia (FFA).
A proportion of patients with LPP were found to have "androgen excess" (increased levels of the male hormones). However there was a portion of patients with FFA that were shown to have "androgen deficiency." This did not prove to be true of everyone - but was a trend seen in a large proportion.
This study is surprising, especially when considering that antiandrogens are helpful in FFA. It may however provide insight into differences between LPP and FFA. More studies are needed. For now, I agree with the authors conclusions that hormone levels are important to order in women with these scarring alopecias.
Reference Ranasinghe GC, et al.Prevalence of hormonal and endocrine dysfunction in patients with lichen planopilaris (LPP): A retrospective data analysis of 168 patients. J Am Acad Dermatol. 2017.
This article was written by Dr. Jeff Donovan, a Canadian and US board certified dermatologist specializing exclusively in hair loss.
Pohl Pinkus constructions or monikethrix-like constrictions are characterized by thinner areas of the hair shaft due to reduced matrix activity. This dermatoscopic finding is common is alopecia areata, and can also be seen in scarring alopecia (shown here), congenital hypotrichosis, and with some chemotherapies
This article was written by Dr. Jeff Donovan, a Canadian and US board certified dermatologist specializing exclusively in hair loss.
