Is scarring visible with the naked eye in patients with scarring alopecia?

Scarring is Visible only in Later Stages: Early Scarring is Beneath the Scalp

I’ve selected this question below for this week’s question of the week. It allows us to review some concepts regarding scarring alopecia.

Question

I was diagnosed with scarring alopecia, specifically a condition called lichen planopilaris. I have had some people look too - but it doesn’t seem that there is any real scarring that is present. Is this something that should be seen with the naked eye?

Answer

Thanks for the great question. In the early stages of scarring alopecia, the scarring is under the scalp. It can’t be seen on the surface, no. That’s when we want to be aggressively treating it to stop progression to a stage where the scarring actually becomes visible on the surface of the scalp too.