Do I Really Need Treatment for My Stable Scarring Alopecia ?

Do I need treatment for my scarring alopecia or not?

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

Question

I think my scarring alopecia is quiet. Do you recommend I have treatment or is this a waste of time and money?

Answer

Great question! Be sure to see a dermatologist so he or she can look carefully at things. Basically if you look 100% the same as 5 years ago with zero change in hair density, then no, you probably don't need any treatment. Again, review that with the doctor who has a chance to review your story in full and examine your scalp up close. But if you have the EXACT SAME number of hairs on your head as five years ago with the same fullness and volume and look, then it's an indication that treatment is not appropriate right now.

If you feel that perhaps you do have a bit less hair than 5 years ago, be sure to have a proper consultation. I can’t emphasize this enough. You’ll want to see what is causing the density reduction. For some, it’s a low grade scarring alopecia destroying hairs very slowly. For others, it’s genetic hair loss that is causing expected age related thinning or some other diagnosis.

A full exam can help determine if truly any surprises could lie ahead.

I would encourage you to dig out photos from the last 3 months, 6 months, 9 months, 12 months, 18 months, 24 months and 36 months and 48 months. Put them all out on the table (or computer screen) and study them. If you don’t have such good photos, start taking them now. Bring them to your doctor as well. If the photos today look 100% the same as 5 years ago, this is stable. If you look at the photos and think “Oh, I think i look a bit different than last year or 2 years ago in this area or that area” —— get a proper consultation to figure out why.

Lots and lots of people think they are stable but they are not. Some people think they are not stable but they are. Photos, photos, photos are key. Not the opinion of the person or the doctor - but photos