This female African American patient had lymphocytic scarring alopecia (CCCA) diagnosed by biopsy. We treated her with a combination of oral doxycycline, topical clobetasol, topical minoxidil, and intralesional steroids (triamcinolone). Her hair regrowth was steady and the patient is very happy.

(L-R) Before, 6 months into treatment and 12 months into treatment

Cicatricial alopecia refers to a diverse group of rare disorders that destroy the hair follicle, replace it with scar tissue, and cause permanent hair loss. The clinical course is highly variable and unpredictable. Hair loss may be slowly progressive over many years, without symptoms, and unnoticed for long periods. Or the hair loss may be rapidly destructive within months and associated with severe itching, pain and burning. The inflammation that destroys the follicle is below the skin surface and there is usually no “scar” seen on the scalp. Affected areas of the scalp may show little signs of inflammation, or have redness, scaling, increased or decreased pigmentation, pustules, or draining sinuses. Cicatricial alopecia occurs in otherwise healthy men and women of all ages, is not contagious, not hereditary and is seen worldwide.