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Clinical dermatology
Scarring alopecia: diagnosis and care
Early, accurate diagnosis of scarring hair loss, and treatment to help protect remaining hair, with dermatologist Dr. Omkar Warang, DNB.
Why act earlyScarred follicles can't regrow
TestsTrichoscopy, often a biopsy
GoalStop further hair loss
Contagious?No
Understanding scarring alopecia
Scarring (cicatricial) alopecias are a group of conditions in which inflammation damages hair follicles and replaces them with scar tissue. Once a follicle is scarred, it cannot regrow hair. They include lichen planopilaris, frontal fibrosing alopecia, discoid lupus and folliculitis decalvans, among others.
Signs can include itching, burning or tenderness of the scalp, redness or scaling around hairs, and smooth, shiny patches where hair has been lost. Because early signs can resemble more common conditions, these alopecias are sometimes recognised late.
How scarring alopecia is diagnosed and treated
Diagnosis: a detailed history and scalp examination, trichoscopy (dermoscopy of the scalp) to look at follicles in detail, and often a small scalp biopsy to confirm the type. Blood tests may be advised.
Treatment: the aim is to calm the inflammation and stop further loss. Depending on the type, this can include topical treatments, injections into the affected areas and oral medicines, with regular reviews to check that the condition is under control.
For selected patients whose condition has been inactive for a long period, hair restoration may be discussed later.
When to see a dermatologist
Seek an early assessment if you notice…
- patches of hair loss with itching, burning or pain
- redness or scale around hair follicles
- a receding hairline with eyebrow thinning
- hair loss that continues despite treatment
Why timing matters
- scarred follicles cannot recover
- earlier treatment may help preserve more hair
- the right diagnosis avoids ineffective treatment
What to expect
1
Before
Bring previous prescriptions, reports and any photos showing how the hair loss has changed.
2
On the day
A scalp examination with trichoscopy. If a biopsy is needed, it is a quick procedure under local anaesthesia.
3
Afterwards
Biopsy results guide the diagnosis and treatment plan, which is explained at a follow-up visit.
4
Results
The goal is to stop the condition progressing. Activity is monitored over months, sometimes with comparison photographs.
Care by Dr. Omkar Warang, DNB
Dr. Warang combines clinical dermatology and trichology. He served as Director of Trichology at Hair and Shape Clinic from 2023 to 2026, and uses dermoscopy in diagnosis. Scarring alopecia is among the complex conditions he treats, including long-standing cases that need a careful, fresh assessment.
Will my hair grow back?
Hair cannot regrow from follicles that are already scarred. Treatment aims to protect the follicles that remain. Hair in areas that are inflamed but not yet scarred may sometimes recover.
Do I need a biopsy?
Often, yes. A small biopsy is the most reliable way to confirm the type of scarring alopecia, which guides treatment.
Is scarring alopecia contagious?
No.
Can I have a hair transplant?
Sometimes, but only after the condition has been inactive for a long time and after careful assessment, because active inflammation can affect transplanted hair.
How long is treatment needed?
Usually months to years, with regular reviews. Treatment is reduced gradually once the condition is under control.
Related treatments
Have your hair loss assessed
If your hair loss comes with itching, burning or tenderness, an early assessment matters.
Visit Warang Wellness
- Monday–Saturday · 9:00 AM – 6:00 PM
- 4th Floor, Parth Business Plaza, near Valnai Mithchowki Metro Station, Malad (West), Mumbai - 400064
- 90032 89132
- warangomkar@gmail.com
This page provides general information and is not a substitute for a medical consultation. Suitability, risks and results vary between individuals and are discussed during your consultation with Dr. Omkar Warang.