New Research into Treatment for Scarring Alopecia

Although there are many different types of alopecia, there are only effective treatments available for some of them.

Scarring alopecia is one of those that currently has no viable treatment options, however, a new study has found hope in something called tacrolimus lotion.

What is Scarring alopecia?

Also known as Cicatricial alopecia, Scarring alopecia is a catch-all term for a number of conditions caused by an inflammation of the scalp. This inflammation destroys the hair follicles leading the scalp to scar over causing hair loss as hair cannot grow once scar tissue has formed.

These types of cicatricial alopecias are divided into two categories; primary cicatricial alopecias attack the hair follicle directly and include lichen planopilaris, frontal fibrosing alopecia and pseudopelade. Secondary cicatricial alopecia occurs when the hair follicle is not the main target but is still damaged, usually as a side effect of an illness or burns.

These hair loss conditions are fairly rare but can affect anyone of any age, gender or race, including children.

Trials with Lupus patients

Researchers from the New York University School of Medicine's Dermatology Department recently released the findings of their study into treating Scarring alopecia.

The trial involved three patients with Discoid lupus erythematosus (DLE). This is a chronic variant of cutaneous lupus erythematosus which is an autoimmune inflammatory skin disorder that can result in Scarring alopecia.

Scalp lesions brought on by this disorder can result in permanent scarring which, in turn, causes permanent hairloss. As some, but not all, cases of DLE responds to topical or intralesional treatment with corticosteroids and/or oral antimalarials, the team wanted to expand upon this knowledge to see if they could find a way to treat this kind of alopecia.

Developing effective treatments

For the purpose of this study, three patients with 'treatment-refractory, biopsy-proved DLE' were treated with tacrolimus lotion, 0.3%, in an alcohol base which was used in addition to their oral antimalarial therapy.

Findings show that, after three months of continuous use, an improvement in the severity of their lesions and hair regrowth were noticeable in all three test subjects. Further improvement was also reported after this initial period following a retrospective analysis of the patients.

According to the research authors, they believe this to be  'the first mention of tacrolimus being used in a lotion formulation to treat DLE lesions, resulting in hair regrowth'. As such, this is an extremely significant development, showing that topical tacrolimus lotion, 0.3%, in an alcohol base may have potential as a therapeutic option for patients with DLE who are at risk of permanent, scarring alopecia.

"This is great since there is no medication to help slow down or even better prevent more patches with this type of alopecia. Although, hair is unlikely to regrow on the damaged follicles, any regrowth on the surviving ones will help the cosmetic appearance overall. Minoxidil cannot be used on scarring hair loss and steroids are not a popular choice either hence, this is a lifeline to those with a scarring hair loss," says Leonora Doclis, senior trichologist at The Belgravia Centre, adding, "For now, it is possible to refer people with certain types of scarring hair loss for a hair transplant although not those whose hairloss is caused by autoimmune conditions, such as Lupus or Pseudopelade."

Further investigation is needed to see if this will provide promising results in those with scarring alopecia from other causal conditions but this is definitely an encouraging and positive discovery to build upon.