Why Does Scarring Alopecia Come Back?

Why Does Scarring Alopecia Come Back?

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Scarring alopecia is a condition in which the hair loss is accompanied by both inflammation and scarring. The treatment methodology followed for it includes medication to decrease the inflammation. In general, steroid injections, topical steroids,  and systemic immunosuppressive medications are used. Antibiotics may be used in special cases. Most of the time, the patient will react favorably to the treatment. It will lead to the halting of symptoms if they are present. But in some cases, the patient might experience a flare-up. This happens when the inactive alopecia becomes active again. Hair transplant is a suitable method to treat alopecia. It is one of the best hair loss treatments in the medical world.

Causes of flare-up 


An injury on the scalp might cause a flare-up in cases where the disease had been present in a quiet manner. If the patient has faced an injury which involves a direct blow on the head, sunburn or surgery, it might lead to scarring alopecia. Due to this reason, hair transplant surgery is not a safe option until the disease has completely disappeared.


Some medications might lead to the flare-up of scarring alopecia. People who use hydroxychloroquine, steroids injections, methotrexate, steroid shampoos, minoxidil, or retinoids find that their hair loss has become worse. It is important to find the specific drug which is responsible and exclude it from your routine.

Wrong Medication /Dose

Many patients change dose or medicine due to the unavailability of the original one. This might cause a flare-up, especially if the drugs are compounded.

Some Other Conditions

A medical issue or condition can cause a flare-up or worsen the condition. A patient might seek medication for a particular condition like iron deficiency or hyperthyroidism. The medication for the same may lead to the worsening of alopecia.

Rejection of Prescribed Medications 

As some patients might stop taking the medication before the minimum required period, they may have to face the consequences in the form of alopecia. Adherence to the doctor’s advice is recommended in such cases.


Stress might trigger alopecia in many cases. Many scarring alopecia forms like pseudopelade, lichen planopilaris, folliculitis decalvans, frontal fibrosing alopecia can become aggravated and itchy during stressful times. The stress related to work, relationships, or finances needs to be kept under control.

No Clear Reason

Sometimes ,the flare-up maybe without any identifiable reason. The flare-up might be triggered due to unknown reasons.

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