Management of Primary Cicatricial Alopecias: Options for Treatment

M.J. Harries; R.D. Sinclair; S. MacDonald-Hull; D.A. Whiting; C.E.M. Griffiths; R. Paus

Disclosures

The British Journal of Dermatology. 2008;159(1):1-22. 

In This Article

Adjunctive Treatments

If patients have associated androgenetic alopecia, a trial of minoxidil solution (1mL twice daily) may improve the cosmetic appearance by thickening and lengthening miniaturized hairs.[2] Hair cosmetics, such as wigs or camouflage make-up, may benefit some patients, especially those with extensive disease.

Various surgical procedures have been employed to treat cicatricial alopecia, including hair transplantation,[18] scalp reduction, tissue expansion and flap surgery.[381] A recent series of nine patients found improved follicular unit transplant success when the scarred area was pretreated with carbon dioxide laser. It was felt that laser pretreatment resulted in scar tissue remodelling that produced a recipient site more receptive to follicular unit grafts.[382] Podda et al.[383] generated recipient holes for hair transplant using an Er:YAG laser. All five patients treated achieved good cosmetic results after two to five transplant sessions.[383] Surgical treatment is only an option if the disease process has fully burned out. Some recommend a 2-year disease-free period before surgery is performed, to minimize the risk of disease recrudescence.[2]

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