Scarring Alopecia vs Nonscarring Alopecia

A group of disorders in which follicles are destroyed and replaced by scar tissue. Hair loss in which follicles remain present and regrowth may be possible.

Research updated 2026-10-23

Key differences What is it?What it looks like Diagrams When it starts Triggers Daily Care Treatment Outlook Complications When to get help Questions

Key differences

The same eight facts on every condition comparison.

Usual age

Adults

Any age

Where

Scalp

Scalp, sometimes brows

Main sign

Smooth shiny bald patches

Hair loss with follicles intact

Itch or pain

Can itch or burn

Usually neither

Contagious

Long term

Permanent hair loss

Often regrows

Scars

Yes

Who gets it

Depends on the type

Anyone; depends on the cause

What is it?

Scarring Alopecia

Nonscarring Alopecia

What is it?

What it is
A group of disorders in which follicles are destroyed and replaced by scar tissue.

What it is
Hair loss in which follicles remain present and regrowth may be possible.

What it looks like

Scarring Alopecia

An irregular smooth scarred scalp patch without visible follicular openings in its center.

Smooth scarred scalp The central patch looks smooth and shiny, with loss of visible hair-follicle openings.

Nonscarring Alopecia

The back of a head with a broad thinning area centered on the crown.

Nonscarring Alopecia The scalp is visible between remaining hairs at the top of the head.

Skin tones

Reduced hair density with intact scalp between remaining hairs.

In the skin

Inflammation, infection or injury destroys hair follicles and replaces them with scar tissue. Hair cannot regrow from follicles that have been permanently lost.

Growth-cycle changes, follicle miniaturization, immune activity or other processes reduce visible hair. The follicles are not replaced by scar tissue, although the chance of regrowth depends on the cause.

When it usually starts

010203040506070+

Scarring Alopecia. Depends on the underlying disorder; it is not one single diagnosis.

Nonscarring Alopecia. Depends on the cause; possible at any age.

Causes and triggers

Causes

Inflammation, infection or injury permanently damages follicles.

Growth-cycle changes, miniaturisation, immune activity or other causes affect hair without destroying all follicles.

Risk factors

Inflammatory scalp disease, Trauma, Severe follicular infection

Family tendency, Illness, Nutritional or hormonal factors

Trigger

● Scarring Alopecia

● Nonscarring Alopecia

No established short-term flare trigger

Not a typical trigger

Daily Care

Scarring Alopecia

Nonscarring Alopecia

Daily care

Habits that help

Handle hair gently when washing and detangling
Avoid vigorous brushing, pulling or scalp massage on fragile areas.
Choose loose hairstyles and limit repeated heat or chemicals
Minimize additional shaft damage and traction.
Eat a balanced diet with adequate protein
Investigate suspected deficiencies with a clinician rather than using supplements indiscriminately.
Take occasional photographs under consistent lighting
Track a pattern over months rather than counting shed hairs every day.
Seek assessment for continuing loss or scalp symptoms
Pain, redness, scale or patchy progression may need specific treatment.
Arrange prompt specialist review for active scalp inflammation
Destroyed follicles cannot regrow; gentle hair care cannot stop an untreated scarring process.
Discuss prompt dermatology assessment
Examination and sometimes biopsy identify the cause while remaining follicles can still be protected.

Avoid

Avoid: Tight styles, crash dieting and unproven hair-growth remedies
These may add damage or distract from the underlying diagnosis.

Habits that help

Handle hair gently when washing and detangling
Avoid vigorous brushing, pulling or scalp massage on fragile areas.
Choose loose hairstyles and limit repeated heat or chemicals
Minimize additional shaft damage and traction.
Eat a balanced diet with adequate protein
Investigate suspected deficiencies with a clinician rather than using supplements indiscriminately.
Take occasional photographs under consistent lighting
Track a pattern over months rather than counting shed hairs every day.
Seek assessment for continuing loss or scalp symptoms
Pain, redness, scale or patchy progression may need specific treatment.
Discuss cause-specific hair-loss assessment
Treatment differs for shedding, pattern hair loss, alopecia areata and infection; first identify the cause.

Avoid

Avoid: Tight styles, crash dieting and unproven hair-growth remedies
These may add damage or distract from the underlying diagnosis.

Treatment differences

Evidence labels come from each condition’s own treatment list.

Treatment

● Scarring Alopecia

● Nonscarring Alopecia

Treatment approach

—

Treatment depends on the diagnosis, such as shedding, pattern hair loss, alopecia areata or infection. Confirm the cause before choosing medicines or supplements.

Prescription topicals

Diagnosis-specific anti-inflammatory treatment

Listed

Topical, injected or systemic treatment depends on the scarring disorder; one generic hair-growth medicine is insufficient.

None listed

Outlook

Long term

Hair cannot usually regrow from follicles that have been replaced by scar tissue. Treatment aims to stop or slow further loss, so early diagnosis and monitoring matter.

Regrowth may be possible because follicles remain present, but the outlook depends on the diagnosis. Some causes recover, while others need continuing treatment to preserve density.