A condition characterized by irreversible hair loss due to the destruction of hair follicles in skin areas following the healing of surface injuries and wounds.

Scarring alopecia may occur as a result inflammation or tissue destruction due to physical or chemical trauma, such as burns; radiation or chemotherapy; friction; or tension on the hair shaft, such as braiding or rolling the hair. Disease conditions that may lead to the condition include: destructive skin tumors; granulomas; scleroderma (see Analogous Code: 6399-6350 Scleroderma); systemic lupus erythematosus [see Diagnostic Code: 6350 Lupus erythematosus, systemic (disseminated)]; follicular lichen planus; and severe bacterial or viral infections, such as folliculitis (see Analogous Code: 7899-7806 Folliculitis) and herpes simplex.

Symptoms usually include localized or general thinning of the hair, progressing to hair loss. The condition is characterized by loss of hair with atrophy of the scalp and absence of hair follicles.

Physical examination, along with a thorough history, are usually sufficient to confirm the diagnosis. Diagnosis may also include measures to identify any underlying disorder. The physician may confirm alopecia with a pluck or hair pull test. In this test, a group of 8 to 10 hairs are pulled firmly, and if more than 4 hairs come out, the person most likely has alopecia. If the pluck or pull test is positive, a microscopic analysis may be done to identify structural abnormalities or signs of infection. Wood's lamp examination may be used to identify fungal infection. If fungal infection is present, the infected area glows, producing a positive test. In this case, the scalp may then be scraped lightly, and the scrapings examined under a microscope.

Treatment of scarring alopecia may vary depending on the cause of the condition, and is directed at eliminating the cause.

Although alopecia has no physiologic complications, it may impair a person's self-image. Little growth can be expected following atrophy of the scalp and scarring.

None.

While service connection is not warranted for alopecia of androgenetic origin, VA recognizes hair loss due to scarring alopecia and alopecia areata under 38 CFR 4.118, DCs 7830 and 7831, as disabilities for which service connection is warranted if first manifest in service.