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Scarring and non-scarring hair loss, in cross-section

Two scalp cross-sections. Where the alopecia is non-scarring the follicle survives and its opening at the surface stays visible, so regrowth remains possible; where it is scarring (cicatricial) fibrous tissue has replaced the follicle, the opening is gone, and that loss is permanent. Which of the two a scalp shows is settled by examination and trichoscopy, not from a diagram.

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Scarring and non-scarring hair loss, in cross-section. Two scalp cross-sections.
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Every number printed on this figure, and where it came from

Each quantity the diagram prints, the sentence it was taken from, and the guide that sentence is in. The build refuses to publish if one of these sentences is no longer in the guide it names.

ValueWhat it is, and the sentence behind itSource guide
87%Sensitivity of absent follicular openings for scarring alopecia
“Studies show 87% sensitivity and 93% specificity.”
Scarring Alopecia Types and Management: Complete Guide
93%Specificity of absent follicular openings for scarring alopecia
“Studies show 87% sensitivity and 93% specificity.”
Scarring Alopecia Types and Management: Complete Guide
3-7%Share of hair clinic presentations that are scarring alopecias
“These conditions represent 3-7% of all hair clinic presentations.”
Scarring Alopecia Types and Management: Complete Guide
What is behind the drawing (36 entries)

Shapes carry claims as much as printed numbers do, and some quantities shape the drawing without appearing in it. Each entry below names the sentence that justifies it.

Drawn asThe decision, and the sentence behind itSource guide
intact vs replacedThe distinction the whole figure draws
“Unlike non-scarring alopecias where follicles remain intact but dormant”
Scarring Alopecia Types and Management: Complete Guide
fibrous scar tissueWhat replaces the follicle on the scarring side of the drawing
“scarring alopecias replace follicles with fibrous scar tissue”
Scarring Alopecia Types and Management: Complete Guide
scar tissue replacesWhy the right-hand follicle is drawn as a field of collagen, not a shrunken tube
“Scar tissue (fibrosis) gradually replaces the destroyed follicle structures.”
Frontal Fibrosing Alopecia: Complete Guide to Symptoms, Causes & Treatment (2026)
remain aliveWhy the left-hand follicles are drawn whole even where no hair is emerging
“follicles remain alive even as they shrink, leaving the door open for regrowth”
Frontal Fibrosing Alopecia: Complete Guide to Symptoms, Causes & Treatment (2026)
dormant, not deadThe state of the middle follicle on the left: an open pore with nothing growing from it
“the follicles themselves aren't destroyed. They're dormant, not dead”
Alopecia Areata: Types, Treatment, and Outlook
openings retainedWhy the left-hand skin line is drawn broken by three follicular openings
“In non-scarring alopecia, even bald areas retain these openings”
Scarring Alopecia Types and Management: Complete Guide
no openingsWhy the right-hand skin line is drawn unbroken
“the skin no longer has the tiny openings (ostia) where hairs emerge”
Scarring Alopecia Types and Management: Complete Guide
featurelessHow the scarred surface reads to the eye
“Affected areas appear featureless without visible hair openings”
Frontal Fibrosing Alopecia: Complete Guide to Symptoms, Causes & Treatment (2026)
openings present or absentThe comparison the two panels are built to make
“Scarring alopecia shows smooth, shiny scalp without visible follicular openings. Non-scarring alopecia retains these openings even in bald areas.”
Scarring Alopecia Types and Management: Complete Guide
absent follicular openingsThe most reliable sign distinguishing the two on trichoscopy
“Absence of follicular openings (ostia)”
Scarring Alopecia Types and Management: Complete Guide
bulge regionWhat the marked node on the left-hand follicles is, and why it is marked
“housing stem cells that regenerate hair through multiple growth cycles”
Scarring Alopecia Types and Management: Complete Guide
stem cellsThe bulge as the site of the hair follicle stem cells
“the **bulge region**, which houses hair follicle stem cells”
Frontal Fibrosing Alopecia: Complete Guide to Symptoms, Causes & Treatment (2026)
destroyedWhy the same node on the right-hand follicles is struck through
“Once the bulge is destroyed and replaced by collagen scar tissue”
Scarring Alopecia Types and Management: Complete Guide
regrowth possibleThe consequence, as C03 states it for alopecia areata; the general form the plate prints is folliclesAlive, above
“Because follicles are preserved, regrowth is always possible”
Alopecia Areata: Types, Treatment, and Outlook
not possibleThe consequence stated on the scarring side
“Regrowth in scarred areas is not possible”
Scarring Alopecia Types and Management: Complete Guide
stopping progressionWhat treatment achieves on the scarring side
“Success means stopping progression”
Scarring Alopecia Types and Management: Complete Guide
narrowWhy the plate closes on the timing rather than on the treatment
“The window for intervention is narrow”
Scarring Alopecia Types and Management: Complete Guide
no regrowthThe same point as the scalp-inflammation guide states it
“once follicles are destroyed, regrowth isn't possible”
Scalp Inflammation: Signs, Causes, and Treatment Guide
NAHRSWhere the three groups on the scarring side come from
“the North American Hair Research Society established a classification system for primary cicatricial alopecias”
Scarring Alopecia Types and Management: Complete Guide
lymphocyticFirst group heading on the scarring side
“inflammation characterizes the most common scarring alopecias”
Scarring Alopecia Types and Management: Complete Guide
neutrophilicSecond group heading on the scarring side
“inflammation creates pustular, often painful conditions”
Scarring Alopecia Types and Management: Complete Guide
mixedThird group heading on the scarring side
“Both lymphocytes and neutrophils”
Scarring Alopecia Types and Management: Complete Guide
LPPLichen planopilaris, listed as lymphocytic
“**Lichen Planopilaris (LPP)**: Multifocal patches with perifollicular scaling”
Scarring Alopecia Types and Management: Complete Guide
FFAFrontal fibrosing alopecia, listed as lymphocytic
“**Frontal Fibrosing Alopecia (FFA)**: Band-like recession with eyebrow loss”
Scarring Alopecia Types and Management: Complete Guide
most commonThe note under the scarring list, and the reason C06 carries this plate
“most common form of scarring alopecia worldwide”
Frontal Fibrosing Alopecia: Complete Guide to Symptoms, Causes & Treatment (2026)
CCCACentral centrifugal cicatricial alopecia, listed as lymphocytic
“**Central Centrifugal Cicatricial Alopecia (CCCA)**: Vertex-starting, spreading outward”
Scarring Alopecia Types and Management: Complete Guide
DLEDiscoid lupus erythematosus, listed as lymphocytic
“**Discoid Lupus Erythematosus (DLE)**: Associated with systemic lupus”
Scarring Alopecia Types and Management: Complete Guide
folliculitis decalvansListed as neutrophilic
“**Folliculitis Decalvans**: Pustules with characteristic”
Scarring Alopecia Types and Management: Complete Guide
dissecting cellulitisListed as neutrophilic
“**Dissecting Cellulitis**: Painful nodules and interconnecting sinuses”
Scarring Alopecia Types and Management: Complete Guide
acne keloidalis nuchaeListed as mixed
“**Acne Keloidalis Nuchae**: Firm papules on posterior neck/scalp”
Scarring Alopecia Types and Management: Complete Guide
erosive pustular dermatosisListed as mixed
“**Erosive Pustular Dermatosis**: Rare, often post-surgical or post-radiation”
Scarring Alopecia Types and Management: Complete Guide
pattern hair lossPlaced outside the scarring group by C07
“You have pattern hair loss without scalp scarring”
Scarring Alopecia Types and Management: Complete Guide
alopecia areataPlaced outside the scarring group by C07
“You have patchy hair loss with regrowth potential”
Scarring Alopecia Types and Management: Complete Guide
telogen effluviumPlaced outside the scarring group by C07
“You have temporary hair loss from stress”
Scarring Alopecia Types and Management: Complete Guide
diffuse thinningPlaced outside the scarring group by C07
“You're experiencing general thinning without inflammation”
Scarring Alopecia Types and Management: Complete Guide
seborrheic dermatitis, psoriasis, contact dermatitisInflammatory scalp conditions the scalp-inflammation guide places on the non-scarring side
“Non-scarring inflammatory conditions (seborrheic dermatitis, psoriasis, contact dermatitis) don't typically cause permanent loss”
Scalp Inflammation: Signs, Causes, and Treatment Guide

Where this figure appears

Scarring Alopecia Types and Management: Complete Guide · Frontal Fibrosing Alopecia: Complete Guide to Symptoms, Causes & Treatment (2026)

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