Also called follicular mucinosis, alopecia mucinosa is an inflammatory health condition affecting the sebaceous glands and hair follicles, causing hair loss. The hair loss is generally at the scalp, face and neck, but hair on other body parts could be affected too. When examined under microscope, the hair follicles have mucin around them. Mucin is made of hyaluronic acid and has a whitish goo or stringy clear appearance to it.
When the mucinous material settles in the sebaceous glands and hair follicles, it causes inflammation that eventually disrupts the follicles’ ability to make hair.
Alopecia mucinosa could be of the following types:
- Primary acute disorder affecting kids and teenagers
Generally, this type entails a few lesions (reddish plaques or papules) on the neck, head and upper arm. The problem generally resolves within the two-month to two-year period. The condition is usually linked with pediatric cases.
- Primary chronic condition affecting people aged 40 years and above
Primary chronic condition entails a much wider lesion distribution, which could recur or persist indefinitely. There are no disorders associated with the condition.
- Secondary disorder, which is linked with malignant (cancerous) or benign (non-cancerous) skin disease
Secondary disorder generally affects people in the 40-70 years age group, who either have malignant disease or benign disease. The condition is synonymous with several widely spread lesions.
Alopecia mucinosa causes are not clear but immune-related problems are suspect. Injury to the hair follicles may also cause the condition.
Early alopecia mucinosa signs include raised follicular papules or spots, which appear as reddened patches or plaques. Consequentially, these affected follicles lose their hair-growing abilities. Hair grows once the patches clear up. However, in some cases, hair regrowth doesn’t take place even if the follicular inflammation or redness subsides or is cured.
The hair may grow back once the condition is treated. This is usually when the hair loss condition is in its early stage. Some extremely severe cases may not witness any hair regrowth even post complete cure. In other words, even if the inflammation goes down, the follicles are already destructed enough during the advanced stages, making normal hair growth unfeasible.
A few treatments that have exhibited moderate success include systemic, intralesional and topical corticosteroids; oral antibiotics like minocycline; systemic and topical chemotherapy; topical bexarotene and UVA1 phototherapy. Scalp micropigmentation can help camouflage alopecia mucinosa.