While the exact role of inflammation in alopecia is still debated, research points to its presence in many cases.

 

Inflammatory Markers:

 

T-cells: Activated T-cells, a type of immune cell, have been found in the lower areas of hair follicles in scalp biopsies from those with alopecia.

 

Perifollicular Infiltration: About 40% of people with alopecia show moderate infiltration of immune cells around hair follicles, as opposed to only 10% in those without the condition.

Cell Types: In addition to the commonly found lympho-histiocytic cells, eosinophils and mast cells have been occasionally observed.

 

Location of Inflammation: While inflammation typically centres around the upper part of hair follicles, it can sometimes be seen around the lower follicles and even involve the follicular structures.

 

Comparison: There's a noted difference in the degree of inflammation between scalps that are balding and those that aren't.

 

Scarring and Hair Loss: The irreversible nature of male androgenic alopecia (MAA) hair loss, combined with the observation of fibrous tracts in tissue studies, has led some researchers to speculate that a slow scarring process might be at play. Interestingly, there are histological similarities between MAA and lichen planopilaris, a known scarring hair loss condition.

 

In summary, inflammation appears to be a feature in MAA, but its exact role in the progression and onset of the condition is still a topic of research. The possibility of scarring processes further complicates our understanding of this common form of hair loss.