White Dot Scarring

White Dot Scarring refers to small, pale, often pinpoint areas on the scalp where hair follicles have been replaced by scar tissue, producing a dotted pattern of permanent hair loss. These white dots correspond to absent follicular openings and indicate follicular destruction; causes include inflammatory scarring alopecias (for example, lichen planopilaris or discoid lupus), severe infections, burns, or chronic mechanical trauma.

Diagnosis is clinical and may be supported by dermoscopy (trichoscopy) and a scalp biopsy to determine the specific cause and whether inflammation is still active. Treatment focuses on controlling any ongoing inflammatory process to prevent further loss, while cosmetic or surgical restoration options may be considered only after the scarring process is inactive, since regrowth from scarred follicles is generally not possible.