Lonely hairs and receding hairline (Photo)

The answer to your question is: No. They are not the only signs. There are many signs of scarring alooecia and different conditions have different signs. Scarring alopecia may even be associated with ONE or MORE OF THE FOLLOWING: visible hair loss, increased shedding, itching, burning, pain, tenderness, tingling, redness, pustules, change in hair texture, pigment change in the skin, isolated islands of hair or single hairs, hair breakage, pus discharge, bleeding, bumps, crusts, thinning of the skin, depressions in the skin, thickening of the skin, visible veins, and scalp odour (smell). There are a few other ones too but generally patients with scarring alopecia have AT LEAST ONE of these. Some other hair conditions also have these so they are not specific.  Many people who think they have “lonely” hairs don’t actually have lonely hairs. 

There are a series of ways of making the diagnosis of scarring alopecia. The first is to look for vellus hair is at the hairline and if they’re not present that means that there is a possibility of an autoimmune disease. Second is to see if dermatologist and get a biopsy for a definitive diagnosis