Cicatricial alopecia is a group of conditions affecting the scalp and ultimately leading to permanent hair loss. Damage to hair follicles (HF) can be primary, when they are a specific target of inflammation while non-follicular structures are practically not affected, or secondary, when HF are damaged together with other skin structures after injuries, fungal, bacterial, viral infections, based on granulomatous and neoplastic processes, as well as autoimmune diseases. Early diagnosis and the earliest possible prescription of effective treatment allows preventing the expansion of the area of foci of cicatricial alopecia, and in some cases, resuming hair growth. Clinical diagnosis with the naked eye is often difficult due to the similarity of clinical manifestations of diseases leading to scarring hair loss. An essential role in establishing the diagnosis is played by dermatoscopic examination, so it is possible to identify dermatoscopic patterns characteristic of diseases leading to the development of cicatricial alopecia, as well as clinical and morphological correlation. The article discusses the issues of differential diagnosis of the most common pathologies from the group of primary cicatricial alopecia, such as decalvating folliculitis, discoid lupus erythematosus, follicular lichen planus, based on scientific literature and own clinical observations.