A Simple Guide to Alopecia(Hair Loss)

A Simple Guide to Alopecia(Hair Loss)
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What is Alopecia(Hair Loss)?
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Alopecia or Hair Loss is the partial or complete loss of hair in the scalp, armpit or other areas of the body to the extent that skin is evident and sparse amount of hair is present or completely absent. Hair loss usually develops gradually and may be patchy or diffuse (all over)

Who get Alopecia?
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Hair loss is experienced by both men and women, young or old.

The most common type of hair loss is called

1.male pattern baldness or androgenetic alopecia.

Its causes have been linked to genes, hormones and age.

Other types of hair loss are:

2. an auto-immune condition known as patchy hair loss (alopecia areata),

3.temporary hair loss (telogen effluvium),

4.compulsive hair pulling (trichotillomania) and

5.traction alopecia.

What is the cause of Alopecia?
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The hair is made up of keratin, the same protein that is found in nails and the outer layer of our skin. The average adult has more than 100,000 strands of hair on his scalp.

It is normal to lose about 50 to 100 strands every day.

Old strands of hair are shed so that new ones can grow out of the hair follicles.

However, various factors can lead to sudden or excessive shedding such as:
1.genes(Male pattern baldness, Congenital),

Genetic baldness is caused by the body's failure to produce new hairs and not by excessive hair loss.

Some women also develop a particular pattern of hair loss due to genetics, age, and male hormones that tend to increase in women after menopause.

The pattern is different from that of men. Female pattern baldness involves a thinning throughout the scalp while the frontal hairline generally remains intact.

Congenital Alopecia occurs in a new born who does not develop any more hairs.

2.hormones(excessive DHT or dihydrotestosterone)

Androgens appear to play a role in male pattern baldness. These very same hormones trigger the growth of hair in the pubic, underarm and facial areas at puberty. People with male pattern baldness may have the same male hormone levels as normal people, but these hormones seem to accumulate in certain areas of their scalp and cause the hair follicles there to regress.
Women are protected from male pattern baldness because they produce less androgens, and because their female hormones, estrogen can counter the effect of their male hormones. However, women who produce excess androgens may have male pattern baldness.

Other hormones, such as those from your thyroid glands, can also affect your hair.

Too much or too little hormones from your thyroid gland can cause hair loss.

3.stress,

Sudden emotional stress can also trigger patchy baldness (alopecia areata) or temporary hair loss (telogen effluvium). Temporary hair loss may also be triggered by the stress of giving birth or losing a loved one.

4. Medical conditions

Some medicines, such as blood thinners (anti-coagulants), birth control pills, anti-depressants, anti-thyroid drugs or drugs used in chemotherapy, may cause hair loss.

5.Improper hair care

Having a hairstyle that exerts too much pull(traction) on the scalp can cause your hair to turn brittle and break. Hair breakage can also be caused by over-shampooing and the excessive use of chemical treatments such as dyes, tints, bleaches, and permanent waves.

6.Burns - Excessive heat damages the cells of the skin including the hair roots.

7.Infectious diseases such as syphilis and fungal infection can cause damage to the hair roots.

What are the Signs and Symptoms of Alopecia?
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Male pattern baldness (or androgenetic alopecia) accounts for the majority of all hair losses. This is the most common type of baldness in men, especially older men.

It can also occur in some women, though the instances are rare.

Hair loss is usually gradual.

The hair loss pattern differs between the sexes.

In men, the hair loss usually starts with a receding hairline.

In women, there is a diffuse thinning of the crown.

Male pattern baldness in women is usually not as severe.

Besides male pattern baldness, there are various other types of hair loss.

Patchy baldness (alopecia areata): Here a few bald patches suddenly appear.

Emotional stress(eg examinations) appears to be a triggering factor.

This condition can progress to more serious forms in which all the scalp and body hair may be lost (alopecia totalis).

Temporary hair loss (telogen effluvium): Here clumps of hair begin to fall out suddenly over a few days. It can be caused by severe stress, childbirth, severe illnesses, surgery and some medications. As its name implies, its effect is usually temporary.

Recovery though may take a year or longer depending on the cause.

Compulsive hair pulling (trichotillomania): This causes hair breakage and usually leaves the scalp undamaged. It usually affects children and women and has been linked to a psychological cause.

Traction alopecia: This is hair loss caused by certain hairstyles such as ponytails, buns or braids that pull excessively on the hair.

What tests can be done in Alopecia?
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1.Microscopic examination of a plucked hair

2.Skin biopsy (if skin changes are present)

Ringworm on the scalp may require the use of an oral drug, such as griseofulvin, because creams and lotions applied to the affected area may not get into the hair follicles to kill the fungus.

What is the Treatment and Prevention of Alopecia?
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It is important to determine the underlying cause before treatment.

Most of the conditions are temporary and can be resolved once the underlying cause such as stress is removed.

However, male pattern baldness may have a permanent effect.

There has been some medical progress in helping these people regain their hair.

Two medications Finasteride and Minoxidil work by stimulating the regrowth of hair in hair follicles.

1.Finasteride counteracts the effects of the male hormone testosterone. It is available only by prescription and is taken orally. It is approved for use only in men and is not recommended in women because of its link to birth defects. Finasteride takes a few months to show its effect.
2.Minoxidil is available over the counter. . It is applied on the scalp and works by reversing the regression of hair follicles caused by hormones.It takes a few months before any effect can be seen.

Alopecia areata is sometimes treated by steroid injections into the affected scalp areas while any underlying scalp problems such as tinea capitis (fungal infection) should be treated accordingly.

Causes of telogen effluvium should be addressed and given professional guidance by psychiatrist if necessary. Those due to childbirth should recover spontaneously within a year.
Hair loss from menopause or childbirth often returns to normal 6 months to 2 years later.

For hair loss caused by illness (such as fever), radiation therapy, or medication use, no treatment is necessary. The hair will usually grow back when the illness has ended or the therapy is finished. A wig, hat, or other covering may be desired until the hair grows back.

For hair loss due to heredity, age, and hormones, the topical medication minoxidil can be helpful for both male and female pattern baldness. You may need to wait 6 months before you see results.

The oral medication Propecia (finasteride) is effective in some men. This medicine can decrease sex drive.

When either medication is stopped, the former baldness pattern returns.

Hair transplants performed by a physician is a surgical approach to transferring growing hair from one part of the head to another. It is somewhat painful and expensive, but usually permanent.

Hair weaves, hair pieces, or changes of hair style may disguise hair loss. This is generally the least expensive and safest approach to hair loss. Hair pieces should not be sutured to the scalp because of the risk of scars and infection.