Hair loss types: Alopecia diagnosis and treatment
Introduction
Alopecia is a general term for hair loss that can affect any part of the body. It can be caused by various factors, such as genetics, hormones, autoimmune disorders, infections, medications, stress, trauma, or styling practices. Alopecia can have a significant impact on the quality of life and self-esteem of those who suffer from it.
There are different forms of alopecia, each with its own characteristics, causes, and treatments. In this article, we will explore the most common types of alopecia and how they can be managed.
Androgenetic Alopecia
Androgenetic alopecia, also known as male-pattern or female-pattern baldness, is the most common form of hair loss.
It affects about 50% of men and 40% of women by the age of 50. It is caused by a combination of genetic and hormonal factors that make the hair follicles shrink and produce thinner and shorter hairs over time.
The pattern of hair loss varies depending on the gender and the individual. In men, it usually starts with a receding hairline and progresses to a bald spot on the crown or complete baldness on the top of the head.
In women, it usually manifests as a diffuse thinning of hair on the entire scalp, with more noticeable loss on the crown and the frontal area.
The treatment options for androgenetic alopecia include:
Medications: such as minoxidil (Rogaine) or finasteride (Propecia), which can slow down or stop hair loss and stimulate some regrowth in some cases. However, they have to be used continuously and may have side effects or contraindications.
Hair transplantation: a surgical procedure that involves moving healthy hair follicles from one area of the scalp to another where the hair is thinning or missing. It can provide a natural-looking and permanent result, but it is expensive and may require multiple sessions.
Low-level laser therapy
A non-invasive technique that uses low-intensity light to stimulate blood flow and cellular activity in the scalp. It may improve hair density and quality, but it requires regular sessions, and its effectiveness is not proven.
Cosmetic solutions: such as wigs, hairpieces, extensions, or concealers, can cover up the bald areas and create a fuller appearance. They are easy to use and affordable, but they may not look natural or match the original hair color or texture.
Alopecia Areata
Alopecia areata is an autoimmune disorder that causes patchy hair loss on the scalp or other parts of the body. It affects about 2% of the population and can occur at any age, but it is more common in children and young adults. It is not contagious or life-threatening, but it can be unpredictable and distressing.
Cause of alopecia areata
The exact cause of alopecia areata is unknown, but it is believed to be triggered by an abnormal immune response that attacks the hair follicles. The factors that may influence this response include genetics, infections, stress, allergies, or environmental factors.
The pattern and extent of hair loss vary from person to person. Some people may experience only one or a few small patches of hair loss that regrow spontaneously within a few months.
Others may lose more than half of their scalp hair or all of their body hair (including eyebrows, eyelashes, and pubic hair). This is known as alopecia totalis or universalis respectively.
The treatment options for alopecia areata include:
Immunotherapy
A treatment that involves applying a chemical substance (such as diphencyprone or squaric acid dibutyl ester) to the bald patches to induce an allergic reaction.
This may stimulate the immune system to shift its focus from attacking the hair follicles to fighting the allergen. It may result in some hair regrowth in some cases, but it is not guaranteed and may cause skin irritation or other reactions.
Other medications: such as minoxidil, anthralin, cyclosporine, or methotrexate, may have some effect on hair growth in some cases, but they are not approved for alopecia areata and may have side effects or interactions.
Alternative therapies: such as acupuncture, hypnosis, aromatherapy, or herbal remedies, may help reduce stress and improve the overall well-being of the patient. However, they have no scientific evidence to support their effectiveness for alopecia areata and may have risks or costs.
Alopecia Totalis and Universalis
Alopecia Totalis and universalis are the most severe forms of alopecia areata, where the patient loses all of the scalp hair (alopecia totalis) or all of the body hair (alopecia universalis).
They are rare and affect less than 1% of the people with alopecia areata. They usually develop after a history of patchy hair loss, but they can also occur suddenly without any warning signs.
The cause and treatment of alopecia totalis and universalis are the same as for alopecia areata. However, the chances of hair regrowth are very low and the psychological impact is very high. The patients may experience social isolation, depression, anxiety, or low self-esteem.
The coping strategies for alopecia totalis and universalis include:
Seeking professional help: such as a dermatologist, a psychologist, or a counselor, who can provide medical advice, emotional support, and guidance on how to deal with the condition.
Joining a support group: such as the National Alopecia Areata Foundation (NAAF) or Alopecia UK, which can offer information, resources, and peer support to the patients and their families.
Exploring cosmetic options: such as wigs, hats, scarves, or makeup, which can help restore the appearance and confidence of the patients. They can also express their personality and creativity through their choices.
Educating others: such as friends, family, colleagues, or strangers, who may not understand the condition or may have misconceptions about it. They can explain what alopecia is, how it affects them, and how they want to be treated.
Traction Alopecia
Traction alopecia is a form of hair loss that is caused by excessive pulling or tension on the hair due to certain hairstyles or practices.
It affects mainly women and children of African descent, but it can also affect anyone who wears their hair in tight braids, ponytails, cornrows, dreadlocks, or extensions. It can also be caused by using harsh chemicals, heat, or tools on the hair.
The symptoms of traction alopecia include:
- Thinning or balding of the hairline or temples
- Redness, itching, or inflammation of the scalp
- Bumps or blisters on the scalp
- Headaches or pain in the scalp
- Broken or damaged hairs
The treatment options for traction alopecia include:
Changing the hairstyle: such as loosening the braids, ponytails, or extensions, taking breaks from them, or avoiding them altogether. This can prevent further damage and allow the hair follicles to recover.
Medications: such as minoxidil or corticosteroids, which can stimulate some hair regrowth in some cases. However, they have to be used continuously and may have side effects or limitations.
Hair transplantation: a surgical procedure that involves moving healthy hair follicles from one area of the scalp to another where the hair is missing. It can provide a permanent solution for severe cases of traction alopecia, but it is expensive and may require multiple sessions.
Scarring Alopecia
Scarring alopecia, also known as cicatricial alopecia, is a rare form of hair loss that is caused by inflammation or damage to the hair follicles that results in scar tissue formation.
It affects about 3% of people with hair loss and can occur at any age. It is more common in women than men and in people of African or Asian descent.
The causes of scarring alopecia are not fully understood, but they may include:
Autoimmune disorders: such as lupus erythematosus, lichen planopilaris, or frontal fibrosing alopecia
Infections: such as folliculitis decalvans, dissecting cellulitis, or tinea capitis
Trauma: such as burns, injuries, or surgery
Neoplasms: such as skin cancer
- The symptoms of scarring alopecia include:
- Patchy or diffuse hair loss on the scalp or other parts of the body
- Smooth or shiny areas of skin where the hair is missing
- Redness, scaling, crusting, or pus on the scalp
- Itching, burning, or pain in the scalp
The treatment options for scarring alopecia include:
Scarring alopecia, also known as cicatricial alopecia, is a rare condition that causes permanent hair loss due to inflammation and scarring of the hair follicles.
The treatment options for scarring alopecia depend on the type and severity of the condition, but they generally aim to reduce inflammation, prevent further hair loss, and restore some hair growth if possible. Some of the common treatment options for scarring alopecia include:
Anti-inflammatory medications, such as corticosteroids, antibiotics, or immunosuppressants, can be applied topically, injected into the scalp, or taken orally to reduce inflammation and suppress the immune system.
Hair transplantation
Hair transplantation involves surgically moving healthy hair follicles from one part of the scalp to another to cover the areas of hair loss. This procedure can only be done if there is enough donor hair available and if the scarring is not too extensive or active.
Scalp reduction or flap surgery, involves removing the scarred areas of the scalp and stretching the remaining skin to cover the bald spots. This procedure can improve the appearance of the scalp, but it may not be suitable for everyone and it may have some risks and complications.
Scalp Micropigmentation: Technique for Hair Loss Concealment
Scalp micropigmentation involves tattooing tiny dots of pigment on the scalp to create the illusion of hair. This procedure can be done to camouflage small areas of scarring or to create a shaved look for those who have lost most or all of their hair.
Wigs, hairpieces, or cosmetic products, such as sprays, powders, or fibers, can be used to cover or disguise the areas of hair loss. These options can provide temporary relief and improve self-esteem, but they may not address the underlying cause of scarring alopecia.
onclusion
Alopecia is a term that refers to hair loss from any part of the body. There are different forms of alopecia, such as androgenetic alopecia, alopecia areata, cicatricial alopecia, traction alopecia, and telogen effluvium. Each form has its own causes, symptoms, and treatments.
Alopecia can affect anyone, regardless of age, gender, or ethnicity. It can have a significant impact on the quality of life and psychological well-being of those who suffer from it. Therefore, it is important to seek medical advice and appropriate treatment if one experiences hair loss.