Alopecia is a condition that can result in hair loss from the scalp and other parts of the body. It can affect both men and women of all ages and can be very distressing. There are a number of different types of alopecia, ranging from mild to severe.
Alopecia can be caused by a variety of factors, including genetics, autoimmune disorders, and certain medications. There is no cure for alopecia, but there are a number of treatments that can help improve the condition.
This article provides a comprehensive guide to coping with alopecia. It covers the causes, symptoms, diagnosis, and treatment of the condition. It also provides information on how to cope with the psychological impact of hair loss.
Alopecia
Alopecia, another name for hair loss, can affect any area of the body. Baldness is the term used to describe hair loss on the scalp. Hair loss is frequently a source of considerable anxiety for people for cosmetic reasons, but it can also be a symptom of a systemic condition that affects the entire body.
Cycles of hair growth exist. Each cycle consists of:
- A protracted growth phase (anagen) that lasts between two and six years
- A three-week-long transient phase known as catagen
- A brief (telogen) resting phase lasting two to three months
The cycle restarts as new hair begins to grow in the follicle after the hair falls out (exogen) at the conclusion of the resting period. Each day, between 50 to 100 scalp hairs exit the resting phase and fall off.
Hair loss is caused by issues with the growth cycle, which include:
- Anagen effluvium: a disruption of the anagen hair’s growth phase
- Telogen effluvium: More than 100 hairs enter the resting phase each day before falling out.
Hair loss is sometimes categorized by doctors as diffuse or localized (limited to a specific area of the scalp) (widespread). The presence or absence of scarring can also be used to categorize hair loss.
What causes Alopecia
Depending on the type of hair loss you experience, there are a number of causes, including the following
Alopecia androgenetica
Nearly the course of 80 years, this type of alopecia may eventually impact 50% of all women and over 70% of males who experience male-pattern hair loss. Along with heredity, the hormone dihydrotestosterone is important. Even throughout adolescence, hair loss can start at any age, during or after puberty. White persons are more likely than Chinese, Asian, and African Americans to suffer from androgenetic alopecia.
Hair loss in men typically starts at the temples or on the top of the head, moving backwards. Male-pattern hair loss is the name given to this phenomenon.
The top of the head is typically where hair loss in women begins. The hairline usually remains intact and the hair typically thins rather than falling out altogether. The term “female-pattern hair loss” refers to this pattern.
Areata alopecia
Alopecia areata is characterized by the abrupt loss of hair in typically rounded, erratic patches. Also possible is a more significant hair loss from the scalp and body. The immune system of the body is thought to malfunction in this illness, causing the body to attack its tissues (called an autoimmune reaction).
Alopecia cicatricial centrifuge central
The most typical cause of scarring alopecia in black women is central centrifugal cicatricial alopecia. Progressive hair loss and scarring on the top and back of the scalp are caused by injury to the scalp, which may be caused by hot combs, chemical relaxers, or hair weaves, in combination with a genetic propensity for follicular damage brought on by aberrant hair follicles.
Lupus Erythematosus Of The Skin
In cutaneous lupus erythematosus, hair loss may occur in certain regions. If the hair follicle is fully destroyed, hair loss may become permanent. People with or without systemic lupus erythematosus (SLE, or just lupus), a condition in which the body attacks its own tissues, can develop cutaneous lupus erythematosus (called an autoimmune disorder).
Numerous organs in the body are impacted by systemic lupus erythematosus, which can also result in widespread nonscarring hair loss. Hair loss in cutaneous lupus erythematosus typically occurs in patches, with the potential for permanent hair loss or scarring.
Hormonal imbalance
Women may experience scalp hair loss, acne, and hair growth in areas more typical of male hair development, such the face and trunk, if they have an overabundance of male hormones or are more susceptible to their effects genetically (hirsutism). Polycystic ovarian syndrome is the most typical cause of androgen excess in women (PCOS). Most PCOS patients have excessive facial and body hair, while others experience scalp hair loss (female-pattern baldness).
When androgen levels are high enough to cause scalp hair loss in addition to other signs and symptoms like a deepening voice, smaller breasts, more muscle mass, irregular menstrual cycles, enlarged clitoris (the smaller female organ that corresponds to the penis), and increased libido, virilization results. Rarely, virilization can result from the secretion of male hormones by an ovarian or adrenal tumor, or it can happen to women who use anabolic steroids to improve their athletic performance or have an adrenal gland issue (congenital adrenal hyperplasia).
Drugs
When anabolic steroids are used, baldness that has a masculine or female pattern might develop. Anagen effluvium is often brought on by chemotherapy treatments. By generating a telogen effluvium, other prescription medications (such as those used to treat high blood pressure, acne, thyroid issues, seizures, or blood thinners) frequently result in hair loss.
Nutritional disorders
Less frequently, nutritional issues result in hair loss. The symptoms change depending on the particular nutritional disorder:
- Overdoses of vitamin A include rashes, chapped, scaly lips, painful limb swelling, fatigue, appetite loss, and weight loss.
- Iron deficiency: anemia, fatigue that is simple to deal with, and a reduced capacity for exercise
- Lack of zinc: rashes, diarrhea, recurrent infections, appetite loss, and inadequate wound healing
Physical stresses
Stress factors that can increase the amount of hairs that enter the resting phase include a high temperature, surgery, a serious illness, weight loss, and pregnancy (causing telogen effluvium). Usually, a few months after the stress, hair starts to fall out. This kind of hair loss is frequently temporary.
Psychological stresses
These pressures can result in habitual hair tugging, twisting, or teasing (trichotillomania). Although it can happen to adults, the practice is more common among youngsters. Doctors and parents may be confused if the hair pulling goes unnoticed for a while, leading them to believe that a disorder like alopecia areata or a fungal infection is to blame for the hair loss. Additionally, chronic, severe psychologic stress can induce hair loss on its own (telogen effluvium). However, this hair loss is caused by significant, ongoing stress rather than the normal stressors of daily living.
The scalp’s ringworm (tinea capitis)
A frequent fungus that causes patchy hair loss in youngsters is scalp ringworm. An initial dry, scaly spot that gradually becomes larger is the infection. Eventually, hairs may fall out, usually flush with the scalp’s surface and appearing as black spots. Short stubs of hair are occasionally left behind when hair breaks off above the scalp’s surface. Permanent hair loss is possible, particularly if the illness is not treated.
Pull-out alopecia
This condition is characterized by hair loss brought on by tightly wound ponytails, rollers, or braids. The forehead and temple hairlines are the areas where hair loss most frequently happens.
Signs and symptoms of alopecia
You run a considerable risk of losing your hair if you encounter the following:
- Symptoms of a systemic problem
- The emergence of masculine traits in women (virilization), such as a deepened voice, hair that grows in places more commonly associated with male hair growth (hirsutism), irregular menstrual cycles, acne, breast atrophy, increased muscle bulk, enlarged clitoris, and increased libido (sex drive).
If any of the aforementioned warning indicators apply to you, you should think about seeing a doctor.
Treatment for alopecia
- Addressing particular causes
- Hair replacement techniques occasionally
When possible, specific reasons of hair loss are treated:
- Hair loss-causing medications are changed or discontinued.
- Depending on the underlying cause, hormonal abnormalities may be treated surgically or with medications.
If these minerals are low, iron or zinc supplements may be administered.
- Vitamin A consumption can be reduced in persons with excess vitamin A-induced alopecia.
- Corticosteroids that are injected into the skin, administered topically to the scalp, or taken orally are typically used to treat alopecia areata (oral). It is possible to administer additional oral and topical medications.
- In general, corticosteroids that are injected into the skin, administered topically, or combined with other topical or oral medications can be used to treat cutaneous lupus erythematosus, lichen planopilaris, and frontal fibrosing alopecia.
Eliminating physical traction or tension on the scalp is how traction alopecia is treated.
The treatment for scalp ringworm is oral antifungal medication.
Behavioral adjustment, clomipramine, or a selective serotonin reuptake inhibitor (such as fluoxetine, fluvoxamine, paroxetine, sertraline, escitalopram, or citalopram) may be effective treatments for trichotillomania despite the fact that they are difficult to administer.
Telogen effluvium, or hair loss brought on by physical stress such as recent weight loss, surgery, a severe illness with a high temperature, or childbirth, is not commonly treated because it usually resolves on its own. For some people, applying minoxidil to the scalp might be beneficial.
If hair doesn’t grow back naturally, there are hair replacement options that can be attempted, such as
- Medicines that promote hair growth or stop additional hair loss
- Hair restoration
- Wigs
Drugs
Drugs can sometimes be used to address hair loss in both male and female patterns.
When applied directly to the scalp twice daily, minoxidil may stop future hair loss and promote hair growth. Only approximately 30 to 40% of patients get visible hair regrowth, which can take 8 to 12 months. The most frequent adverse effects are rashes and itching of the skin. There may also be an increase in facial hair.
Finasteride, which is taken orally every day, blocks the effects of male hormones on hair follicles. Finasteride is occasionally prescribed to women, but it should never be given to expectant mothers. Its effectiveness in halting hair loss and promoting hair growth in men normally becomes apparent within 6 to 8 months of treatment and grows over time, however individual results may vary.
Finasteride can cause erectile dysfunction, increase breast size, and reduce libido. Additionally, prostate-specific antigen (PSA) levels can be reduced with finasteride. Before starting medication, men should talk to their doctor about how finasteride may affect prostate cancer screening.
The ability of minoxidil or finasteride to stop additional hair loss may be their most significant effect. Only as long as the medications are used does the impact last.
For certain women, hormonal modulators like spironolactone or birth control tablets (oral contraceptives) may be helpful.
