Physiologically, every day from the hair drops 50-80 strands that replace with new ones. The condition in which hair falls more strands than they create is called effluvium. If this process does not stop, then baldness – medically known as alopecia – occurs.
Alopecia characterizes by hair loss and may be temporary or permanent.
The most common hair diseases, where the main symptom is the scarcity and lack of hair are:
It is a transient hair loss that occurs as a result of damage to the hair follicle from internal or external factors. The most common causes leading to this type of diffuse hair loss are:
- Severe psychological stress;
- Strict diets;
- Certain drugs – anticonvulsants, antidepressants, beta-blockers, anticoagulants, anti-acne remedies containing vitamin A (oral retinoids), drugs for thyroid disease, oral contraceptives, NSAIDs – nonsteroidal anti-inflammatory drugs, cholesterol-lowering drugs, hormone therapy, etc.
- Iron deficiency anemia;
- Disruption of thyroid function;
- Severe infections;
- High febrile condition.
Clinical image: The main symptom is an increased and sudden loss of hair, resulting in diffuse hair thinning. Daily can fall from 150 to 1,000 strands.
The diagnosis is set based on the clinical picture and the finding from the trichogram (microscopic examination of the roots of the hair).
Treatment depends on the cause that triggered diffuse hair loss. Once the cause is treated, the hair spontaneously grows again.
This is the most common type of alopecia that occurs as a result of androgenic stimulation of the hair follicles. It is a genetic hereditary disease, where, as the name itself says, hair loss is induced by androgens. This type of alopecia is more common in the male population but also affects women.
The clinical picture is different in men and women.
ANDROGENIC ALOPECIA IN MEN
In men, the process of hair loss begins most often in the third decade. It consists of 4 stages.
- In the first stage, the so-called. “Secret corners” appear in the frontal, front part of the head.
- In the second stage, in addition to the presence of “secret corners” that are more pronounced, there is a thinning in the central part, but there are still “bridges of hair” between bold spots.
- In the third stage, “hair bridges” are absent,
- And in the fourth degree, only a “wreath of hair” is present – a Hippocratic baldness. All men of the white population suffer from this type of alopecia.
ANDROGENIC ALOPECIA IN WOMEN
In women, androgenic alopecia begins in around the 30th year of age and is intensifying towards the middle of the fourth decade. The process of hair loss takes place in three stages.
- In the first stage, hair thinning is limited and does not affect the area 1-3 cm directly above the forehead.
- For the second stage, the spacing in the central part is more pronounced, but the area above the forehead is unchanged.
- At the third stage, full baldness in the central part is present, with hair extensions present in the front part – above the forehead area is preserved.
With androgenic alopecia in women, there is a possibility of increased hairiness over the upper lip and limbs in parallel.
The diagnosis is made using the clinical picture and the finding from the trichogram.
Treatment for androgenic alopecia in women involves the local application of estrogen solutions and oral anti-androgenic therapy in combination with estrogens. (Need to be aware of contraindications!). In men, treatment involves a local application of 2% minoxidil and oral finasteride therapy. Hair transplantation is also possible.
Unfortunately, the prognosis for this type of alopecia is unfavorable.
Alopecia areata is a sudden loss of hair, which manifest in the form of well-limited round or oval areas.
The causes of this type of alopecia are not completely defined. It is thought that genetic predisposition plays a role, but also the influence of other factors such as emotional stress and the presence of chronic inflammatory focuses (teeth, sinuses, throat, etc.). The cause of alopecia areata is assumed to be a disorder of the immune system, (it’s targeting against its own organism – autoimmunity).
Clinical picture: We distinguish three stages in alopecia areata.
- The first, the progression phase, is characterized by the appearance of one or more hot spots where the hair loss begins. Skin of the places where the hair falls is smooth and shiny. At this stage, the fibers in the affected area are easily torn off. With the spread of the hotspots, a process that often lasts for weeks may result in their merging and the formation of a larger hairless area.
- The second phase is a phase of stabilization, a period when the hair neither falls nor grows and follows the regression phase.
The disease usually lasts 3-6 months, after which in most cases hair grows again. However, the evolution of this disease is quite uncertain, as there are cases where new hot spots still appear, which can affect the entire scalp, as well as other parts of the body. In an aggressive flow of alopecia areata, a loss of whole hair occurs in 10-15 days.
The diagnosis is made using the clinical picture and by microscopic examination of the roots of the hair – trichogram.
The treatment aims to stimulate the follicles for reproduction of fibers. It might be:
- Local therapy: salicylic acid in alcoholic solution, cignolin(dithranol), corticosteroid fats, local immunotherapy, intradermal application of triamcinolone acetonide, etc.
- General therapy: systemic corticosteroids and UVA therapy.
Unfortunately, the outcome of the disease is often unpredictable.
Trichotillomania is a self-induced alopecia, in which hair loss is due to a deliberate and often unconscious hair loss. This condition is typical of children and is usually an unconscious response to temporary stress. In adults, it occurs less frequently and is the result of a psychological disorder.
Clinical picture: People who suffer from this disease through the plucking of the hair reduce the psychic tension, after which they feel pleasure and calm. Most commonly affected parts of the scalp are easily accessible with their hads, but in some cases, the eyebrows and eyelashes are also affected. If the person is right-handed, the changes are in the parts of the scalp that are more easily available for the right hand, and vice versa.
Diagnosis: Before establishing a definitive diagnosis of trichotillomania, it is necessary to exclude other diseases that give similar symptoms, such as alopecia areata or tinea capitis (a fungal disease of the affected part of the head – scalp, eyebrows, and eyelashes).
Treatment depends on the cause of the disease and most often involves consultation with a psychologist or psychiatrist.
This type of alopecia occurs in chemotherapy and radiotherapy. The condition is characterized by diffuse hair loss, and usually, after the treatment has stopped that has led to the hair loss, the hair is renewed.
NOTE: If you notice an increase in hair loss, visit your doctor in order to find out the cause and if needed, to get the required therapy in a timely manner.