ALOPECIA- THE MENACING PATTERNS OF HAIR LOSS

7 min


INTRODUCTION:

Firstly, hair loss is a common thing that happens to everyone every day in their life. Further, normal hair fall from 50 – 100 hair strands per day is considered normal and anything above it needs to be considered. Also, an increase in hair fall can be due to many reasons like hereditary, stress, improper hair care, scalp infection, hairstyle, age, lifestyle and alopecia.

Alopecia areata is also known as spot baldness where hair falls out in small round patches. Further, it’s an autoimmune disease, the condition occurs where a person’s own immune system attacks its own hair follicles and causes hair loss. Therefore, it leads to few bald spots on the head, some people tend to lose more hair and leads to baldness. This not only affects the scalp but also can occur in hair-bearing skin and also loss of eyelash and nasal hair. It affects both males and females, males are often affected.

The condition is non-scarring, there is no permanent damage to the hair follicle. Also, it produces one or more patches of balding without a change in the texture of the skin. Moreover, in most people, new hair grows back in affected areas. Further, if a person has mild alopecia they can recover within a year. Moreover, this disease causes severe psychological stress.

TYPES OF ALOPECIA:

There are two major types of alopecia,

Type of alopecia Type of loss
Alopecia totalisall hair in the scalp is lost
Alopecia Universalisall hair in scalp and body is lost

This hair loss can be permanent sometimes. We will see the causes of alopecia and how to avoid it and treatment and advanced procedures followed to treat this condition.

Other alopecia conditions are,

  • Alopecia Barbae
  • Androgenic Alopecia
  • Alopecia Areata
  • Cicatricial Alopecia ( scarring alopecia )
  • And, traction Alopecia

SYMPTOMS OF ALOPECIA:

The main symptom of alopecia is hair loss.

Hair fall in patches:

Hair falls out in patches on the scalp and they can be several centimetres or less. Subsequently, these patches may get large and form baldness.

Moreover, sometimes hair loss occurs in other parts of the face can occur. For instance in the eyebrows, eyelashes and beard. Further, more hair loss is seen in cold weather.

CAUSES OF ALOPECIA:

 ALOPECIA AREATA:

It can be due to abnormality in the immune system which damages hair follicles. Further, it is autoimmune where the immune system attacks its own body.  Also, in the case of alopecia areata, the immune system attacks hair follicles (hair follicles are structures from which hair grows) and restrict normal hair formation as the follicles become smaller and prevent growth and cause hair loss

Autoimmune conditions associated are,

Further, the extent of hair loss differs with each person and their condition

ANDROGENIC ALOPECIA:

It is the most common type of alopecia and has a pattern of hair loss which is M shape.  It occurs in both males and females and the pattern of hair loss in females differs from the male pattern. Moreover, in women, hair becomes thinner.

Also, in men, it is associated with conditions like coronary heart disease and enlargement of the prostate, disorder of insulin resistance and hypertension. Further, in women, it is associated with an increased risk of PCOS (polycystic ovary syndrome). It is due to hormonal imbalance which leads to irregular menstruation, hirsutism (excessive growth of hair), weight gain and acne.

ALOPECIA BARBAE:

It is a specific form of alopecia that affects the beard and it causes hair loss in small circular patches. Causes are unknown but can be due to stress and genetics. Also, it is common in people with asthma or allergies.

CICATRICIAL ALOPECIA:

Firstly, inflammation damages hair follicles. Further, the inflammation destroys stem cells and oil glands of the hair follicles which leads to fibrosis and hair loss.

TRACTION ALOPECIA:

Tight ponies, hairstyling and heat styling tools can cause traction alopecia.

HAIR ANALYSIS:

  • History of onset
  • Pattern of hair loss
  • Hair thinning and area involved
  • Hair fall
  • Any other symptoms
  • Scalp lesions
  • Any associated systemic disease
  • Nutritional history
  • Family history
  • Drug history
  • And, menstrual history in women

EXAMINATION:

  • Trichoscopic examination
  • Inspection ( pattern of alopecia )
  • Palpation
  • Laboratory workout:
  • CBC
  • Serum ferritin
  • Serum iron
  • FSH & LH
  • Testosterone
  • Vit D3
  • Thyroid profile – T3 , T4 , TSH
  • Zinc
  • DHT (Di Hydro Testosterone)
  • PCOS for females
  • Leutinizing hormone
  • Prolactin
  • Hair shaft examination ( texture and colour)
  • Hair tug test:

A cluster of hairs is grasped with one hand and distal ends are pulled away with another hand, if the hair is fragile it breaks into small bits.

  • Hair pull test:

50 to 60 hairs grasped between thumb and forefinger and pulled away from the scalp, if more than 6 hairs are extracted it’s positive

TREATMENT FOR ALOPECIA:

  • PRP
  • Stem cell PRP
  • LLLT
  • Regenera activa
  • Topical
  • Hair transplant
  • Micropigmentation
  • And, non surgical hair patches

PRP:

In Platelet Rich Plasma, draw the patient’s blood from a vein. Consequently, separate the blood and the plasma. Further, inject the plasma into the scalp. Also, it triggers natural hair growth and increases blood supply to the hair follicle.

  1. Firstly, draw blood from the patient. Subsequently, keep the blood in centrifuge and spin to separate fluid.
  2. Seperate blood as platelet rich plasma, platelet poor plasma and RBC.
  3. Obtain the Platelet rich plasma and inject in scalp.

Moreover, it can’t be given to a person under blood thinner, keloid disease and chronic infections. Further, it is given at a gap of 4-6 weeks period.

LLLT (Red light therapy or cold laser therapy):

Firstly, the photons are irradiated into the scalp tissues. Also, the absorbed photons by weak cells encourage hair growth. Further, it is non-invasive and doesn’t have side effects.

REGENERA ACTIVA:

Firstly, it is the latest non-surgical hair growth treatment which is based on capillary regenerative therapy. Further, stem cells are taken from the patient’s body and are processed and growth factors are induced and injected along with mesotherapy.

TRANSPLANT:

There are two types of transplant,

  • The micro grafts – contains 4 to 10 hairs per graft
  • Slit grafts – contains 1 to 2 hairs per graft.

Firstly, the surgeon places small punch incisions. Secondly, place the hair follicles in these incisions. Moreover, major side effects are inflammation of hair follicles, bleeding and infection.

MICROPIGMENT:

Firstly, it is a popular non-surgical hair loss treatment in which natural pigments are given within the dermal layer of the scalp. Further, it’s camouflaging hair follicles over the surface area of the scalp.

In cases of severe hair loss, corticosteroid medications are given such as MINOXIDIL and FLUOCINONIDE.  Also, application in form of cream can be less effective and takes longer to give results. Oral corticosteroids decrease hair fall but can cause side effects. Also, it varies in different individuals as some show positive results and some show no response to treatment.

Corticosteroids are given in injection form on the scalp and can also be given in form of creams and ointment

When alopecia areata is associated with celiac disease, the medication along with a gluten-free diet is given which helps in the permanent regrowth of hair on the scalp.

MINOXIDIL:

Moreover, minoxidil helps to increase blood flow to hair follicles by dilating blood vessels for more nutrients to reach the hair follicles and promote growth.

Mechanism of action:

  • Firstly, it stimulates human dermal papilla.
  • Secondly, it regulates vascular endothelial growth factor mRNA in human hair dermal papilla cells.
  • Further, this promotes diverse cell function and helps in growth.

Dosage:

Topical Minoxidil of 2% of 1ml solution twice daily.

MINOXIDIL ALTERNATIVES:

The long duration of this vasodilator is not possible. Secondly, an alternative DHT blocker is the saw palmetto extract-based serum, mulberry extract, peppermint oil.

FINASTERIDE :

Firstly, it works by stopping the conversion of testosterone to dihydrotestosterone. Finasteride has its own side effects and doctors need to convey all possible effects of finasteride to patients before prescribing the drug. Also, it causes reduced or inability to have sex, allergic reaction and depression.

TREATMENT PREFERRED ACCORDING TO DIFFERENT ALOPECIA:

TYPE OF ALOPECIATREATMENT PROTOCOL
ANDROGENIC ALOPECIAMinoxidil topical + PRP + Cyclical nutrition
Hair transplant
ALOPECIA AREATA / ALOPECIA TOTALISImmunosuppressant drugs
Micropigmentation
Hair transplant
TRACTION ALOPECIAMinoxidil topical + PRP + Cyclical nutrition
ALOPECIA TOTALISHair transplant and micropigmentation
ALOPECIA BARBAEMicropigmentation

ALTERNATIVE THERAPIES:

  • Vitamins like zinc and biotin
  • Probiotics
  • Aromatherapy
  • Acupuncture
  • Microneedling
  • Onion juice
  • Aloe Vera drinks
  • Oils like – peppermint , lavender, rosemary and tea tree
  • Coconut oil, castor oil, jojoba oil
  • Diet with meats and vegetables
  • Green tea
  • And, Ginseng

CONCLUSION:

To sum up, as discussed hair loss is a common condition seen in everyone but excess hair loss can be a worrying and stressful issue. Also, in certain rare cases, medical conditions are associated. Prevention is better than cure such as eating healthier foods and maintaining a good and healthy lifestyle helps to build the body and prevent any diseases occurring due to environmental and health factors.  Every disease has its treatment and everything is treatable but a stress-free mind and health is more important for the success of treatment.


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Dr. Reshma

I am a dental surgeon and cosmetologist. I love to take care of pets, draw mandala and travel. My area of interest is aesthetic medicine and forensics.

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