Alopecia denotes the acceleration of hair loss. Hair is a slender threadlike outgrowth of protein on the skin of your skull. It is a reflection of your health. When you are stressed or sick, it has an impact on your hair. Certain diseases can make it dull, brittle, and sometimes fall. You lose 45 to 60 hairs per day; this type of hair loss is normal, every one experiences it once a while. You suffer from medical hair loss when you lose excessive hair every day; this condition is called Alopecia.
Alopecia is any type of hair loss. There are many types of hair loss:
Androgenic alopecia or male-pattern baldness – the most common form of hair loss in both men and women
Alopecia Areata – this is a recurrent nonscarring type of hair loss that can affect any hair-bearing area
Telogen effluvium – this is a temporay type of hair loss; your hairs grow back after the causes are treated. Hair loss during chemotherapy is a type of telogen effluvium. In the case of chemotherapy for instance, the hair grow back within two or three months.
Thinning hair is the precursor of alopecia. The thinning is then followed by a partial or generalized hair loss. In addition, you may experience:
- Itching of the scalp
- Pain in your hair roots or scalp
- Excess sebum
- Onset of dandruff.
Alopecia Causes and Risk Factors
Pattern baldness – hereditary balding is the most common cause of hair loss; that is, you are inherited hair loss from either your parents’ gene. Certain men are genetically predisposed to male pattern hair loss. In this case, the hair fall due to effect of dihydrotestosterone (DHT) on the hair follicle that produces male pattern baldness. This condition occurs when the testosterone is transformed into dihydrotestosterone (DHT), which blocks or shortens the growth of the hair and leads to hair loss.
Stress – stress is sometimes involved in the occurrence of hair loss. Some researchers believe stress can be a trigger of hair loss in some individuals, but this theory has not been fully confirmed by scientific studies.
Poor nutrition – Good nutrition is vital to healthy hair growth. Having inadequate protein or iron in your diet can cause you to experience hair loss. Lack of certain vitamins in your diet can lead to Alopecia. Recent studies reveal that Folic Acid helps maintain healthy hair, nails and skin. Vitamin B3 (Niacin) and Vitamin E, two powerful antioxidants, enhance scalp circulation. Many studies have shown that Vitamin B12 plays a major role in preventing hair loss.
Note: increasing those vitamins intake in your diet may take months to produce visible positive effects in your hair’s condition. Natural hair loss treatment requires patience and persistence.
Medications – Hair loss may be due to some medical treatments. Some of the drugs known to cause falling hair include allopurinol (used to treat gout or kidney stones), bromocriptine (used to treat pituitary tumors and Parkinson’s disease), carbamazepine (used in the treatment of epilepsy and bipolar disorder), chlorambucil (used in the treatment of chronic lymphocytic leukemia) and all chemotherapy drugs or radiation therapy.
Fungal infection – Some fungi are responsible for the development of different types of ringworm, which, if they persist in adulthood, may lead to hair loss.
Diseases – some diseases are known to be factors of certain types of hairloss: scarring alopecia can be caused by cutaneous lupus erythematosus, folliculitis, cicatricial alopecia, and Postmenopausal frontal fibrosing alopecia; Localized hair loss can be due to effects of basal cell carcinoma and epidermoid carcinoma (two forms of tumor); and Traction alopecia can be resulted from trichotillomania. Tight braids and hair straightening can be also responsible for developing Traction alopecia.
Hormonal changes – Hormonal changes due to hyperthyroidism (high level of thyroid hormone) can cause hair loss. Pregnancy can also affect health of the hair in some women. A few months after childbirth, many women tend to suffer a massive loss; this loss is linked to hormonal changes caused by the pregnancy. When hormones regain their normal levels, hair regains their normal life cycle of growth and loss.
Other causes – certan external aggressions are also susceptible of causing alopecia: air pollution, aggressive shampooing or brushing. This type of hair loss is remedied with no treatment once the aggression is reversed.
The diagnosis is based on a complete health check of your hair. This can be done by lab analysis and physical exam. Your doctor will look for signs of patchy hair loss, Onset of dandruff, scaling or swelling. However, it is often difficult to detect hairloss at early stage. Before the top of your head becomes visibly bald, there is generally no or quasi-visible reduction of hair growth. In case there is lack of evidence of alopecia, the diagnosis will be confirmed by the following tests:
Trichogram – it is an evaluating test done to measure hair growth and loss. A hair specialist takes a few hairs in different areas of your scalp and observes them under a microscope. The exam provides accurate information on quantity hair growth and hair loss.
Phototrichogram – introduced by Saitoh M in 1970, Phototrichogram consist of shaving an area of the scalp, and photograph it in 2 or 3 days later to estimate the hair growth cycle. This test is not always accurate.
Pull Test – The Pull test is a method consisting of pulling your hair gently to detect growing hair from hairs in telogen phase. During the test, your physician pulls a couple dozen hairs between his thumb and forefinger. The result is based on the number of hairs pulled and the number of hair come out. If 10 -15% of hairs pulled come out, your hairs are in excellent health; if up to 20-25% come out, the result is typical; in case 35% and over come out, there definitely is a hair loss problem. However, pull test result is not accurate in miniaturization and genetic hair loss.
Skin scraping – This test is done in case your physician suspects the alopecia is caused by infection. The test consists of taking a tiny sample from your skin to detect presence of mites, fungal infections and other skin problems.
Punch biopsy – this is a medical procedure in which your doctor uses a sharp, hollow chirurgical tool to remove a piece of your skin’s deeper layer to examine so that he can rule out other illnesses that are potential for causing hair loss. This test is done when a doctor is unable to confirm the diagnosis with the other exams.
Medication – Minoxidil is a nonprescription medication used in the treatment of alopecia. The 2% and a 5% formulation are approved by the FDA for use in both Men and Women hair loss. Used as suggested, Minoxidil has the ability to dilate blood vessels, and promote hair growth. However, Minoxidil requires a prolonged treatment; otherwise, new hairs will stop growing soon after the cessation. All hairs grown during the treatment will disappear in about 3 months. In addition, the effect of Minoxidil starts from 3 months of treatment and is characterized by a decrease of hair loss. Then, between the 4th and 6th months of treatment regrowth of hair can be visible enough to hide bald spots.
Finasteride (Propecia) is another drug Approved by the FDA to treat male pattern hair loss in men. However, unlike Minoxidil, Finasteride can be taken only orally and required a prescription. The drug works by inhibiting the conversion of the male hormone testosterone into dihydrotestosterone (DHT). Testosterone acts at the root of the hair after having been transformed in dihydrotestosterone (DHT) by enzymes called 5-alpha reductase type 1 and 2. Finasteride inhibits 5-alpha reductase type 2 and lowers the levels of DHT, which results in hair regrowth. However, the treatment can take several months to produce positive results.
Surgery – Drugs are considered the primary means to treat hair loss. However, when the alopecia has been installed for years and all treatments have no positive results, surgical treatment (hair transplant) is the only option to be considered.
Hair transplant is a surgical technique that has been around for more than 60 years. It is told that the first hair transplants were performed in Japan in the 30s by Doctors Issagawa, Okuda and Tamura. The method was not so popular, and the results were not as satisfying as today. In recent years, several surgeons in many parts of the world do remarkable jobs. In most people, six months after the implant, it is very difficult to differentiate the transplanted hairs from the natural hairs.
Hair transplant procedure is painless and required no hospitalization. It is done under local anesthesia and takes about 2 hours to 3 hours. No major post-surgical restriction; most people return to their professional activities from the next day
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