Skin Disorders Guide

What do doctors call this condition?

Alopecia

мебелиWhat is this condition?

Hair loss usually occurs on the scalp; hair loss elsewhere on the body is less common and less conspicuous. In the nonscarring form of this disorder, the hair follicle can generally regrow hair. But scarring hair loss usually destroys the hair follicle, making hair loss irreversible.

What causes it?

The most common form of nonscarring hair loss is male-pattern hair loss, which appears to be related to androgen levels and aging. Genetic predisposition commonly influences time of onset, degree of baldness, speed with which hair loss spreads, and pattern of hair loss. Women may experience diffuse thinning over the top of the scalp.

Other forms of nonscarring hair loss include:

• physiologic hair loss - sudden hair loss in infants, loss of straight hairline in adolescents, and diffuse hair loss after childbirth; usually temporary
• alopecia areata - patchy hair loss that is generally reversible and selflimiting (in rare cases alopecia areata can lead to complete hair loss); occurs most frequently in young and middle-aged adults of both sexes
• trichotillomania - compulsive pulling out of one’s own hair; most common in children.

Other causes of nonscarring hair loss include radiation, many types of drug therapies and reactions to drugs, bacterial and fungal infections, psoriasis, seborrhea, and endocrine disorders, such as thyroid, parathyroid, and pituitary dysfunctions.

Scarring hair loss may be caused by physical or chemical trauma or chronic tension on a hair shaft, as occurs in braiding.

Diseases that produce hair loss include destructive skin tumors, granulomas, lupus, scleroderma, inflammatory skin disease involving the hair follicles, and severe fungal, bacterial, or viral infections, such as tinea infection, folliculitis, or herpes simplex infection.

What are its symptoms?

Male-pattern hair loss occurs gradually and usually affects the thinner, shorter, and less pigmented hairs of the front and side of the scalp. In women, hair loss is generally more diffuse; completely bald areas are uncommon but may occur.

Alopecia areata usually affects small patches of the scalp but may also occur as alopecia totalis, which involves the entire scalp, or as alopecia universalis, which involves the entire body. Although mild redness may occur initially, affected areas of the scalp or skin appear normal. “Exclamation point” hairs (loose hairs with dark, rough, brushlike tips on narrow, less pigmented shafts) occur at the periphery of new patches. Regrowth initially appears as fine, white, downy hair, which is replaced by normal hair.

In trichotillomania, patchy areas of hair loss and many broken hairs appear on the scalp and possibly on other areas, such as the eyebrows.

How is it diagnosed?

A physical exam is usually sufficient to confirm hair loss. In trichotillomania, an occlusive dressing can establish the diagnosis by allowing new hair to grow, revealing that the hair is being pulled out. Diagnosis must also include tests to identifY any underlying disorder.

How is it treated?

Topical application of minoxidil, a drug more commonly used to treat high blood pressure, has had limited success in treating male­pattern hair loss. (The topical form of this drug is known as Rogaine.) An alternative treatment is surgical redistribution of hair follicles by autografting.

In alopecia areata, Rogaine is more effective, although treatment is often unnecessary because spontaneous regrowth is common. The doctor may administer corticosteroid injections into the affected areas; this is beneficial for small patches and may produce regrowth in 4 to 6 weeks. Hair loss that persists for over a year is unlikely to grow back.

In trichotillomania, use of an occlusive dressing may protect the person’s hair and allow normal growth. Long-term treatment may include behavior modification therapy. Treatment of other types of hair loss varies according to the underlying cause. Some hair products are also used for the treatment of Hair Loss.

What can a person with hair loss do?

• If you’re a woman with female-pattern hair loss, know that it doesn’t lead to total baldness. Consider restyling your hair to mask thinning areas or consider wearing a wig.
• If you have alopecia areata, be aware that complete regrowth is possible.