A Quick Bite Of What Alopecia Looks Like

 Though hair loss is a common condition faced by males and females alike, it does not come without treatment. The major step is diagnosing the underlying reason and finding the best-suited treatment to your scalp and hair follicles. Being a very delicate area, it has to be decided with caution and care. This will surely help in the re-growth and brings your hair back along with your self-esteem and confidence

A Quick Bite Of What Alopecia Looks Like

What Is Alopecia?

 Many people suffer from hair loss problems usually referred to as alopecia, that is lack of hair on part of or entire scalp and in remote cases, other parts of the body. With hair loss being temporary or permanent, it can affect people of all ages ranging from small bare patches easily masked by hairstyling to the more diffuse and obvious pattern. It is the most depressing when it affects the scalp even though it can affect any part of the body.

 What Causes Alopecia?

 The few Causes of alopecia include,

  1. Genetic reasons
  2. Fever for a prolonged time
  3. Hormonal changes happening in occasions, such as childbirth, use of birth control pills or thyroid disease
  4. Treatment for cancer, like those of chemotherapy
  5. Hair pulling or scalp rubbing over longtime
  6. Radiation therapy or burns
  7. Physical stress including emotional stress
  8. Ringworm affecting the scalp (Tinea capitas)
  9. Some kind of prescription medicine

 Different Types Of Alopecia

 Loss of hair on the scalp, associated with alopecia comes in different types including, 

  1. Androgenetic Alopecia (Commonly Known For Genetic Hair Loss)

Also known as male pattern hair loss, comes as a major problem affecting men and by the age of 50, up to 50% of men who are genetically predisposed are affected. Characterized by progressive, patterned hair loss from the scalp, the prerequisites are usually genetic predisposition and sufficient circulating androgens (steroid hormones like testosterone or androsterone promoting male characteristics). According to studies, every Caucasian male possesses the autosomal inherited predisposition and 96% lose hair to some degree. They are our times more likely to develop premature balding than Black men. Usually, hair loss does not start until after puberty with an extremely variable rate of progression. 

In women also the condition is fairly common referred to as female pattern hair loss. This type of hair loss is characterized by a diffuse reduction in hair density over the crown and frontal scalp with retention of the frontal hairline. Researches mention that in some cases, the hair loss affects a small area of the frontal scalp while in others the entire scalp is involved. The advanced female pattern hair loss causes hair to be sparse over the top of the scalp but a rim of hair is retained along the frontal margin. While the vertex (crown or top of the head) balding is rare in women, a female pattern of balding is not uncommon in men. Female pattern hair loss caused by the androgen-dependent nature of the genetic basis of this type of hair loss is not established. Studies show androgens play an important role in the development of female pattern hair loss.  

  1. Alopecia Areata (AA)

 A common immune-mediated, nonscarring form of hair loss that occurs in all ethnic groups, ages(common in children and young adults) and both sexes, affects around 1.7% of the population. In this case, it is unpredictable with patients presenting several episodes of hair loss and regrowth during the lifetime. While recovery from hair loss can be complete, partial, or nonexistent, about 34 to 50% of patients recover within a year while 15 to 25% progress to the total loss of scalp hair or loss of the entire scalp and body hair where full recovery is quite unusual. This type of alopecia is seen as a single oval patch or multiple confluent patches of asymptomatic, well-circumscribed Alopecia with severity ranging from small bare patch to loss of hair on the entire scalp. The frequent features of patches are exclamation mark hairs, present at its margin, the exclamation mark hairs broken with short hairs tapering proximally. This hair loss becomes obvious as clinical abnormality associated with nail abnormalities. Thyroid disease and vitiligo are the less common associated diseases. 

The clinical presentation is subcategorized based on the pattern and extent of hair loss. According to the pattern, the following are visible:

 

  1. patchy AA, that consists of round or oval patches of hair loss which is the most common,
  2. reticular AA comes as a reticulated (networked) pattern of patchy hair loss,
  3. ophiasis band-like AA, this is the type of hair loss in the parieto-temporo-occipital scalp (middle-side-back of scalp),
  4. ophiasis inversus comes like a rare band-like pattern of hair loss in the fronto-parieto-temporal scalp (front-middle-side of scalp), and
  5. diffuse AA, that is a diffuse decrease in hair density.

When categorized according to the extent of involvement, the following are observed:

  1. alopecia areata, accounts for the partial loss of scalp hair,
  2. alopecia totalis comes with a 100% loss of scalp hair and
  3. alopecia Universalis, that is 100% loss of body hair

   3. Telogen Effluvium (Te)

 This is an abnormality of hair cycling resulting in excessive loss of telogen (the resting phase of hair cycles) hairs most commonly found in women. This disorder is usually noticed as an increased amount of loose hairs on the hairbrush or shower floor. The loss of hair ranges from 100 to 300 hairs daily, and it is thought that TE may unmask the previously unrecognized Androgenetic Alopecia. The reason behind TE is usually found to be stress, including other reasons such as thyroid, pituitary diseases, some sort of medication, childbirth to mention a few. In most cases, no cause is found. It usually begins two to four months after the causative event and will probably last for several months. TE is a temporary condition and hair regrowth is possible, unlike other hair loss conditions. TE presents in three forms: 

 

  1. Acute telogen effluvium, which comes as the shedding of hair that is expected to cease within 3 to 6-month.
  2. Chronic diffuse telogen hair loss, where the hair shedding lasts longer than 6 months. The causes of this type of hair loss include thyroid disorders, acrodermatitis, profound iron deficiency anemia, and malnutrition.
  3. Chronic telogen effluvium (CTE) which comes as the most common cause of hair loss in women, affects 30% of females, mostly between the ages of 30 and 60 years old. CTE comes as a relative change in the proportion of growing to rest hair with most cases have excessive shedding of hair being present for at least 6 months. Studies show that 95% of CTE cases caused due to nutritional imbalance involving the essential amino acid L-lysine and iron. To name other common causes of CTE, it includes drugs, thyroid disease, and childbirth. 

 

  1. Cicatricial Alopecia (Scarring Alopecia)

 It is a group of rare hair disorders that result from a condition damaging the scalp and hair follicle, affecting areas including an underlying scalp that is scarred, sclerosed, or atrophic. The disorder destroys the hair follicle replacing the follicles with scar tissue causing permanent hair loss. Cicatricial Alopecia includes conditions such as autoimmune diseases such as discoid lupus erythematosus, scalp trauma, infections including tuberculosis and syphilis, and radiation therapy. It affects both adults and children alike and may be present as primary or secondary Cicatricial Alopecia. 

 

  1. Chemotherapy-Related Alopecia

 When caused by chemotherapy, alopecia varies from slight thinning of the hair to complete baldness. Depending on the choice of drugs and the dose, the extent of alopecia varies. Those drugs causing severe alopecia include methotrexate, vinblastine, adriamycin, ifosphamide, vincristine and taxoids to mention a few. The severity of alopecia depends on the combination of the drugs used which is the case with many treatment regimes. This kind of chemotherapy-related Alopecia is rated as one of the most severe, troublesome, and traumatic chemotherapy-related side effects. This hair loss is not permanent and the hair is sure to grow back once the treatment ends. 

 

  1. Traumatic Alopecia

 Being the most common cause of hair loss of some ethnic backgrounds mainly women of African/ Caribbean descent, it is caused as a result of hair grooming techniques by the use of hair reshaping products such as relaxers, straightener, hot combs, foam rollers, and permanent wave products along with hair braiding methods. Due to damage to follicles over time, this type of alopecia is divided into three categories:

 

a.Traction Alopecia, 

This results from persistent pulling by tight rollers, tight braiding, or ponytails. Also use of blow dryers, vigorous combing, brushing and bleaching of hair accelerates hair breakage. Whereas thinning begins above the ears and forehead, the causative styling methods, if not stopped, could cause irreversible hair loss destroying hair follicles. 

b.Chemical Alopecia, 

The use of commercial relaxer and styling products are the underlying cause of this kind of alopecia. While the products contain chemicals like thioglycolates, creating curls or straightening the hair destroys the disulphide bonds of keratin. Also, these chemicals have irritant effects on the scalp resulting in hair shaft damage, inflammation of the scalp and loss of hair roots. The ultimate result is irreversible damage to hair follicles.

c.Hot-Comb Alopecia, 

This is also known as follicular degeneration syndrome resulting from excessive use of pomades with a hot comb or iron leading to the gradual destruction of hair follicles. As pomades come in contact with a hot comb or hot iron, it liquefies and drips down the hair shaft into the follicle. As a result, chronic inflammatory folliculitis leads to scarring alopecia and subsequent permanent hair loss. The thinning is usually at the crown spreading evenly throughout the head making the condition irreversible.

 Common Myths Around Baldness And Hair Loss

 So many myths exist around hair loss, some that are serious whereas others that are not so serious. Following are some of the myths, 

  1. Male and female pattern baldness alike is inherited from the mother’s side of the family. Studies have concluded that it can come from either side of the family. 
  2. Hair grows faster and stronger by cutting it. The truth is that as hair grows longer, it is worn down by normal wear and tear and results in them getting slightly thinner around the diameter of the shaft. As you cut off the hair shaft that’s worn down, it is slightly thicker giving the impression that cutting it makes the hair look thicker. Regardless of whether it is cut or not, the hair grows almost exactly half an inch per month. 
  3. Hair loss can be caused by wearing a hat. In case the hat is prohibitively tight, any form of pulling or tightening can affect hair loss, however, it is not the cause of hair loss.
  4. Hair fall will be faster while towel drying the hair rigorously. This is only true if the hair was in the first place due to falling out anyway, and will not be promoted by additional hair loss with rigorous toweling.
  5. Hair loss can be done with by rubbing curry on the head. It does not work and along with that, it is likely to smell afterward as well.
  6. Repairing split ends. Split ends an never be repaired and should be cut off immediately to avoid splitting them higher damaging the hair even more. 
  7. Hanging upside or standing on your head increases the blood flow to the head and reduce hair loss. This is not true as of course, it increases the blood flow but it doesn’t help hair loss in any way.  

 How Does Quality Of Life And Psychological Aspects Affect Hair Loss?

 Being an integral part of the self and the identity, hair loss causes a wide range of psychological problems related to the identity of the person affected. With few physically harmful effects, alopecia may lead to problems such as a high level of anxiety, social phobias, paranoid disorder, and serious depressive episodes. The severity of psychological distress depends on the extent of Alopecia.

 Especially in the case of women, it is an important link between hair and identity. Studies prove feminity, sexuality, attractiveness, and personality are symbolically linked to a woman’s hair and hair loss can seriously affect self-esteem and body image. Around 40% of women with alopecia have marital problems as a consequence while about 63% claimed to have career-related problems.

 Even children with alopecia are reported to have psychological problems. 

 How Do You Manage Alopecia?

 There are several different ways in which Alopecia can be managed depending on the type and severity. These include the following methods:

  • The use of topical minoxidil, oral finasteride, topical tretinoin, exogenous estrogen, spironolactone, and anti-androgens make up the treatment for Androgenetic alopecia, with the type and dosage varying depending on the gender and age.
  • Use of immunomodulatory agents, like corticosteroids, 5% minoxidil, and anthralin cream, along with topical immunotherapeutic agents like dinitrochlorobenzene and diphenylcyclopropene are the best-known medication for alopecia areata.
  • When telogen effluvium is the cause of hair loss, the underlying cause is treated first. 
  • For cicatricial alopecia, the best medication is using systemic and topical therapy that includes the use of hydroxychloroquine, topical immunomodulators, like tacrolimus and pimecrolimus, intralesional injections of triamcinolone, mycophenolate mofetil, cyclosporine, and isotretinoin.
  • For excessive hair loss, wigs may be worn with an option or hair transplantation using mini grafts.
  • Traumatic alopecia requires more care and to reduce the risk, techniques for hair grooming should be used with caution bearing in mind the sensitivity of the scalp and follicles. Hair loss and partial hair growth can be abated by discontinuing the styling practices depending on the length of insult to the roots. By managing early, complete re-growth is not far away. 
  • By using laser phototherapy, it offers respite from drugs, chemicals, lotions, visits to hospitals, dermatologist centers and surgery that is non-toxic, safe and can be used at home.

 To Sum Up

 Though hair loss is a common condition faced by males and females alike, it does not come without treatment. The major step is diagnosing the underlying reason and finding the best-suited treatment to your scalp and hair follicles. Being a very delicate area, it has to be decided with caution and care. This will surely help in the re-growth and brings your hair back along with your self-esteem and confidence. 

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