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ALOPECIA

 Alopecia is a generic medical term for all forms of hair loss, from the patchy baldness of alopecia areata, which in some cases becomes total loss, to the diffuse thinning and male pattern baldness of alopecia androgenetica.

  Hair loss can be sudden, frightening and severe.  Although it is not life-threatening or even physically painful, alopecia causes a high level of psychological and emotional suffering.  A survey by Hairline International of women who had lost or were losing their hair found that 76% felt less of a woman; 40% said that marriages (or long term partnerships) had suffered and of these many had broken down; whilst 63% said they had been forced to compromise a career.  A large proportion of the respondents (43%) had considered suicide.

  Types and Symptoms

  Alopecia areata (patchy baldness)

Affects both men and women.  In children it often begins at puberty.  This is a scalp disease which usually starts with a small circumscribed patch of baldness.  Other patches may follow.  The affected hair follicles slow down production, become very small and often grow no hair that is visible above the surface for months of years.  However the follicles remain alive and can resume hair production with the appropriate trigger.

Alopecia areata can develop into total loss of scalp hair (alopecia totalis) or the loss of all body hair including the scalp – alopecia universalis – which occurs in about one fifth of cases.

  Androgenetic alopecia 

The natural balding of ageing seen in both men and women (‘male’ pattern baldness).  It is an hereditary condition which usually occurs at a younger age in men.

  Telogen effluvium

The human moult hair loss occurs after the body has suffered severe trauma of shock. It can be quite stressful and it results in clumps of hair being lost at all times not only in the bath but just gentle pull will result in severe hair loss .Sometimes the hair collected is so much that it can fill a bag. The treatment is usually to take vitamins and wait for hair to regrow. 

  Hair loss related to medication

The side effects of some psychiatric drugs, antidepressants and Warfarin, as well as chemotherapy treatment can include significant hair loss.

  Trichotillomania

Hair loss which is self-inflicted.This is usually seen a rough irregular hair loss area close to but typically not involving the scalp margin and also about 2-8 mm hair remains. Some amount of trauma to the scalp may be seen.

  Causes

Alopecia areata is believed to be an autoimmune disease in which the body rejects the hair follicle.  The alopecia areata may be more severe in patients who have eczema, asthma or hay fever.  Other factors include: thyroid conditions, vaccinations and stress.  It can also be a family problem.  One-in-five patients can recall a relative with a similar condition.

Many younger women also develop androgenetic alopecia, because they have an over-sensitivity to the androgens (male hormones) in the blood.  When they have predisposed sensitivity, progestogen containing contraceptive pills can exacerbate the problem.  Hormone replacement therapy (HRT) has similar components to the pill and many women find that their hair becomes thinner during this treatment.  The stress of modern life is a common causative agent.

  Treatments

For alopecia areata, and its related conditions, re-growth success has been achieved with the use of topical steroid creams plus topical minoxidil, systemic steroids (such as Prednisolone) and, occasionally, zinc.  In severe cases and those of total loss, the phenol derivative diphencyprone is often successful.  Immunosuppressive drugs such as cyclosporin and Azathioprine have had some success.

Topical minoxidil preparations improve the thin hair of alopecia androgenetica.  This has a success rate of approximately 40% and is available without a prescription.  Anti-androgen drugs such as cyproterone acetate can also help.  Many cases recover without medical treatment.

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ALOPECIA AREATA - CLICK HERE

Generalized alopecia                      

Alopecia areata