Alopecia (hair loss)

Гінекологія Dermatology
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Alopecia or baldness, hypotrichosis, baldness is a pathological condition in which a person loses hair. The problem affects many people and causes significant psychological discomfort. It can occur due to various reasons and attempts of self-treatment rarely help restore the hair cover and eliminate baldness.

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Professional consultation with a dermatologist at Universum Clinic will help patients restore body aesthetics. And, sometimes, for this, you don't even have to take a course of expensive therapy.

Classification and types of alopecia

Every day, every healthy person loses from 30 to 200 hairs. This is a physiological process; new ones grow in place of lost ones. However, sometimes there are failures in the change of "generations" of hair, and then alopecia occurs.

Baldness can occur for three reasons:

  1. Excessive hair loss.
  2. Insufficiently active recovery of the growth of new hair.
  3. Combination of the first and second mechanisms at once.

As a result, there are bald spots, individual hairless areas, and total baldness. Understanding the situation and determining the factor that causes hairless areas is the first step to restoring a beautiful hairstyle.

In their practice, dermatologists divide alopecia into two major categories:

  1. Congenital hypotrichosis. As a rule, they are associated with disorders of the formation of hair follicles. The problem manifests itself in childhood and is very difficult to treat.
  2. Acquired baldness is the most common situation. Hair loss begins against the background of its normal appearance and quantity, as a result of the influence of one or another factor. At the same time, the reasons for hair loss are not always obvious.

As for clinical classification, alopecia is divided into two forms, according to the extent of baldness:

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  1. Focal hypotrichosis, is when more or less limited hairless areas appear on the head and body.
  2. Diffuse alopecia - uniform loss of hair on the head and face. Sometimes eyebrows with eyelashes can fall out.

Both of these types of baldness have their own causes and differences that need to be identified and eliminated. There is another problem: if focal lesions are not treated they can turn into a total, diffuse form.

Provocative factors

Congenital alopecia occurs due to defects in the development of hair follicles: there are either few of them, or they are not able to function normally.

Many different factors can cause various forms of acquired hypotrichosis.

Frequent causes of focal alopecia (Alopecia areata)

The signs of this type of baldness are quite characteristic: loss of hair cover in the form of spots, and areas of baldness. At the same time, the normal density of the hair cover is preserved in the adjacent areas of the head and body.

In men and women, focal alopecia appears due to the following reasons:

  • skin infections, for example - demodicosis, fungal infection, herpes;
  • some infections (syphilis);
  • osteochondrosis of the cervical spine, occipital neuritis - the skin and hair follicles suffer;
  • stressful situations;
  • heredity, which includes widespread androgenetic alopecia;
  • focal scleroderma is a dermatological pathology in which scar tissue appears instead of normal skin;
  • unbalanced nutrition, in particular - deficiency of sulfur intake with food.​

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The most common cause of hypotrichosis nowadays is stress. Also, nest baldness often occurs due to hormonal disorders. The function of the hair bulb depends on the level of testosterone, so fluctuations in sex hormones in men and women lead to the appearance of hairless areas.

Common causes of diffuse alopecia 

Such situations, as a rule, are a symptom of one or another systemic disease or disorder.

Uniform hair loss over a large area can occur due to the following reasons:

  • severe stress - spasm of blood vessels reaches the hair follicles, their nutrition and function are disturbed;
  • use of certain drugs (cytostatics);
  • poisoning by heavy metals, mercury;
  • severe infection with exhaustion;
  • massive blood loss – women’s baldness  can occur after obstetric bleeding;
  • age changes, involution of hair follicles;
  • diseases of the glands of endocrine secretion - thyroid, testicles, ovaries.

Unfortunately, diffuse alopecia of the head can occur due to improper care. For example, using the wrong shampoo or water with the wrong temperature.

Signs and symptoms

Focal alopecia manifests itself as:

  • rounded hairless foci, single or multiple, appear on areas with a hair cover;
  • whether there will be unpleasant sensations - depends on the reason, but usually they are absent;
  • later, bald areas multiply and merge.

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In the case of a favorable course and treatment, it is possible to restore uniform hair in 4-6 months. If the pathology has an unfavorable course, hair follicles die in the affected areas, then it is almost impossible to return a normal hairstyle.

Manifestations of diffuse alopecia consist in the loss of the hair cover in a large area, for example, the head or beard. And, as a rule, they are combined with the symptoms of the pathology that caused diffuse baldness. Sometimes hypotrichosis can become the first noticeable symptom of a particular pathology, for example, thyroid gland dysfunction.

Androgenetic baldness

A common variant of baldness, which occurs not only in men, but also in women. An imbalance of male and female sex hormones in the blood provokes dysfunction of the follicles, long hair is replaced by short, thin, thinning and falling out.

 

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Androgenic alopecia has its own signs and degrees:

  1. at first, triangular bald patches appear on the temples;
  2. then the areas of the forehead and the back of the head become bald;
  3. the parietal region of the head suffers next;
  4. later, the hair remains only in the area between the forehead and the parietal area;
  5. the fifth degree of androgenetic alopecia - complete disappearance of hair on the head.

The sooner a person goes to the clinic, the more chances there are to stop the process and restore aesthetics to the body.

Diagnostics

An experienced dermatologist will already be able to suggest how to deal with hypotrichosis based on the complaints and history of the patient's life and work. But in order to determine and eliminate the exact cause of baldness, additional examinations will be needed:

  • examination of affected areas of the body using a dermatoscope;
  • a trichogram is performed - microscopy of hair that has fallen out and is growing;
  • ultraviolet illumination with a Wood's lamp;
  • microscopy of skin scrapings from affected areas;
  • blood tests for hormones: androgens; thyroid hormones;
  • measuring the level of cholesterol, minerals in the blood;
  • examination of the condition of the nerves and vessels of the cervical spine, dopplerography.

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If necessary, other specialists are involved: consultation of a neuropathologist, an endocrinologist.

Treatment

There is no universal method of treating alopecia, neither diffuse nor focal, and there cannot be. Everything depends on the cause of hypotrichosis.

Trichologists can recommend:

  • treatment of the main dermatological pathology (demodecosis, seborrhea, pyoderma);
  • sedatives;
  • immunomodulatory drugs;
  • drugs to improve blood circulation in the skin;
  • vitamins and minerals;
  • physiotherapeutic methods (photolaser therapy, UFO, acupuncture);
  • metabolic drugs, platelet-rich plasma; -
  • phytotherapy - decoctions and infusions of buckwheat, burdock root, violets, parsley;
  • antiandrogenic drugs;
  • medical cosmetics - masks, oils, lotions.

A well-thought-out therapy, a combination of local and systemic agents, helps stop hair loss and restores normal function to the hair follicles. As a rule, this process is not fast: sometimes it takes several months to get rid of baldness.

It also happens that after the examination, the doctor gives the person a recommendation to change the temperature of the water used to wash his head or advises him to use a different shampoo. Then the effect is achieved quickly, in a few weeks.

Also, every Universum Сlinic patient receives recommendations for the prevention of baldness in the future.

Literature

  1. Phillips TG, Slomiany WP, Allison R. Hair Loss: Common Causes and Treatment. Am Fam Physician. 2017 Sep 15;96(6):371-378. PMID: 28925637.
  2. Tai T, Kochhar A. Physiology and Medical Treatments for Alopecia. Facial Plast Surg Clin North Am. 2020 May;28(2):149-159. doi: 10.1016/j.fsc.2020.01.004. PMID: 32312501.
  3. Lin RL et al. Systemic causes of hair loss. Ann Med. 2016 Sep;48(6):393-402. doi: 10.1080/07853890.2016.1180426. Epub 2016 May 5. PMID: 27145919.
  4. Lolli F et al. Androgenetic alopecia: a review. Endocrine. 2017 Jul;57(1):9-17. doi: 10.1007/s12020-017-1280-y. Epub 2017 Mar 28. PMID: 28349362.
  5. Fukumoto T et al Treatments for alopecia areata: A systematic review and network meta-analysis. Dermatol Ther. 2021 May;34(3):e14916. doi: 10.1111/dth.14916. Epub 2021 Mar 4. PMID: 33631058.

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F. A. Q.
How to cure alopecia on the head?
  • contact the clinic for a consultation with a dermatologist, trichologist;
  • find out the cause of baldness;
  • undergo a course of treatment and follow the recommendations for further scalp care.
How quickly does hair fall out with alopecia?
  • focal baldness can occur in a short time, in a matter of days;
  • diffuse baldness usually develops gradually over several months;
  • androgenic alopecia begins at the age of 20-30 and develops over decades.
How dangerous is alopecia?
  • if baldness is a symptom of some pathology, then ignoring hair loss leads to the progression of the underlying disease;
  • psychological complexes arise, provoked by a cosmetic defect;
  • the psycho-emotional state worsens, depression develops;
  • the social and professional side of life suffers.
 

 

Which alopecia is not treated?
  • a noticeable effect cannot be achieved with some forms of hereditary, congenital baldness;
  • it will not be possible to restore the hairstyle therapeutically if the hair follicles in the scalp or face have died.
What can cause alopecia?
  • congenital absence of hair follicles;
  • violation of blood supply to the skin;
  • bacteria, fungi and parasites;
  • problems with digestion, improper nutrition;
  • stress;
  • increased sensitivity of bulbs to male sex hormones;
  • injuries of hairy areas;
  • improper hair and beard care;
  • connective tissue diseases: systemic lupus erythematosus, diffuse scleroderma, dermatomyositis;
  • neuroses, when people do not control themselves and pull out their hair, pluck their eyebrows, beard.
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