What is Hair Loss?
Also known as alopecia, hair loss is referred to the phenomenon of excessive hair fall from the scalp or the body. Severe conditions of hair loss may even lead to baldness. The process usually starts with less number of hair falls but with passing time, it may get severe enough so that plenty of hair starts falling.
Baldness or excessive hair loss can be due to hereditary conditions. It may affect anyone, children women or men. However, it is more readily found in men of older age.
Hair loss may also be taken as a social problem. Some people may try to hide baldness with the help of wigs but if it occurs it may be the best to discuss with your doctor for possible treatment options.
Alopecia may arise from various triggers, such as psychological compulsion to pull one’s own hair, specific hairstyling routines (tight ponytails or braids) or burns to scalp which can take place through caustic hair relaxer solutions or hot hair irons.
When hair fall occurs in only one part of the body, it is known as alopecia areata. When this happens to all parts of the body, it is called alopecia universalis.
Symptoms of Hair Loss
Hair loss can either be permanent or temporary.
Permanent Hair loss
Androgenetic alopecia: In case of males, pattern baldness or androgenetic alopecia may start early (in the 20’s). This may lead to partial or complete baldness. However in women pattern baldness results in partial hair loss of the front, side or crown. It is observed that women maintain their frontal hair loss. Complete baldness is very rare in women.
Scarring Alopecia: Scarring alopecia is caused by inflammation, which damages and scars the hair follicles leading to permanent hair loss.
Temporary Hair Loss
Traction alopecia: Traction alopecia occurs due to certain regular hairstyles, such as pigtails, braids or cornrows. It may also occur due to the use of hot rollers. This type of hair loss is usually limited to the portion of hair where it is pulled tightly or sometimes along the rows.
Telogen affluvium: This type of hair loss occurs suddenly. A handful of hair may detach from the scalp while combing or gently pulling your hair. This type of hair loss results in thinning of hair all over the scalp but not in complete baldness.
Alopecia areata: This type of hair loss usually occurs in small patches. The patches may occur at various portions of the scalp. This type of hair loss can also occur at eyebrows, eyelashes and beard. In some cases, it may lead to hair loss of the complete body. If it occurs on the entire scalp, then it is known as alopecia totalis. Alopecia universalis refers to the condition of having the effect on entire body.
Diagnosis of Hair Loss
For diagnosis of alopecia, the doctor might want to learn about the complete family history, medical history of the patients and the symptoms. The pattern of hair loss and appearance of nearby hairs will be closely observed for making the diagnosis. However, if these factors are not enough to surely diagnose hair loss, some additional tests may be required.
A pull test may be performed to judge the situation of the patient. In this test, dozens of hairs are pulled out gently to see whether there are possibilities of Telogen affluvium.
A skin scrapping may also be performed to assess the condition of hair fall. A sample taken from the skin or a handful of hairs taken from the scalp is tested for possible infections in this process.
When diagnosis is difficult, especially in cases of alopecia areata or scarring alopecia, a punch biopsy may be performed by the doctor. A small section of the deeper layers of the skin is taken out for testing in this process.
Sometimes, hair loss is the outcome of some other underlying medical conditions, such as thyroid disease, diabetes or lupus. The doctor therefore may screen for these conditions. Sometimes, hair loss also occurs due to the use of some specific medicines, such as those for gout, depression, arthritis, heart problems and high blood pressure. So, the doctor may also verify whether the patient is taking any of these medications, too.
Causes of Hair Loss
Various reasons may be associated with hair loss. Some of the major causes are outlined here.
1. It is believed that androgenetic alopecia has a relation with genetic conditions. Heredity plays a major role in pattern baldness.
2. Fungal infections, including “black dot”tinea or tinea capitis may be associated with hair loss.
3. Chemicals may also contribute to hair loss. Frequent use of chemical based hair relaxer may result in hair loss.
4. Heat damage, such as use of frequent hot combs may also contribute to hair loss.
5. Compulsive behavioral aspects, such as hair pulling may also contribute to alopecia.
6. Medical conditions, such as hypothyroidism and iron deficiency may be behind hair loss.
7. Physical or psychological stress may contribute to Telogen effluvium.
8. Genodermatoses or hereditary disorder of the hair shaft may also be responsible for hair loss.
9. Syphilis may also be a reason for frequent hair loss.
10. Discoid lupus erythematosus or chronic cutanous lupus erythematosus may also result in hair loss.
Types of Hair Loss
Hair loss may be divided into five major parts depending upon their nature.
1. Androgenetic alopecia or pattern baldness refers to the hereditary baldness in men and women. It is found that persons who have a family history of baldness usually suffer from this type of hair loss.
2. Scarring alopecia occurs when inflammation damages or scars the hair follicles. This condition prevents new hair growth and can be seen in several skin conditions, including lupus erythematosus or lichen planus.
3. Alopecia areata is an autoimmune disease. Although the predominant reason is unknown yet, some people believe genetic factors or viral infection may result in this condition.
4. Telogen effluvium results from change in normal hair cycle. It is believed to result from a sudden shock to the hair system which results in premature resting of the hairs leading to hair loss.
5. Traction alopecia results from some kind of traction such as strict hair styles and some kind of pulling of the hair.
Treatment of Hair Loss
Although baldness is not treatable, there are various medication and surgery options available for minimizing hair loss.
Medications: There are many medications, both over the counter and prescription drugs to treat alopecia. One of the most effective over the counter medication is minoxidil (Rogaine). It is spproved as a remedy for androgenetic alopecia and alopecia areata. It is available in liquid or foam that should be applied over the scalp. Minoxidil is effective in minimizing hair loss and initiating new hair growth.
Finasteride (Propecia) is a medication for male pattern baldness and is available in pill form. It is believed to slow down the rate of hair fall and, sometimes, initiate new hair growth. It works by stopping the conversion of testosterone into dihydrotestosterone (DHT), a hormone responsible for shrinking the hair follicles. However, it could be dangerous for women of childbearing age and is not approved for women due to its serious effects on the male fetus.
Corticosteroids are applicable for alopecia areata. The most common form, as injections, is administered to reduce the effects of alopecia areata. Usually, new hair growth is visible weeks after the injection. It si also available in pill and ointment form, hwoever, these can be less effective.
Various surgery options, such as hair transplants and scalp reduction surgeries are available for treating hair loss. While hair transplants are useful for implanting hair on balder sections, scalp reduction is based on the principle of decreasing the bald sections of scalp.
Living with Hair Loss
Hair loss may be genetic and the only restrictions that can be applicable is to obey the doctor’s advises to reduce hair fall.
Prevention of Hair Loss
Some of the preventive measures for stopping hair loss include eating nutritious diet, handling the hairs gently, avoiding tight hairstyles and compulsive traction and the over the counter nonprescription drugs for minimizing hair fall.