Wednesday, December 19, 2007

Alopecia: What is it?

Everyone is familiar with male pattern baldness, a condition that sooner or later catches up to at least two-thirds of men. But what about those three bald spots that appeared recently on the back of your head? You’ve recently noticed quite a few of your own hairs clogging up the shower.

What’s going on? What’s happening?

The loss of some hair - about 80 to 120 a day - is normal, part of the natural process of growth and replacement cycle. At any given time, about 10 percent of hair on the scalp are in a resting (telogen) phase in preparation for being shed. A new hair then begins to grow in the same hair follicle. Excessive hair loss, partial or total, is known as alopecia. And it comes in many forms.

The male-type baldness that is most common typically occurs in certain patterns - a receding hairline, a bald patch at the crown or a completely bald top. This type of hair loss is primarily determined by genetics and male hormones.

In response to dihydrotestosterone, some hair follicles shrink or become miniaturized, producing progressively shorter, finer hair. Known as androgenetic alopecia, this type of progressive hair loss can begin as early as in your teens.

Women also suffer from androgenetic alopecia, although generally without a receding hair line or completely bald areas. A woman may notice general thinning on top with a more exaggerated part line, that can be masked through hair styling.

Women with androgenetic hair loss do not necessarily have higher levels of male hormone but rather more androgen receptors in hair follicles.

Similar appearing diffuse hair loss can be a result of telogen effluvium - a condition in which the normal growth cycle of hair become abnormally shortened, causing a predominance of hairs in the telogen or resting phase preparing to be shed.

Telogen effluvium is a temporary condition, usually caused by stress, either emotional or physical, or abnormalities of the thyroid, parathyroid or pituitary glands. It can be reversed by identifying and treating the underlying cause.

The patchy hair loss that are suffering is more than likely alopecia areata, an autoimmune disorder that affects about 2 percent of both men and women. Although it can occur at any age, this type of hair loss is actually more common in children and young adults.

There is usually no clear reason why the immune system starts to attack hair follicles, and the problem often goes away on its own, usually to recur later. In milder forms, no treatment may be necessary, but it is still a good idea to see a trichologist. In severe cases, the patient may lose every hair on the head or even every hair on the body.

Treatment may involve corticosteroids - taken orally, rubbed on the skin or injected into the scalp. Anthralin cream, a psoriasis medication, may also be used.

Treatment usually requires counseling, behavioral therapy and antidepressant medications. Damage to the scalp should also be repaired.

Traction alopecia refers to hair loss caused by hair styles such as ponytails or corn rows that put excessive pressure on hair follicles. With both trichotillomania and traction alopecia, it’s important to stop the damage before scarring of hair follicles occurs. Any disorder or infection that causes scarring of the scalp can cause irreversible hair loss.

In addition to treating the underlying cause, most types of hair loss can be reversed to some extent with minoxidil in a topical solution to apply to the scalp.

Minoxidil revitalizes and increases the size of hair follicles that are dwindling in size, creating increased hair density in a certain percentage of patients. Minoxodil should not be used on scalp areas that are inflamed, infected or irritated.

The other treatment for male pattern baldness, finasteride, works by inhibiting the conversion of testosterone to dihydrotestosterone. As an oral prescription medication, it is not approved for females. It’s too easy to dismiss thinning, receding or patchy hair as a cosmetic problem. Even though only about five percent of cases are caused by illness, hair loss can have a damaging effect on image and self confidence in social relationships.

Some persons have patchy hair because they can’t stop pulling it out. Trichotillomania is a compulsive hair pulling behavior that the individual may try to hide. Sometimes a response to stress, this disorder often starts in childhood. For further advice why not speak to one of our trichologists today.