Hair loss (alopecia)

Hair loss (alopecia)

Alopecia is partial or complete hair loss affecting the scalp or other parts of the body. It can be temporary or permanent, due to genetic predisposition, hormonal or age-related changes, various diseases, stress.

Causes of hair loss

Genetic predisposition

Androgenetic alopecia (androgen-dependent hair loss) is the most common cause of hair loss, distributed in the male (MPHL) or female (FPHL) type. The development of the disease is due to a genetic predisposition, hair loss occurs because of the increased sensitivity of hair follicles to the male sex hormone androgens. This process can start as early as adolescence, but usually affects adult men or women (progressing with the onset of menopause).

Autoimmune disease

Alopecia nervosa (or focal alopecia) is classified as an autoimmune disorder: for an unknown reason, the immune system attacks the hair follicles, resulting in hair loss on the head or other parts of the skin. In rare cases, there is complete loss of scalp hair (total alopecia) or hair on the entire body, including the eyebrow and eyelash growth area (universal alopecia). The risk is higher in people who have relatives with the same disease or relatives suffering from autoimmune diseases: type 1 diabetes, systemic lupus erythematosus, thyroid abnormalities.

Age

In most people, the anagen phase (the stage of active growth of hair follicles) decreases with age. The hair on the head becomes thin, brittle, and hair loss is diffuse. More often women older than 50 years are subjected to age-related alopecia. The first noticeable sign is a shift of the frontal hair growth line backwards.

Hormonal changes, diseases

Temporary or permanent hair loss can be related to hormonal changes (polycystic ovarian syndrome, discontinuation of oral contraceptives, pregnancy, childbirth, menopause), thyroid disease, fungal infections of the scalp (ringworm), psoriasis of the scalp, sexually transmitted infections (such as syphilis, if untreated).

Drug therapy

Some medications (for depression, cardiovascular disease, arterial hypertension, arthritis, gout) can provoke hair loss. Hair loss is also closely related to medications and treatments for cancer: chemotherapy drugs and radiation therapy (anagen alopecia, caused by toxic effects on hair follicles).

Other reasons

Hair loss can be triggered by stress (caused by physiological or psychological factors). It usually occurs in the form of a delayed reaction (after a few months), hair loss occurs quickly and in a short period of time. Such alopecia is called telogenic alopecia, it can also occur as a result of sudden hormonal changes.

Hair loss can also be associated with the choice of very tight hairstyles (braids, ponytails, bunches), improper combing, trichotillomania, use of aggressive cosmetics (traction alopecia, caused by external traumatic effects on the hair follicles). When hair follicles are destroyed, hair loss can become irreversible.

Finally, significant nutritional deficiencies, especially lack of iron, protein, or zinc; poor nutrition; significant weight loss; and an excess of vitamin A or selenium in the body can lead to hair loss.

Symptoms

A person normally loses between 25 and 100 hairs a day. If there is more hair loss, it is easy to notice when combing and washing your head. Hair becomes thinner, the parting becomes wider, the frontal hairline shifts, and bald spots appear.

The first noticeable signs of androgenetic alopecia in men are displacement of the frontal hair growth line backwards (baldness) and baldness of the crown of the head, in women – thinning of hair at the crown, thinning of hair in the parting zone.

The main symptoms of alopecia nervosa are hair loss in pockets in any area, the degree of hair loss varies and can be total. Hair loss is usually not accompanied by skin symptoms (pain, itching, peeling).

Diagnosis

Alopecia in many cases is successfully treated, the key to effective treatment of hair loss is determining the cause and establishing an accurate diagnosis.

Diagnosis of alopecia includes taking a medical history, examining the scalp and other areas of the skin, hair loss test, examining the scalp and hair under magnification (using a trichoscope), and in some cases scalp biopsies. Laboratory tests help rule out or detect diseases that may cause hair loss.

Further, depending on the results of diagnostic tests, a dermatologist (or trichologist) may recommend that the patient consult with a therapist, endocrinologist, gynecologist, rheumatologist and other specialists.

Hair Loss Treatment

Treatment of alopecia depends on the diagnosis and includes medication therapy and surgical methods (hair transplantation). There are vasodilating antihypertensive external agents (Minoxidil), corticosteroids (topically, orally, as injections), 5-alpha reductase inhibitor (Finasteride), immunosuppressive treatment, antimicrobial therapy for fungal skin lesions and other methods. In some cases, remission of the disease may occur spontaneously, without treatment (alopecia nervosa).

If hair loss is caused by an underlying disease, you should focus on treating it. If hair loss is caused by taking a certain medication, you should talk to your doctor. Depending on your individual situation, he or she may suggest stopping the medication or prescribing an alternative medication.

You can prevent hair loss (this includes preventable alopecia) by following these tips:

If you are being treated for cancer with chemotherapy drugs, discuss with your oncologist the possibility of using a cold helmet, with its help you can achieve a significant reduction in hair loss.