Alopecia

Alopecia is the medical term for hair loss, which can range from small patches to widespread hair loss all over the body.

Overview

Alopecia may be linked to environmental, lifestyle or genetic factors, which vary depending on the individual; or it may have no obvious cause.

There are several different types of alopecia, which may determine whether the condition is temporary or permanent, as well its treatment.

Most people normally shed 50-100 hairs daily, which can be more obvious and disconcerting in those with longer hair. Typically, this is not anything to worry about. The vast majority of people find their hair changes as they age – for example thinning out, becoming more brittle or changing texture – however, the early onset, or sudden appearance of alopecia can be worrying and negatively impact individuals’ confidence and self-esteem.

For many individuals, alopecia can be upsetting and traumatic, so it may be helpful to seek support from groups or organisations that can provide additional resources, such as Alopecia UK or Alopecia Awareness. There are also communities on social media, and both male and female celebrities with alopecia now share their stories to help support others with the condition.

Alopecia can be temporary, or it can be permanent – which may be affected by genetic factors. If your mother or father has alopecia, you may be more likely to have it as well.

While some types of alopecia may respond to lifestyle changes, it’s wise to visit the GP, to rule out underlying medical conditions.



It’s especially important to see a doctor if;

  • Hair loss is sudden
  • Bald patches appear
  • Hair loss is occurring in ‘clumps’
  • The skin of the scalp is itchy or ‘burning’


Symptoms of Alopecia

Hair loss occurs in everyone, and it may follow a pattern, or be relatively random, as each experience is completely unique.

The rate at which an individual experiences of hair loss can vary significantly from person to person. Even when there is a genetic predisposition to hair loss, the presentation of alopecia may be completely different between siblings who share the same parents, or even twins.

There are broadly 6 types of alopecia;

This is the scientific name for genetic hair loss. It is the most common form of alopecia, which affects most people at some point in their lives, sometimes developing in the late teens. It may also be called as male or female pattern baldness, or abbreviated as MPB or FPB. In males, androgenic alopecia often presents in a horseshoe shaped ring of hair recession, but the severity and rate of hair loss varies. Some men may see a minor receding hairline and thinning hair, while others suffer complete hair loss from the front all the way to the crown.

The most common presentation of patchy hair loss on the scalp is how most people think of alopecia. This recurrent autoimmune condition often presents as round or oval patches, most commonly on the scalp or in the eyebrows – although it can appear in any area hair grows. While patches will usually naturally regrow within six months to a year, many patients who develop alopecia areata say it can return in the same places. Alopecia areata can progress to alopecia totalis, meaning the loss of all scalp hair, and in rare cases it can affect the entire body, when it is called alopecia universalis.
This is caused by chronic traction, or pulling, on the hair follicle, It often presents in areas of the scalp where a hairpiece is frequently affixed, or where traction is caused by a hairstyle, for example, tight ponytails, braids or dreadlocks. Traction alopecia may also be a result of trichotillomania, a compulsive disorder in which patients pull on, or ‘pluck’ hairs, usually in a specific area, creating unusual hair loss patterns that differ distinctly from alopecia areata, but which can also lead to cicatricial (scarring) alopecia or long-term permanent hair loss.

This condition is the result of injury to the scalp caused by physical trauma, disease or burns that may leave permanent scars and permanent hair loss.

When the patches of alopecia areata progress to the loss of all the hair on the scalp hair, it is called alopecia totalis, and in rare cases it can progress further to affect the entire body. While generally, alopecia areata is temporary and hair regrows naturally, the likelihood of regrowth decreases in patients with alopecia totalis, or alopecia universalis.

In the rare instances when alopecia areata progresses to the widespread loss of all hair on the body, it is known as alopecia universalis. While generally, alopecia areata is temporary and hair regrows naturally, the likelihood of regrowth decreases in patients with alopecia totalis or alopecia universalis.

Causes of Alopecia

The causes of alopecia vary for each individual and although lifestyle habits and environment do play a role, the most common reason is genetics, meaning that hair loss is almost always inevitable, although it may respond to medical treatment.

Some factors that correlate with thinning hair are smoking, excess alcohol intake, and exposure to strong chemicals or ultraviolet (UV) light. These factors may contribute to, or accelerate hair loss, and so making choices that eliminate unhealthy habits will help to maintain healthy hair and scalp, which may slow alopecia and promote hair regrowth.

Temporary hair loss will usually naturally return within six months to a year, and while it’s best to have a doctor check for any underlying conditions, some causes may be illness, stress, cancer treatment, weight loss or an iron deficiency.

The different types of alopecia will have different causes, for example;

In men, male pattern baldness (MPB) is likely to be genetic, and it may be brought on by the onset of puberty, when the androgens (the hormones that produced in the adrenal gland and are associated with the development of the reproductive system) in the blood naturally increase.

This autoimmune condition means the body’s immune system (which usually defends against foreign substances, like viruses or bacteria) is mistaking the healthy cells of the hair follicles for foreign substances. Beyond knowing that it is an autoimmune issue, alopecia areata frustratingly has no known specific cause, although many patients cite stress or anxiety as contributing factors.

This is caused by chronic traction, or pulling, on the hair follicle, and often presents in areas of the scalp where a hairpiece is be frequently affixed, or where traction is caused by the hairstyle (for example, tight ponytails, braids or dreadlocks.) Traction alopecia may also be a result of trichotillomania, a compulsive disorder in which patients pull on, or ‘pluck’ hairs, usually from a specific area, creating hair loss patterns that differ distinctly from alopecia areata. If untreated, traction alopecia can lead to cicatricial (scarring) alopecia or long-term permanent hair loss.

This is when injury to the scalp is caused by physical trauma, disease or burns, which may leave permanent scars and hair loss. Chemical processes on the hair and scalp weaken the protein bonds of the hair, making it more susceptible to breakage, and can chemically burn the scalp. Some common chemical processes include bleaching, tints and dyes, perming or relaxing treatments – even if

performed by a qualified professional in a salon. Autoimmune diseases such as lupus or scleroderma may cause scalp scarring, but cicatricial alopecia can also be caused by bacterial infections – like folliculitis; fungal infections; and viral infections - such as shingles.

The progression of the autoimmune condition alopecia areata is the cause, and arises as the body’s immune system (which usually defends against foreign substances, like viruses or bacteria) is malfunctioning and attacking the healthy cells of the hair follicles.

In the rare instances when autoimmune condition alopecia areata progresses to alopecia universalis, this occurs as the body’s immune system (which usually defends against foreign substances, like viruses or bacteria) is malfunctioning and attacking the healthy cells of the hair follicles.

Treatment of Alopecia at Derma

The first step in treating alopecia is identifying the type of hair loss and what’s caused it. Your appointment will begin with a skin check and medical history, followed by recommended treatment options.

For some forms of alopecia, the dermatologist will need to take a biopsy in addition to an examination of the scalp in order to analyse the hair follicles.

Some treatments for alopecia include; steroid injections, creams, lotions, or tablets, dependent on the type of hair loss. The dermatologist will explain all of the potential side-effects, to enable you to select the best treatment option for you. Please note that not all patients are suitable for all treatments, and in some instances, tests and follow-up appointments will be required to manage the treatment.

At Derma, we have seen and treated all types of Alopecia, so you can be assured that Derma will provide the very best care, the latest research and the most effective treatments.

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