Hair loss (Alopecia)

Alopecia refers to any form of hair loss, hair thinning, or balding anywhere in the body. There are a variety of causes which can lead to hair loss, though the most common and natural one is ageing.

Hair loss often goes untreated, since it is not considered as a disease, besides regular hair fall is also a natural phenomenon. However, this can lead to unfortunate consequences, if the hair fall is more than normal.

On an average, one can lose between 80 - 100 hairs a day, of the 100,000 to 150,000 hairs on an adult head. There is a cause for concern if the hair loss is double than that.

Acute hair loss, or a sudden increase in hair loss, could occur due to many reasons such as stress, pregnancy in women, male pattern baldness, female pattern baldness, exposure to strong sunlight, anaemia, hypothyroidism, vitamin B deficiency, autoimmune disorder, chemotherapy, etc.

Should you notice:

  • loss of clumps of hair from your scalp
  • excessive thinning of your hair
  • unexplained loss of hair from any part of the body
  • that you are tearing and pulling out your hair (Trichotillomania)
  • incomplete hair loss on the scalp and/or eyebrows

you need to consult your family physician or a general practitioner immediately.

Depending on your condition, the general practitioner may direct you to a dermatologist, a trichologist, or even an endocrinologist if the hair loss is related to hormonal imbalance. You may also be referred to a psychologist if you suffer from Trichotillomania.

No health feed found.

First, your doctor or dermatologist (a doctor who specializes in skin problems) will try to determine the underlying cause of your hair loss. The most common cause of hair loss is hereditary male- or female-pattern baldness. If you have a family history of baldness, you may have this type of hair loss. Certain sex hormones can trigger hereditary hair loss. It may begin as early as puberty.

In some cases, hair loss may occur with a simple halt in the cycle of hair growth. Major illnesses, surgeries, or traumatic events can trigger hair loss. However, your hair will usually start growing back without treatment.

Hormonal changes associated with pregnancy, childbirth, discontinuing the use of birth control pills, and menopause can cause temporary hair loss.

Medical conditions that can cause hair loss include thyroid disease, alopecia areata (an autoimmune disease that attacks hair follicles), and scalp infections like ringworm. Diseases that cause scarring, such as lichen planus and some types of lupus, can result in permanent hair loss because of the scarring.

Hair loss can also be due to medications used to treat cancer, high blood pressure, arthritis, depression, and heart problems.

A physical or emotional shock may trigger noticeable hair loss. Examples of this type of shock include a death in the family, extreme weight loss, or a high fever. People with trichotillomania (hair-pulling disorder) have a compulsion to pull out their hair, usually from their head, eyebrows, or eyelashes. Traction hair loss can be due to hairstyles that put pressure on the follicles by pulling the hair back very tightly.

 A diet lacking in protein, iron, and other nutrients can lead to thinning hair.

A number of factors can increase your risk of hair loss, including:
  • Family history of balding, in either of your parent's families
  • Age
  • Significant weight loss
  • Certain medical conditions, such as diabetes and lupus
  • Stress
Hair loss can appear in many different ways, depending on what's causing it. It can come on suddenly or gradually and affect just your scalp or your whole body. Some types of hair loss are temporary, and others are permanent.

Signs and symptoms of hair loss may include:

  • Gradual thinning on top of head. This is the most common type of hair loss, affecting both men and women as they age. In men, hair often begins to recede from the forehead in a line that resembles the letter M. Women typically retain the hairline on the forehead but have a broadening of the part in their hair.
  • Circular or patchy bald spots. Some people experience smooth, coin-sized bald spots. This type of hair loss usually affects just the scalp, but it sometimes also occurs in beards or eyebrows. In some cases, your skin may become itchy or painful before the hair falls out.
  • Sudden loosening of hair. A physical or emotional shock can cause hair to loosen. Handfuls of hair may come out when combing or washing your hair or even after gentle tugging. This type of hair loss usually causes overall hair thinning and not bald patches.
  • Full-body hair loss. Some conditions and medical treatments, such as chemotherapy for cancer, can result in the loss of hair all over your body. The hair usually grows back.
  • Patches of scaling that spread over the scalp.This is a sign of ringworm. It may be accompanied by broken hair, redness, swelling and, at times, oozing.
Before making a diagnosis, your doctor will likely give you a physical exam and ask about your medical history and family history. He or she may also perform tests, such as the following:
  • Blood test. This may help uncover medical conditions related to hair loss.
  • Pull test. Your doctor gently pulls several dozen hairs to see how many come out. This helps determine the stage of the shedding process.
  • Scalp biopsy. Your doctor scrapes samples from the skin or from a few hairs plucked from the scalp to examine the hair roots. This can help determine whether an infection is causing hair loss.
  • Light microscopy. Your doctor uses a special instrument to examine hairs trimmed at their bases. Microscopy helps uncover possible disorders of the hair shaft.
Medication

Medications will likely be the first course of treatment for hair loss. Over-the-counter medications generally consist of topical creams and gels that you apply directly to the scalp. The most common products contain an ingredient called minoxidil (Rogaine). According to the AAD, your doctor may recommend minoxidil in conjunction with other hair loss treatments. Side effects of minoxidil include scalp irritation and hair growth in adjacent areas, such as your forehead or face.

Prescription medications may also treat hair loss. Doctors prescribe the oral medication finasteride (Propecia) for male-pattern baldness. You take this medication daily to slow hair loss. Some men experience new hair growth when taking finasteride. Rare side effects of this medication include diminished sex drive and impaired sexual function. There may be a link between use of finasteride and a fast-growing type of prostate cancer.

Doctor also prescribe corticosteroids like prednisone. Individuals with alopecia areata can use this to reduce inflammation and suppress the immune system. Corticosteroids mimic the hormones made by your adrenal glands. A high amount of corticosteroid in the body reduces inflammation and suppresses the immune system.

You should monitor side effects from these medications carefully. Possible side effects include:

  • glaucoma, a collection of eye diseases that can result in optic nerve damage and vision loss
  • fluid retention and swelling in the lower legs
  • higher blood pressure
  • cataracts
  • high blood sugar

There is evidence that corticosteroid use may also put you at higher risk for the following conditions:

  • infections
  • calcium loss from bones, which may lead to osteoporosis
  • thin skin and easy bruising
  • sore throat
  • hoarseness

Medical Procedures

Sometimes, medications aren’t enough to stop hair loss. There are surgical procedures to treat baldness.

Hair Transplant Surgery

Hair transplant surgery involves moving small plugs of skin, each with a few hairs, to bald parts of your scalp. This works well for people with inherited baldness since they typically lose hair on the top of the head. Because that type of hair loss is progressive, you would need multiple surgeries over time.

Scalp Reduction

In a scalp reduction, a surgeon removes part of your scalp that lacks hair. The surgeon then closes the area with a piece of your scalp that has hair. Another option is a flap, in which your surgeon folds scalp that has hair over a bald patch. This is a type of scalp reduction.Tissue expansion can also cover bald spots. It requires two surgeries. In the first surgery, a surgeon places a tissue expander under a part of the scalp that has hair and is next to the bald spot. After several weeks, the expander causes the growth of new skin cells. In the second surgery, your surgeon removes the expander and places the new skin with hair over the bald spot.

These surgical remedies for baldness tend to be expensive, and they carry risks. These include:

  • patchy hair growth
  • bleeding
  • wide scars
  • infection

Your graft might also not take, meaning that you would need to repeat the surgery.

Most baldness is caused by genetics (male-pattern baldness and female-pattern baldness). This type of hair loss is not preventable.

These tips may help you avoid preventable types of hair loss:

  • Avoid tight hairstyles, such as braids, buns or ponytails.
  • Avoid compulsively twisting, rubbing or pulling your hair.
  • Treat your hair gently when washing and brushing. A wide-toothed comb may help prevent pulling out hair.
  • Avoid harsh treatments such as hot rollers, curling irons, hot oil treatments and permanents.
  • Avoid medications and supplements that could cause hair loss.
  • Protect your hair from sunlight and other sources of ultraviolet light.
  • Stop smoking. Some studies show an association between smoking and baldness in men.
  • If you are being treated with chemotherapy, ask your doctor about a cooling cap. This cap can reduce your risk of losing hair during chemotherapy.

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