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Alopecia (baldness or hair loss)
What is alopecia?
Alopecia (also known as baldness or the hair loss) refers to the loss or absence of hair on part or all of the scalp and in some cases, other body parts. Loss hair can be temporary or permanent and can affect people of all ages. Although alopecia can occur anywhere on the body, it is more painful when it affects the scalp. It may be a small bare area, which is easily masked by hairstyling to a more diffuse and more obvious patterns [3, 4].
Causes of alopecia
Causes include alopecia,
1. Genetic
2. prolonged fever 8. Ringworm of the scalp (tinea capitis)
9. Some prescription
(To name a few)
Types of Alopecia
Different types of alopecia associated with loss of hair on the scalp in particular,
1. Androgenetic alopecia (hair loss genetic)
androgenetic alopecia, also known as Baldness is a major problem that affects men and is such that by age 50 years, up to 50% of men who are genetically predisposed to be affected. It is characterized by progressive hair loss reasons on the scalp and its prerequisites are a genetic predisposition and sufficient circulating androgens (steroid hormones like testosterone or androsterone, that promotes male characteristics). According to Sinclair (1998) all white males have a hereditary predisposition autosomal, and as such, 96% lose hair to some extent. Sinclair also noted that white men are four times more likely develop premature baldness, that black men. Hair loss usually starts after puberty with a growth rate very variables [1, 5].
The condition is fairly common in women and is known as hair loss in women. Among women, "it is characterized a reduction in hair density diffuse on the crown and frontal scalp with retention of the frontal hairline "[6]. Birch et al (2002) are mention that some women, hair loss can affect a small area of the frontal zone, while in others the entire scalp is involved. Peak loss female hair, the hair becomes very sparse on the scalp just above a rim of hair is retained along the frontal margin. The top (crown or above the head) baldness in men is rare among women, but a female model of baldness is not uncommon among men [6]. The nature of androgen-dependent or the genetic basis of female hair loss has not been clearly established, although a study by Sinclair et al (2005) showed that androgens play an important role in the development of hair loss in women.
2. Alopecia areata (AA)
Alopecia areata (AA) is a common mediated immune nonscarring form of hair loss, which occurs in all ethnic groups, age (more common among children and young adults), and both sexes, and affects about 1.7% of the population [8, 9]. Alopecia areata is unpredictable and patients usually present with several episodes loss and regrowth of hair during their lifetime. Recovery of hair loss may be complete, partial or nonexistent. It is believed that 34-50% of patients suffering from AA will recover in one year, while 15-25% will progress to total hair loss or loss of all scalp and body hair with full recovery is rare [8, 11]. It usually presents as an oval spot one or more spots confluent asymptomatic (without signs or symptoms disease), alopecia circumscribed with a severity ranging from a small bare plot to the loss of hair all over the scalp. characteristic frequent patches AA exclamation point hairs, which may be present at its margin, the exclamation mark hairs are broken, the hairs short, which taper proximally. Hair loss of AA may be the only obvious clinical abnormality or there may be associated abnormalities of the nails. Other Less common associated diseases include thyroid disease and vitiligo [4, 10, 11].
The clinical presentation of AA is subcategorised based on the model and the extent of hair loss. If classified according to the model, the following are considered;
a. patchy AA, which is composed of round or oval patches of hair loss and is the most common
b. reticular AA, which is a crosslinked (network) model loss of hair in places,
C. ophiasis band like AA, which is the loss of hair in the scalp parieto-temporo-occipital (middle of the next record scalp)
d. ophiasis inversus is a rare band like hair loss in fronto-temporal-parietal scalp (front side of the East scalp), and
e. diffuse AA, which is a decrease in the density of diffuse hair.
[Extract Shapiro J and S Madani, 1999]
If combined the extent of participation, the following can be seen;
a. alopecia areata, which is the partial loss of hair,
b. total alopecia, which is 100% hair loss, and
C. alopecia universalis, which is 100% of hair loss.
[Extract Shapiro J and S Madani, 1999]
3. Telogen effluvium (TE)
telogen effluvium is an abnormality of hair cycling, which results in excessive loss of telogen (rest phase of hair cycle) and hair is more common in women. Women with this disorder do not usually notice an increased amount of hair on their hairbrush or shower floor. the daily loss of hair can vary from 100-300 hairs. It is believed that TGF can unmask previously unrecognized androgenetic alopecia. The most common underlying cause TE is the stress, other causes include diseases such as diseases of the thyroid and pituitary, certain medications and birth to name a few. In many cases, however, no cause can be found. TE usually begins two to four months after the event causal and may take several months [4, 12]. Unlike some other hair loss conditions, TE is temporary and hair growth is possible [4]. telogen effluvium present in about three forms;
a. Acute telogen effluvium, which should stop shedding of hair in 3 to 6 months
b. diffuse chronic telogen hair loss, which are telogen hair shedding persisting longer than 6 months. The common causes are thyroid disorders, acrodermatitis, profound anemia and malnutrition.
C. chronic telogen effluvium (CTE) is the most common cause of hair loss in women, affecting 30% of women aged 30 and 60 years, the United Kingdom. ETC is such that there is a relative change in the proportion of growing hair at rest and in most cases, excessive hair shedding has been present for at least six months. According to Rushton et al (2002) studies have shown that 95% of cases occur ETC from a nutritional imbalance involving the essential amino acid L-lysine and iron. Other common causes of CTE include drugs, thyroid disease and childbirth [1, 11].
4. Cicatricial alopecia (scarring alopecia)
Circatricial alopecia, also known as a scarring alopecia, refers to a group of rare disorders hair from a condition that damages the scalp and the hair follicles. They appear as areas of hair loss in which the underlying scalp is marked sclerotic or atrophic. In other words, disorders of the hair follicle to destroy and replace with a scar follicles thus causing the tissues permanent hair loss. Conditions associated to alopecia circatricial include autoimmune diseases such as lupus erythematosus, discoid scalp trauma, infections such as tuberculosis and syphilis, and radiotherapy. Circatricial alopecia affects both adults and children, and may present as primary or secondary alopecia circatricial [4, 13].
5. Alopecia associated with chemotherapy
Alopecia caused by chemotherapy can vary from a slight thinning hair to baldness. The extent of alopecia depend on the choice of drug and its dose. Drugs that cause alopecia include serious methotrexate, vinblastine, adriamycin, ifosphamide, vincristine and taxoids to mention a few. When drugs are used in combination, which is generally the case with the treatment of many schemes, the incidence and severity of alopecia may be higher than usual. By Randall et al (2005) "alopecia due to chemotherapy was assessed by patients as one of the most severe and painful traumatic side effects associated with chemotherapy. The loss of hair due to chemotherapy is not permanent and as such, hair grow back after treatment ends [14].
6. traumatic alopecia
It is usually a very common cause hair loss in women of certain ethnic groups (especially women of African descent and the Caribbean). It is caused due to hair grooming techniques through the use of hair products such as recasting straighteners, irons, hot combs, foam rollers and perming products and methods braiding hair. These techniques hair follicle damage over time [15]. Traumatic alopecia is divided into three categories;
a. Alopecia traction resulting from the persistence of hair pulling with rolled tight, tight braiding or ponytails. The use of hair dryers, vigorous combing or brushing and bleaching of hair can also contribute to hair breakage. Thinning begins above the ears and forehand, and if the methods causal style are not stopped, hair loss can result in irreversible hair follicles that are destroyed [15, 16].
b. alopecia chemical resulting from the use of commercial relax and styling products. These products contain chemicals such as thioglycolates, which create loops or smoothing hair by destroying the disulfide bonds of keratin. Apart from curling or straightening hair, these chemicals may have irritating effects on the leather scalp, which can damage the hair shaft, inflammation of the scalp and loss of hair roots. All these factors can cause irreversible damage hair follicles [15, 16].
C. Hot comb alopecia, also called degenerative syndrome follicular results of the use excessive ointments with a comb or hot iron, which leads to progressive destruction of hair follicles. When the cream comes into contact with a hot iron comb or hot, it melts and flows down the hair shaft in the follicle. This results in a chronic inflammatory folliculitis, which may lead to alopecia scarring and consequent loss of hair permanently. Thinning usually begins at the crown, then spread evenly on the head. The condition is irreversible [15, 16].
pattern baldness / hair loss myths
several myths about hair loss exist, some serious, some not so serious. These myths include;
1. Male pattern baldness (and baldness in women) is inherited from the mother's side of the family: It is not true that studies have been conducted that suggest conclusively that it can come from both sides of the family.
2. Cut hair can grow faster and stronger. When the hair grows longer it is worn by normal wear and as such gets slightly thinner around the diameter of the tree. Cut the hair she cut back to where there is less wear and then the hair shaft is slightly thicker, giving the impression that the cut hair, it is thicker. It would also increase faster than the hair grows almost exactly half an inch per month regardless of whether it is cut.
3. Wearing a hat can cause hair loss. This can occur if the cap is prohibitively tight as any form of tension or clamping hair can affect loss of hair, but wearing a hat on its own can not cause hair loss.
4. Towel dry your hair rigorously will make your Hair fall faster. This can occur if the hair was due to fall anyway, but you will not promote hair loss further Sponge thoroughly
5. Rub curry on his head will help the hair loss. Not only does not work, you may feel so good after.
6. Split ends can be repaired. This is not true that the split ends can not be repaired and must be cut immediately avoid splitting their higher and cause more damage to the hair.
7. Have a cow licking the top of your head can help hair loss. It would not help your hair loss, but it might be fun to watch.
8. Standing on your head, or upside down will increase blood flow to the head and reduce hair loss. It is true that standing on their heads or upside down will increase blood flow to the head, but it will do nothing for hair loss.
Quality of life and psychological aspects
The hair is an integral part of our self and our identity and that hair loss may cause a wide range of psychological problems related to our identity. Alopecia in itself has little physical harm, but it can lead problems such as high levels of anxiety, social phobia, paranoid disorder and major depressive episodes. Scope of alopecia is one of the predictors of the severity of psychological distress [12, 17].
There is an important link between hair and identity, particularly for women. Femininity, sexuality, attractiveness and personality, as reiterated Hunt et al (2005), are symbolically linked to a woman's hair and hair loss for example can seriously affect self-esteem and image body. Hunt et al (2005) also indicated that nearly 40% of women with alopecia had marital problems as a whole accordingly on request 63% have had problems with career [18].
Psychological problems can also be experienced by children affected by alopecia.
Management of alopecia
Alopecia can be managed in different ways, depending on the type and gravity. The different methods of management include;
1. Medical treatment such as use of topical minoxidil, oral finasteride, Topical tretinoin, exogenous estrogens, spironolactone and anti-androgens for androgenetic alopecia. The type of treatment and dose can vary by sex and age (ie adults or children).
2. medical procedures such as the use of immunomodulatory agents (p. eg corticosteroids, 5% minoxidil, and anthralin cream) and topical immunotherapeutic agents (eg dinitrochlorobenzene and diphenylcyclopropene) for alopecia areata.
3. For hair loss caused by telogen effluvium, the underlying cause is usually treated first.
4. alopecia scarring is sometimes managed using both topical and systemic treatments, including the use of hydroxychloroquine, immunomodulators topical (eg tacrolimus and pimecrolimus), intralesional injection of triamcinolone, mycophenolate mofetil, cyclosporine, and isotretinoin, to name a few.
5. When hair loss is extensive, wigs can be worn, there is also the option of transplantation of hair ( Using minigrafts).
6. To reduce the risk of traumatic alopecia, the hair grooming techniques must be used with caution view of the sensitivity of the scalp and hair follicles. Dropping out of style practices can reduce the hair loss and hair growth partial which depends on the length of the insult to the root. Full growth is possible if the hair loss is managed at the beginning [15].
7. Use Laser light therapy, which offers a respite of drugs, chemicals, lotions, visits to hospitals, dermatologist and surgery centers, is non-toxic, safe and can be used at home (see our new product Hairbeam phototherapy).
Recommended Products for hair loss
References
1. Rushton DH, Norris MJ, Busuttil N. Causes hair loss and the developments in hair rejuvenation. Int J Cosmet Sci 2002, 24: 17-23.
2. Biondo S, Goble D, Sinclair R. Women who present with hair loss in women tend to underestimate the severity of their hair loss. Br J Dermatol 2004; 150: 750-752.
3. Anonymous. What should I know about hair loss? Am Fam Physician 2003; 68 (1) :107-108.
4. CC Thiedke. Alopecia in women. Fam Physician Am 2003; 67 (5): 1007-1014.
5. Sinclair R. Page model androgenetic alopecia. Br Med J 1998 317: 865-869.
6. MP Birch, SC Lalla, AG Messenger. Women hair loss pattern. Dermatol Clin 2002; 27: 383-388.
7. Sinclair R, M Wewerinke, Jolley D. Treatment of female hair loss with oral antiandrogens. Br J Dermatol 2005 152: 466-473.
8. Tosti A, Bellavista S, Iorizzo M. Alopecia areata: A long-term study tracking 191 patients. J Am Acad Dermatol 2006; DOI: 10.1016/j.jaad.2006.05.008.
9. Kaelin U, Hassan, Braathen LR. Treatment of alopecia areata partim universalis with efalizumab. J Am Acad Dermatol 2006; DOI: 10.1016/j.jaad.2006.05.062.
10. Olsen et al. Alopecia assessment guidelines for research. J Am Acad Dermal 1999; 40: 242-246.
11. Shapiro J, Madani S. Alopecia: diagnosis and management. Int J Dermatol 1999; 38 (Suppl. 1): 19-24.
12. Harrison S, R. Telogen effluvium Sinclair. Clin Exp Dermatol 2002 27: 389-395.
13. Whiting DA. Scarring alopecia: results Care 2005; 14: 223-231
15. Goodheart HP. Hair and scalp disorders. Women's health in primary care in 1999, 2 (5): 338, 343.
16. Women's Institute for Fine and thinning hair. Traumatic alopecia. Rogaine 2003. Available from: [Accessed http://www.womenshairinstitute.com/th_wcth_ta.asp 05/07/2007].
17. Schmidt S, Fischer TW, Chren MM, Strauss BM, Elsner P. coping strategies and quality of life in women with alopecia. Br J Dermatol 2001 144: 1038-1043.
18. Hunt N, McHale S. The psychological impact of alopecia. BMJ 2005; 331:951-953.
19. Understanding hair loss. myths of hair loss. [Http: / / www.understanding-hair-loss.net/hair-loss-myths.htm Available at: Accessed 05/07/2007].
20. Hair Styles. Top 10 Hair Myths. Available on: http://www.hair-styles.org/top-10-hair-myths.html [Accessed: 05/07/2007].
Disclaimer
This article is for informational purposes only. It is not intended to be medical advice and is not a substitute for professional medical advice. Please consult your doctor for all your medical concerns. Please follow the information contained in this article only after consulting your doctor or professional qualified health. The author is not liable for any outcome or damage resulting from any information obtained from this article.
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Allergymatters was founded in 2001 and has successfully established itself as the #1 resource for allergies. Our aim is to promote good health to allergy sufferers through our knowledge and up-to-date information, advice and recommended products.
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Adderall for Social phobia?
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