With the hormonal changes of aging comes a decrease in the number of active
hair follicles. Though this is a universal change in all of
us, there is a number of other factors that make us lose hair
even earlier in life. Most of them are hair diseases.
Alopecia areata is an
autoimmune condition that appears as a sudden patchy loss
of hair, usually in small circular area on the scalp.
It sometimes follows a shock or worry, it is also a hereditary
trait, and it can run in the family.
In some patients, hair loss is confined to
one or more small oval patches; in others, the scalp
is essentially denuded except for a few tufts of hair.
] The condition is marked by exacerbation and
recovery with high variability among individuals.
This disorder affects about 1 out of every 100 people
in the US population, especially young adults, men and
women equally. It is an autoimmune condition the body's
own antibodies attack the hair follicle, specifically
the papilla/bulb area.
Most, if not all hair re-grows in about 80% of cases;
it is, however, a recurrent condition in many people.
Alopecia totalis is a severe case of Alopecia,
where the whole head of hair falls out, and sometimes, the patient
loses the eyebrows and eyelashes as well. It is a sort of extension
of Alopecia areata. All the hair follicles enter the telogen
phase. About 33% of people afflicted with Alopecia totalis and
Alopecia universalis will grow back all their hair within a
year, although there may be recurrences.
Alopecia universalis is the complete loss
of all body hair, due to physical and/or medical causes. In
physical causes, the functioning of the hair follicles is interrupted
by antibodies in our immune system. There is poor understanding
of how we can restart or trigger the hair follicles into activity.
The medical causes are generally treatments that can cause total
hair loss, such as chemotherapy, which contains "cell toxic"
elements needed to stop cancer cells from growing.
Traction alopecia is a form of hair loss caused
by tight braids, ponytails, daily knotting or other hairstyles
that put pressure on the hair. Hair transplant doctors are reporting
an increase in seeing this type of hair loss in teenage girls
and young women.
Cicatricial Alopecia is a term applied by
some specialists to permanent hair loss which follows the destruction
of the hair follicles, due to a medical or mechanical cause.
Telogen effluvium, (temporary hair loss) the
most common form of diffuse alopecia, is a shedding of hair
of up to 60%; it may have as cause an event that happened 3
months before the onset of shedding. This event may be childbirth,
a crash weight loss diet, sustained high fever, surgery, a systemic
disease, severe emotional stress or a drug reaction. There are
also certain diseases associated with it, such as hyperthyroidism,
hypothyroidism, iron deficiency, seborrheic dermatitis, secondary
syphilis, Systemic Lupus Erythematosus (SLE), Vitiligo and others.
The body needs all the resources for that event childbirth
or recovery from a serious illness, and, through certain neurochemical
reactions, it transmits this to the hair follicles. Thus, a
major change happens in a large portion of the hair follicles
that moves them from the anagen growth phase to the catagen,
then telogen rest phase. The follicle then sheds the hair and
does not provide a replacement.
The acute form normally subsides in 3 to 6 months.
In true telogen effluvium, the hair invariably regrows within
a short time." (1)
Postpartum telogen effluvium is the condition associated with
the postpartum hormone-related changes that temporarily prolong
hair resting phase.
Anagen effluvium is the form of hair loss
caused by chemical damage; a chemical actually kills the hair
follicle, as certain drugs used to treat cancer do. One of the
side effects of medication used to poison tumor
cells is the poisoning of the hair follicles as well. Hair re-grows
about 6 months after that particular medication is stopped.
However, make sure you ask your doctor before discontinuing
a medication, as some of them may cause complications if discontinued
Those undergoing chemotherapy treatments should remember that
if they do lose hair because of it, it also means that it is
really working, and is also killing tumor cells. There are several
good approaches and techniques that should help in dealing with
this type of hair loss. These are the ones recommended by the
American Cancer Society.
- Use mild shampoos.
- Use soft hairbrushes.
- Use low heat if you must use a dryer.
- Don't use brush rollers to set your hair.
- Don't dye your hair or get a permanent.
- Have your hair cut short. A shorter style will make your
hair look thicker and fuller. It also will make hair loss
easier to manage if it occurs.
- Use a sunscreen, sun block, hat, scarf, or wig to protect
your scalp from the sun.
- Use a satin pillowcase.
Tinea capitis (ringworm of the scalp) is a
contagious fungal infection of the scalp, most frequently seen
in children, aged 4 to 14 years.
Symptoms include: Itching of the scalp, round scaly
spots on the skin and scalp, redness and inflammation, bald
patches and/or small black dots on the scalp. In extreme cases,
pus filled lesions on the scalp may appear." (1)
Should you suspect your child is affected by Tinea capitis,
contact your doctor immediately; the disease is treatable, and
it implies administration of antifungals - terbinafine, fluconazole,
itraconazole, griseofulvin; members of the family who have come
into contact with the child should also request an examination.
Trichotillomania is the manifestation
of a psychogenic behavioral pattern of frequent hair-pulling
by the patient (1). Sometimes, it can be a temporary
habit that doesnt have important consequences, but in
other cases, it may be a symptom of serious emotional problems
- a sign of stress and/or strong dislike of ones self,
and most people who suffer from this disease are too embarrassed
to seek help. It is most frequent in preadolescent and adolescent
girls; the act of pulling out the hair is a source of pleasure
or relief. Counseling should be sought immediately, as it can
cause significant distress or impairment in the social and occupational
area of life. Usually scalp hair is pulled, though eyebrows,
eyelashes, or pubic hair may be involved as well.
Systemic lupus erythematosus (SLE) is not
a hair disease, but an autoimmune inflammatory disease affecting
collagen. It involves more than one system of a body, and also
causes hair loss.
Secondary syphilis has as a result patchy
hair loss on the scalp but possibly elsewhere on the body as
well. It usually begins 2 to 8 weeks after chancre type
lesions appear. It can present with patchy hair loss, mostly
on the scalp and often elsewhere on the body. This hair loss
is often described as having a moth-eaten appearance.
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