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ALOPECIA

Alopecia is the loss of hair present on the scalp and other areas of the body. It is also called as spot baldness and it affects both men and women. Hair loss may occur suddenly from the scalp and other areas of the body. Some of the common types of alopecia include alopecia areata caused by autoimmunity and chemotherapy-related alopecia caused by anti-cancer drugs.

The hair follicles function as per hair growth cycle, each cycle consists of growing, regression and shedding phase. In general 80 to 100 hairs are shed from the scalp, loss of hair more than this needs medical attention. Some of the causes of hair loss are anti-cancer drugs, environmental and health conditions. Alopecia may cause emotional and psychological distress.

Signs and Symptoms 

The following are the signs and symptoms of alopecia:

  • Loss of hair from scalp and other areas of body
  • Bunches of hair noticed on the floor while taking shower and on the pillow
  • Single or multiple patches of hair loss
  • Receding hairline
  • Hair thinning

Causes

The following are the causes of alopecia:

  • The presence of autoimmune disorder may cause self-destruction of dividing cells in hair bulb leading to hair loss
  • Alopecia can be triggered by infection, allergies, toxins, burns, injuries and irritants
  • Health conditions like thyroid disorders, hormonal imbalances or pregnancy may cause alopecia
  • Hair loss is the common side effect of any anti-cancer drugs and birth control pills
  • In some people, baldness occurs as heredity.
  • Hair fall may be caused by improper hair care and excessive use of hair dyes, bleach and other cosmetic devices

Risk Factors

The risk factors for alopecia are as follows:

  • Age (30 to 60 years)
  • Nutritional deficiency
  • Medical conditions
  • Lack of hair care
  • Chemotherapy
  • Genetics
  • Stress

Complications

In some people, alopecia may cause low self-esteem and depression as their appearance is affected. Severe alopecia leads to complications, such as:

  • Scalp damage due to the exposure of harmful sun and ultraviolent rays
  • Development of dandruff

Diagnosis

The doctor may examine the scalp and may also ask for the patient’s family history.

Medical Tests

Pull Test: To determine the stage of shedding process, the doctor may pull few hairs, and therefore this technique is called pull test.

To detect the presence of scalp infection the doctor may perform a scalp biopsy. It is a simple test performed under local anesthesia. A sample from the scalp is collected or few hairs are plucked to examine the hair roots. The sample is sent to the laboratory for further evaluation which is done under the microscope.

The shaft of hair is examined using the special light microscopic instrument to detect any abnormality and this process is called as light microscopy.

In cases where the alopecia is secondary to other health conditions like thyroid disorder and autoimmune disorders, blood tests may be done. In general, the doctor may advise for following blood tests:

  • C-reactive protein and erythrocyte sedimentation rate
  • Follicle stimulating and luteinizing hormone
  • Free and total testosterone
  • Antinuclear antibody test
  • Thyroid hormones
  • Iron levels

Treatment

Medications:

The doctor may treat the other health conditions (thyroid disorder, autoimmunity) causing alopecia with suitable medications. In case of drug-induced alopecia, the doctor may advise the patient to withhold any medication that is causing alopecia for about three months. The topical application of minoxidil liquid promotes hair re-growth and prevents further hair loss. The doctor may prescribe oral finasteride only for men as it slows hair fall and helps in the growth of new hair.

Hair Transplant or Restoration Surgery

In this procedure, the tiny hair-containing skin plugs are removed and implanted on the bald area. The doctor may advise the patient to take hair growth medication before and after surgery for better results. This procedure may cause infection and scarring; however, it is expensive and painful.

Alternative Methods:

The wigs and hairpieces are the best alternatives to medications and surgery. They are painless and are made up of good quality adhesives, keeping the wigs intact for a long time. Use of wigs helps to protect the scalp from sunburn.

Prevention 

Alopecia can be prevented by following ways:

  • Washing and brushing hair gently
  • Treating the underlying disease
  • Avoiding braids and tight ponytails
  • Using wide toothed combs
  • Avoiding hot oil massage
  • Maintaining balanced diet
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