Among the reasons why patients visit a dermatologist, hair loss is a frequent one. This problem worries people so much and affects the appearance and feelings in society that the hair is considered as a separate functioning organ, and this disease is treated by individual specialists - trichologists. With hair loss, a person loses self-confidence and energy, and acquires a bad mood and complexes. Hair loss is divided into diffuse and focal.
Diffuse alopecia. Types and causes of diffuse alopecia
Hair has its own cycle of growth, in which hair grows in the anagen phase, falls out in the telogen.
- Telogen hair loss. From anagen to telogen, the growth cycle shifts after severe illnesses, injuries, surgeries, childbirth, after strict diets. This type of baldness can be stopped, and then the hair will be restored. That is, telogen hair loss is a temporary cosmetic defect, and when a person recovers, hair growth again becomes cyclic.
- Anagen hair loss develops after a course of chemotherapy for oncological diseases, as well as against the background of iron deficiency. Diseases of the thyroid gland provoke anagen hair loss.
- Androgenetic alopecia. With this type of baldness, the hair does not fall out on the entire head, but mainly on the forehead and on the top of the head. Such hair loss cannot be massive and severe, but the resulting bald patches do not grow back. Androgenetic alopecia affects many men and women over 35, and especially women after menopause. Minoxidil lotion can stop hair loss with androgenetic alopecia. But this treatment is rarely used, since this drug is not cheap, and the effectiveness is observed only when applied, after the course of treatment, the hair falls out the same way as before. At the same time, women with polycystic ovaries are often prone to androgenetic alopecia. In such women, in addition to hair loss, hirsutism, acne and seborrhea are present. In this case, the correction of the hormonal background of the woman with hormonal preparations will help.
In men with androgenetic alopecia, the hair begins to fall out from the crown and temples. With age, the severity of the disease increases. Genetic predisposition to areas of baldness plays an important role.
Many girls who have passed from adolescence to an older age notice a change in the structure, thickness and density of their hair. This often worries girls, but you should not be afraid, as the hair goes into a state that corresponds to a different age category. These processes are physiological, and concern about this is not justified.
Alopecia areata. Types and causes of alopecia areata
Alopecia areata develops when a person has antibodies to hair follicle cells. Antibodies block hair growth, perceiving them as foreign cells. This process can cover not only the hair on the head, but also the hair of the eyebrows, beards and eyelashes. In severe cases, hair loss occurs over the entire head (alopecia totalis) or even over the entire body (alopecia universalis).
Alopecia areata affects people of all ages and genders, but it is common in adolescents and young adults. Alopecia areata can be triggered by autoimmune diseases, diseases of the thyroid gland or vitiligo.
The course of alopecia areata is not uniform. Spontaneously bald area of the skin can overgrow hair after a while, and then they begin to fall out again. At the same time, the scalp looks absolutely healthy. Alopecia areata on the back of the head grows much worse and less often. With total alopecia, it is possible to recover only in 10% of cases. If alopecia manifested itself before puberty, the course is usually severe.
What diseases are differential diagnostics of alopecia areata?
When making a diagnosis of alopecia areata, other clinically similar diseases should be excluded. These are ringworm, cicatricial alopecia and trichotillomania. With dermatomycosis, peeling of the scalp is observed. In both cases, hair breakage is observed, which makes the amount of hair appear to be less.
Dermatomycosis of the scalp develops in the presence of a fungal infection. Children often get sick. At the same time, the scalp flakes off, numerous areas of hair loss are visible all over the head, the hair at the ends is broken off. To clarify the cause, a scraping is taken or the scalp is examined under a Wood's lamp. Treatment of skin dermatomycosis is effective only with systemic drugs with long six-week courses. In advanced cases, inflammatory elements appear – kerion, the skin is very flaky, the hair is constantly falling out. This is how alopecia develops.
Trichotillomania is manifested by constant twisting and pulling of the hair. This happens unintentionally. Because of this, the hair becomes brittle, breaks off at the ends. The treatment of such a pathology must begin with the treatment of the psyche.
Cicatricial alopecia develops with lichen planus or discoid lupus erythematosus, after an injury. On the scalp against the background of the scar, skin tension, focal areas of hair loss and erythema are observed. Restoring the skin at the site of the scar is almost impossible, but you can stop further baldness. To do this, treat the edges of areas of active damage with local steroid preparations.
When is alopecia treatment not required?
A lot of money is made in the treatment of hair loss. For beauty and a young look, people are ready to give a lot. But is hair loss treatment effective? In most cases, overgrowth of foci of alopecia can occur spontaneously, against the background of a change in the activity of the autoimmune process in alopecia areata. And the use of drugs and ointments helps to achieve only a temporary effect. Hair often grows back naturally within six months.
When the process is severe and the patient has a strong desire to regain hair, the PUVA scheme is used. These are psoralen, high dose systemic steroids and ultraviolet radiation along with many irritants. But the effect of this is negligible compared to the side effects of such treatment.
Therefore, at the first signs of increased hair loss, you need to contact a trichologist, who will make an accurate diagnosis and determine the appropriateness of treatment.
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