CAUSES AND TYPES

ALOPECIA

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What is alopecia?

Alopecia is a medical condition that causes progressive loss of hair production in the hair follicles. Hair reacts to an imbalance in the body that is why, hair loss is a warning signal that something is wrong. However, it is worth to know that hair loss does not necessarily mean baldness. A healthy person loses from 50 to 100 hair every day. This is a normal growth cycle and it should not be a cause for concern. Hair loss occurs only when the production process in the hair follicles slowly disappears. Then the hair becomes weaker and thinner, falling out after some time. However, in this place no other hair appears.

What are the causes of alopecia?

The main causes of excessive hair loss and baldness include:

  • Diseases
    excessive hair loss can be caused by some diseases (for example, anaemia, hormonal disorders, scalp disorders, problems with the proper functioning of the thyroid hormone)
  • Incorrect diet
    hair follicles need a proper portion of protein and some elements (primarily zinc and copper). A low-calorie diet can lead to the weakening and inhibition of the hair growth cycle. In women dietary, iron deficiency is also risky to hair growth.
  • Taking certain medications
  • Genetic predispositions

Types of alopecia

The causes of excessive hair loss depend on many factors. There are different types of baldness. They are following:

Male pattern hair loss

pattern hair loss in men is one of the more common types of hair problem. Its characteristic feature is the gradual loss of hair from the temples. A slight bend appears at the top of head. After some time, it gets deeper and deeper until a narrow strip of hair remains on the sides and back of the head. The cause of pattern hair loss is excess of dihydrotestosterone production (this is one of testosterone derivatives). A lot of DHT causes a slow disappearance of the hair follicles. The hair around the head band does not have DHT sensitive receptors, that is why the follicles do not disappear. Treatment of pattern hair lose in men involves giving the substances (medicines) that inhibit the increased activity of the α-reductase enzyme (this enzyme converts testosterone into DHT). Another method is to transplant the hair from the remaining strip into the area where it has disappeared.

Female pattern hair loss

pattern hair loss appears less frequently in women than in men. It is caused by too much concentration of male hormones or too low concentration of female hormones. As a result of hormonal imbalances, there is hair loss in the parietal and frontal lobes. However, around the temples and forehead, there is a hair strip about 2 cm wide.

Alopecia areata

alopecia areata is the loss of hair in some places which looks like a “bald patches” on the head. After some time the completely hair loss can occur. The causes of alopecia areata have not been discovered yet.

Menopausal alopecia

hair loss also can occur in women during menopause when there is a sharp drop in estrogen. Estrogens accelerate the hair growth cycle, their decrease causes androgen growth that can cause rapid hair loss.

Postpartum alopecia

sometimes the postpartum alopecia occurs about 3-6 months after childbirth. The human body regulates hormone levels that were disturbed during pregnancy. The excess of estrogen during pregnancy inhibits the hair dying. After delivery, the hair falls out but after a few months the condition returns to normal and the hair grows back normally.

Psychogenic alopecia

it is unexpected hair loss that can occur under excessive and prolonged stress. In this case, the irregular skin foci appear without hair.

Alopecia after chemotherapy

anti-cancer drugs destroy DNA cells. A side effect of chemotherapy is the destruction of the hair matrix. Their follicles shield, the hair becomes thinner and falls out.

Every type of baldness is treated differently, so it is very important to diagnose and determine why the hair falls out so excessively. The dermatologist conducts a detailed interview with the patient about his/her general health, taken medications and medical incidents (operations, procedures, anaesthesia). For women, childbirth, breastfeeding or menopause are also important. A diet rich in necessary nutrients and condition (fatigue, joint pain, chronic stress) are also of great importance when it comes to proper hair growth cycle. Your doctor may also recommend blood tests (to eliminate anaemia and element deficiency), thyroid hormone levels and assess the condition of your scalp and hair follicles. When the information is collected, the dermatologist diagnoses the cause of baldness and selects the appropriate treatment method.

How to check if I am affected by pattern hair loss?

Hair loss occurs in accordance to the pattern – the Hamilton-Norwood scale. If you recognize some of the patterns on your head, you observe chronic hair loss and in your family your father or grandfather suffered from alopecia, you may think that the problem will also affect you. For this purpose, it is best to contact a dermatologist to determine the course of treatment.

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Hair structure and growth

Hair consists of:

  • hair shaft
  • hair root
  • hair follicle

The hair follicle which is located in the middle layer of the skin (dermis)is responsible for hair growth. A dermal papilla provides blood with nutrients. Hair follicles begin to form as early as around 60 days of fetal life. An adult has from 85 to even 140 thousand hair. It grows in three different stages and the cycle of its growth is repeated many times throughout life. Hair growth in adjacent hair follicles take place at different times. That is why, when it comes to a healthy person hair appears on the head regularly and the process of natural hair loss that has already gone through all development stages is not visible (if the stages were carried out simultaneously, the person would be periodically bald). This phenomenon is known as an asynchronous hair production.

Hair growth cycle

The hair growth cycle consists of 3 phases. Those are:

  • Anagen (growth) phase – in this phase there is active hair growth in the hair follicle due to intensive division of stem cells. The duration of this phase is from 2 to 7 years (depending on genetic conditions). When it comes to a healthy person (who has no problem with alopecia) about 90% of the hair on the scalp should be in the growth phase.
  • Catagen phase (disappearance) – The disappearance phase should last about 14-21 days. In the hair root remodelling occurs. The hair matrix disappears and the hair is extruded to the surface of the skin. Under normal conditions, about 3% of the scalp hair should be in the catagen phase.
  • Telogen phase (resting, falling out) – the hair completely becomes keratinized – that is why, it does not carry out any metabolism. This phase lasts from about 30 to 90 days. The hair bulb becomes thinner and thinner. The hair eventually falls out while brushing or washing (if this does not happen, it is extruded by the newly growing hair). About 13% of the scalp should be in the telogen phase.

The importance of the hair growth cycle

The phases of the hair cycle are of great importance while diagnosing alopecia problems and choosing an appropriate treatment method. About 90% of the hair on scalp should be in the anagen phase, so it means that no more than 50-100 hair should fall out daily. A greater loss is a warning signal – it can mean the beginning of a problem with baldness, illness or a serious deficiency of nutrients involved in the construction of hair (including protein, zinc, copper, iron).

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