It most often affects the scalp, eyebrows, and eyelashes, but all hair-bearing regions can be affected. In some extreme cases, all scalp hair can be lost- alopecia totalis or even whole bodily hair- alopecia Universalis.
Sometimes, sudden loss of pigment represents the first sign of diffuse alopecia areata. The presence of exclamation point hairs is characteristic of alopecia areata.
TELOGEN EFFLUVIUM
Telogen effluvium is usually manifested as excessive shedding of hair which affects the whole scalp. The underlying cause is increased number of follicles entering the stage when the hair normally falls out- telogen. The process of shedding hair in the telogen phase is a normal occurrence that happens every day and leads to shedding up to 100 hairs per day.
The cause of telogen effluvium is physical, emotional, or other stress that a person experiences 3-5 months prior to the phase of excessive hair shedding. hat stress causes premature entry of hair follicles into telogen phase from the anagen phase (phase of hair growth).
Apart from stress, other common causes are anemia, thyroid disease, fever, surgical procedures, medication, and, in women, delivery. Telogen effluvium most often does not require treatment and the prognosis is generally favorable if the underlying cause is recognized.
For example, cessation of medication which caused telogen effluvium typically leads to the cessation of excessive hair shedding and hair growth starts over.
TRICHOTILLOMANIA
Trichotillomania is a compulsive disoreder in which the affected person uncontrollably pulls out their own hair, eyebrows or eyelashes. It is a psychological disorder in which a person is often unable to stop doing so. Before eventual transplantation, the person should undergo psychological therapy.
Professional examination of the affected area can be useful in the diagnosis of trichotillomania. Professional examination of the affected area can be useful in the diagnosis of trichotillomania.
HOW TO TREAT ALOPECIA?
Therapeutic options in androgenetic alopecia include medications such as minoxidil and finasteride as well as hair transplantation.
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Minoxidil is an antihypertensive drug that, apart from its effect on lowering blood pressure, causes hypertrichosis when taken orally. The formulation of the drug is developed as a 5 percent solution which is rubbed on the scalp to focus the effect of minoxidil on the follicles.
Minoxidil causes prolongation of the anagen-hair growth phase and increases the hair diameter. In doing so it counters the negative effect of androgens on the follicles. The greatest effect is achieved in the early cases where there is some hair thinning but no complete hair loss.
It is rubbed in the scalp twice per day- 1mL in the morning and in the evening. For a small proportion of patients, it leads to hair regrowth and for 80% it reduces the rate of hair loss. It must be used for six months to see improvement. Side effects are rare, but usually, it is irritation, dryness of the scalp, and fingers used to rub in the substance.
Finasterid comes from another group of medications with proven beneficial effects in the treatment of androgenetic alopecia. It blocks type 2 5α reductase, the enzyme which converts testosterone into dihydrotestosterone.
Dihydrotestosterone is a derivative of testosterone that is considered to be a major cause of hair loss in androgenetic alopecia. It is used as an oral medication in a dose of 1mg per day and it is highly effective. 90% of the of patients keep their current hair and up to 65% report noticeable hair regrowth. It has to be used for at least 6 months to notice the results. In a small number of patients, one of the side effects is decrease in libido which stops with the cessation of therapy.
Dutasterid is a second, novel member of the same group of medications as finasteride which blocks type 1 and type 2 of 5α reductase. It is considered an equally safe but even more effective option than finasteride.
Our team makes sure to follow up on recent research in the field of androgenetic alopecia in order to provide contemporary data and treatment options to our clients. Some of the promising new treatment options include clascoterone (antiandrogen) and Oronazol (antimycotic medication)
