By Dr Ananya Mandal, MD
Alopecia is the medical term for hair loss. There are several patterns of natural and disease related hair loss. Hair loss may also be caused by several drugs and medications.
Types of hair loss and symptoms
The commonest type of hair loss is male-pattern baldness. This type of hair loss is typically caused by the effects of hormones. This is also termed androgenic or androgenetic alopecia as the cause lies in androgens of male sex hormones. There is a pattern of receding hairline along with thinning of hair over the crown.
Female pattern baldness – there is thinning of hair over the top of the head.
Alopecia areata – this is also termed patchy baldness as there are patches of baldness that come and go. This may commonly affect teenagers and young adults but may affect a person of any age. Alopecia areata is commonly caused due to a problem in the immune system. The condition may sometimes run in families.
Scarring alopecia – this is mainly caused after a scar over the skin. This type of alopecia is called cicatricial alopecia. The hair follicles that hold the roots of the hair may be completely destroyed. This means that the hair would not grow back at the areas affected. Some diseases and disorders also cause scarring alopecia. These include lichen planus, injury, discoid lupus etc.
Anagen effluvium is a more widespread hair loss that may affect the whole body apart from the scalp. This is caused most commonly due to cancer chemotherapy.
Telogen effluvium - leads to thinning of hair all over the body rather than baldness in patches. This may be the result of stress of some medications.
Treatment of alopecia
Male-pattern baldness usually is the commonest type of hair loss and has no treatment. This may be distressing and there may be cosmetic therapies that might help in preventing thinning of hair.
Some drugs like finasteride and minoxidil can be used. Minoxidil can also be used to treat female-pattern baldness. The efficacy of these drugs often goes away after they are discontinued and are at best modest.
Alopecia areata may be treated with steroids or immunotherapy. This involves stimulating hair growth.
Hair loss and alopecia may also be treated using cosmetic surgical methods. Use of wigs and artificial removal hair may also solve cosmetic problems. Wigs may be made of synthetic material or with real hair.
Hair loss surgeries like hair transplant, scalp reduction, artificial hair implants, weaving and cloning are other surgical alternatives.
Hair transplant is a procedure in which under local anaesthetic a small piece of scalp with plenty of hair and hair follicles is removed and this is transplanted onto areas over the scalp without hair in tiny strips. Hair transplants are carried out over a number of sessions.
Scalp reduction surgery involves removal of part of the bald scalp by tightening. A balloon like device is placed under the bald scalp skin for several weeks to expand and loosen the skin tissues and then the excess bald skin is cut and removed. Artificial hair may also be implanted onto bald skin.
Treating hair loss has a more important aspect – treatment of the emotional and psychological aspects as well.
Reviewed by April Cashin-Garbutt, BA Hons (Cantab)