The medical word for hair loss is alopecia. Alopecia is a general term, and, despite incorrect usage of the word by many media outlets, is not a specific diagnosis per-se. There are multitudes of causes for hair loss and it can occur anywhere on the body where hair grows. Some types of alopecia are temporary and can potentially be treated, while others are permanent.
Dermatologists generally group hair loss into the categories of scarring vs non-scarring alopecia.
With scarring alopecia, the hair unit (called the hair follicle) is destroyed and can no longer produce a hair. Given that the number of hair follicles throughout the body is determined and fixed at birth, once a hair follicle is destroyed, it is gone forever and will not be replaced. Therefore scarring alopecia is permanent, unless new hairs are transplanted into the area. Some causes of scarring alopecia include trauma (burns, chemicals, hot combs, injury), excessive and prolonged traction (tight hairstyles, braids), and a variety of inflammatory skin disorders (lupus, lichen planus, folliculitis decalvans, et al)
With non-scarring alopecia, the hair follicle generally remains intact, however the hair shaft is either not produced, not produced correctly, or the follicle itself is miniaturized. With this type of alopecia, regrowth of hair is theoretically possible, although at times it is not able to be achieved. Several causes of this type of hair loss include androgenic alopecia (male and female pattern hair loss), alopecia areata, telogen effluvium, chemotherapy-induced alopecia, thyroid disease, among others.
Patients regularly present to dermatologists concerned about hair loss, especially on the scalp. Hair loss in this area may be not only noticeable to patients, but, when significant, can be obvious to others as well. Unexpected, and especially unexplained scalp hair loss can cause anxiety, embarrassment, and even depression in those suffering from such. Alopecia of the scalp hair can be especially stressful for women. And while most all dermatologists understand these concerns, improving the situation is often one of the most challenging things we deal with as specialists.
Common Types of Alopecia
- Androgenic Alopecia: This non-scarring alopecia is the most common type of hair loss by far and the cause almost everyone is familiar with. This is also called male pattern baldness and is caused by androgen hormones acting on the hair follicle, shrinking it more and more over time. The hair shaft becomes thinner and smaller over time until the hair that is produced is so fine that it is hard to see. Loss initially involves the crown and temporal areas, which can progress to involve most of the scalp until only the sides and posterior scalp hair remains. Also, unbeknownst to many people, this type of hair loss is also commonly seen in women as well, and called female pattern baldness. The underlying cause and hair follicle changes are the same as with the male version, however, the amount of hair loss and presentation is fortunately usually less dramatic than in men.
- Alopecia Areata: This is another very common cause of hair loss, however most people have never heard of it. Alopecia areata (AA) is a non-scarring hair loss and is the result of an abnormal response of the immune system, where it attacks hair follicles and causes them to shut down producing hair. The reason the immune system does this remains unknown, however affected individuals sometimes have other autoimmune conditions, such as vitiligo, lupus, thyroid disorders, among others. In AA, the location and amount of hair loss is very variable. The most common presentation is roundish patches of hair loss in the scalp, however it can involve anywhere on the body – eyebrows, eyelashes, beard area, trunk, arms, legs, and even groin. The patches may be single and rather small, or can be multiple and involve large areas. Subtypes of AA include Alopecia Totalis in which all scalp hair is lost, and Alopecia Universalis in which all hair is lost from everywhere on the body!
- Telogen Effluvium: This is another type of non-scarring hair loss and most notably affects the scalp. On average, our scalp hair growth cycle is about three years, with each hair in different stages of this cycle, so that when a hair is shed, there are so many hairs in other stages that the loss is not noticeable. In TE however, a large number of hairs relatively quickly go from the growing cycles to the end cycle and are shed much sooner than normal. This can result in large amounts of hair lost in a short period of time, sometimes even in clumps. Overall presentation is a generalized thinning of hair density throughout the scalp, rather than actual bald areas as in other alopecias. No one is exactly sure why this happens, but it seems to be related to major stress events. Although it can take many months or even years, usually the hair cycles slowly begin to return to normal and hair density can return.
- Metabolic Disease: Occasionally certain medical conditions can result in hair loss. These include thyroid disease, anemia, vitamin deficiencies, such as vitamin D, among others. Rather than complete loss, these most often result in hair thinning and decreased density without scarring. Treating the condition or correction of the deficiency should result in improvement of the alopecia in these cases.
Treatment of Alopecias
Treating and improving hair loss can be one of the most difficult challenges in dermatology.
Aside from transplants, there is no way to improve any of the scarring alopecias. Addressing these generally involves controlling the underlying cause to limit the extent of hair loss as much as possible. However, as mentioned previously, the non-scarring alopecias are theoretically treatable, although the amount of improvement may be variable. The types and methods of treatment are diverse and are dependent on the underlying cause. This is why it is important to be evaluated by a dermatologist, a doctor who is specifically trained in addressing hair loss.
Alopecia Treatment in Lake Worth, Texas
If you suffer from hair loss and want to find a way to improve such, it’s time to see an expert. The earlier you seek to address your hair loss, the better chance you have at improvement. At Lakeview Dermatology, we can create a treatment plan to help address all types of alopecia. Contact us by calling (817) 752-5256 or request an appointment online.