Hair Loss

Hair Shedding

Hair shedding is a common condition in both men and women. It occurs after a stressful situation such as child birth, surgery, high grade fever, crash dieting, and emotional stress. This type of hair loss occurs 3 months after the stressor and lasts around 2 months. Fortunately, it is totally reversible. Your dermatologist can diagnose this condition after clinically examining you and excluding any other associated factors such as anemia or thyroid problems.

Hair Thinning

Hair thinning is characterized by decreased density of hair on the scalp. This is noted as a widened part or decreased coverage of the scalp, making it visible. Several conditions can lead to hair thinning such as aging, intake of certain medications, chronic medical problems, and genetic predisposition. Your dermatologist will examine you and ask you about your medical history and whether you take any medications. You may be asked to do blood tests to check if you suffer from iron deficiency anemia, hypo or hyperthyroidism or a hyperandrogenic state.

In regards to treatment, local application of minoxidil solution helps to restore some density; however, it has to be used for at least 6 months before noting any change. Men may also benefit from oral finasteride, a medication that is prescribed for prostatic hypertrophy. For resistant cases, hair follicle illusion or hair transplantation can be considered. Your dermatologist will discuss with you the pros and cons of each therapeutic option.

Patchy Hair Loss

Patches of hair loss on the scalp can be due to fungal infection, alopecia areata, or a scarring type of alopecia.

Fungal infections of the scalp are more common in children; however, they can occur in adults. They present with areas of hair loss accompanied by scaling and itching. Usually there is a history of contact with kittens or puppies. The diagnosis can be confirmed by performing a KOH smear on the affected hairs. This is a simple procedure that can be done in the office with immediate results. The treatment of fungal infections of the scalp is oral antifungal pills. These have to be taken for at least 2 months. In addition, washing the hair with a prescription anti-fungal shampoo helps in preventing the shedding of fungal spores to other members of the
family.

Alopecia areata is another condition that presents with sudden onset of patchy hair loss. It can occur in both men and women. More than half of the patients have their first episode before the age of 20. The exact cause is unknown. The patches in alopecia areata are usually round and the underlying skin is totally normal without crust or scale.

Alopecia areata can be localized to a few patches on the scalp; it can also be so severe to involve the whole scalp as well as body hair. The progress or regrowth of hair in alopecia areata is unpredictable and the recovery can be complete or partial. When the patches are confined to one discrete area the likelihood of total regrowth is good. In patients with more severe hair loss, the chance of recovery without treatment is little.

It is important to realize that despite full recovery, the disease may still be active and manifest as new bald spots. Therefore, the treatment is warranted for as long as the disease is active. Your dermatologist will discuss with you the best treatment for you, depending on the extent of hair loss, your age, and whether you are pregnant or breast feeding.

Scarring alopecia is a type of patchy hair loss that is irreversible. In this type of alopecia, there is inflammation around each hair follicle. The inflammation leads to destruction of the hair follicles. The hair follicles in the destroyed area cannot regenerate and are replaced by a permanent scar. Scarring alopecia can mimic alopecia areata. Therefore it is very important to present to a dermatologist who will be able to diagnose the condition. A skin biopsy is sometimes helpful to distinguish the two conditions. Treatment of scarring alopecia is chronic and is administered to stop the progression of the condition. Your dermatologist will discuss with you the different options, since it differs depending on the extent or hair loss, your age, and whether you are pregnant or breast feeding.

 


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