The causes, effects and treatment for Alopecia

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Ask The Doctor: The causes, effects and treatment for Alopecia

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Alopecia is the medical term for hair loss. Hair loss can be

localised or generalised. The type of the reader must be interested

in knowing will be diffuse alopecia which is described by the lay

people as " Hair Fall " .

Localised Alopecia: This presents as local area of hair loss. It can

be due to:

1. Alopecia areata which presents as a smooth coin shaped areas of

hair loss. This can affect scalp, beard moustache, eye brows, lashes

or any other part of the body where there are hairs present. Most of

the patients seek medical help when scalp, beard or moustache is

lost due to obvious cosmetic reasons. Alopecia areata can be treated

successfully by various modalities of treatment. Results are poorer

if there is total hair loss over scalp and involving other parts of

the body where they tend to recur even after successful therapy.

Thyroid disease should be ruled out in those with alopecia areata.

2. Infections – Fungal infections are the commonest cause of hair

loss in children. It presents as areas of hair loss with broken

hair, scaling, pus and crust formation over the affected areas.

Those in contact with horse, cat, dog are more likely to develop

this if the animals are infected. It should be promptly treated as

it is rapidly spreading and can be transmitted to contacts at home,

school, etc. Bacterial infection can also cause alopecia, especially

the infection of hair follicle.

3. Other – Other causes of localised hair loss include various skin

diseases like lichen planus, psoriasis, morphea, SLE etc.

Diffuse Alopecia: This includes two main causes

1. Diffuse hair loss – It can be due to many reasons. But the

commonest type is called telogen effluvium. This is the variety

which bothers most of patients which they describe it as " excessive

hair fall " . Normal hair cycle is such that one is expected to loose

100 hairs per day. Any thing more than this excessive hair loss.

Most of the patients complain of hair fall while bathing, hairs on

the pillow in the morning or excessive hair loss while combing.

Gradually the density of he hair on the scalp decreases and they

appear spares. Telogen effluvium is mainly due to nutritional stress

as in crash dieting, iron deficiency, stress during exam or at work,

after delivery, long term high fever or long term illness, after

major surgery. Many believe this type of hair loss due to water,

shampoo etc which not true. Usually a new comer expatriate suffer

from such a hair loss as a result of nutritional stress due to

sudden change in dietary habit, mental stress coping with the blues

of settling and adapting to new work atmosphere. The hair loss is

usually seen 6 months after the specific cause.

All such cases should be thoroughly investigation by doing a blood

count, thyroid function test etc. Treatment is by eliminating the

cause by use of vitamins, iron and having proper balance diet. Other

causes of diffuse hair loss include hair shaft defect, anagen

effluvium due to certain drugs like cancer chemotherapy etc.

2. Androgenic alopecia: This is due to the influence of sex hormone

mainly testosterone. It can affect both males and females. In males

it is seen as gradual receding of the hair line from frontal and

temporal areas.

In severe cases only a thin band of hair is left on the side and

back of scalp. In female the pattern of hair loss is in the centre

of scalp. In females it is usually associated with excessive hair

over moustache, beard area, chest and abdomen.

Hormonal imbalance should be ruled out in such cases by doing

thorough blood test and ultrasonography. There many treatment option

available but are not satisfactory and tend to recur after the

stoppage of treatment. Stable cases are managed by surgerical

modalities like hair transplant or use of hair waving, hair bonding

or hair wigs.

Dr Jameel Sayed,

Skin Specialist,

Al Rafa Polyclinic