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Hair loss , also known as alopecia or baldness , refers to the loss of hair from the head or body. Usually at least the head is involved. Hair loss severity can vary from small area to whole body. Usually inflammation or scarring does not exist. Hair loss in some people causes psychological distress.

Common types include: male pattern hair loss, female pattern hair loss, alopecia areata, and hair thinning known as telogen effluvium. The cause of male pattern hair loss is a combination of genetics and male hormones, the cause of female hair loss patterns is unclear, the cause of alopecia areata is autoimmune, and the cause of telogen effluvium is usually a physical or psychological stress event. Telogen effluvium is very common after pregnancy.

Less common causes of hair loss without inflammation or scarring include hair removal, certain drugs including chemotherapy, HIV/AIDS, hypothyroidism, and malnutrition including iron deficiency. Causes of hair loss that occur with scarring or inflammation include fungal infections, lupus erythematosus, radiation therapy, and sarcoidosis. The diagnosis of hair loss is partly based on the affected area.

Treatment of hair loss patterns may involve only acceptance of the condition. Interventions that can be tried include minoxidil (or finasteride) medication and hair transplant surgery. Alopecia areata can be treated with steroid injections in the affected area, but this needs to be repeated in order to be effective. Hair loss is a common problem. The pattern of hair loss at age 50 affects about half of men and a quarter of females. About 2% of people develop alopecia areata at some point in time.

Video Hair loss



Terminology

Baldness is a lack of partial or complete hair growth, and part of a broader topic of "hair thinning". The rates and patterns of baldness vary, but the most common causes are hair loss androgenic, alopecia androgenetica, or alopecia seborrheica, with the last term being used primarily in Europe.

Hypotrichosis

Hypotrichosis is a condition of abnormal hair patterns, especially loss or decrease. This happens, most often, by the growth of vellus hair in the area of ​​the body that usually produces terminal hair. Usually, the growth of individual hair is normal after birth, but soon after that hair is released and replaced with rare and abnormal hair growth. New hair is usually smooth, short and brittle, and may be less pigmentation. Baldness may be present at the time the subject is 25 years old.

Maps Hair loss



Signs and symptoms

Symptoms of hair loss include hair loss in patches usually in circular patterns, dandruff, skin lesions, and scarring. Alopecia areata (mild-medium level) is usually seen in areas of unusual hair loss, for example, eyebrows, the back of the head or above the ear, an area normally unaffected by the male pattern. In hair loss, loss and thinning in men begins in the temples and crowns and hair thinning or falling out. Female pattern hair loss occurs in the frontal and parietal.

People have between 100,000 and 150,000 hairs on their heads. The number of strands that usually disappears in a day varies but the average is 100. To maintain normal volume, the hair should be replaced at the same level where it is lost. The first signs of hair thinning that people often notice are more hair than usual left in a hairbrush after brushing or in the basin after shampooing. Styling can also reveal depletion areas, such as wider sections or thinned crowns.

Skin condition

A very stained face, back and legs can lead to cystic acne. The most severe form of the condition, cystic acne, arises from the same hormonal imbalance that causes hair loss and is associated with the production of dihydrotestosterone. Seborrhoeic dermatitis, a condition in which excessive amounts of sebum are produced and accumulate on the scalp (looks like an adult hat), is also a symptom of hormonal imbalance, such as too oily or dry scalp. Both can cause hair thinning.

Psychological

Hair thinning and baldness cause psychological pressure due to its effect on appearance. Although the public interest in appearance has a long history, this particular branch of psychology became his own during the 1960s and has gained momentum when messages connecting physical attractiveness to success and happiness grow more commonly.

Hair thinning psychology is a complex issue. Hair is considered an important part of the overall identity: especially for women, who often represent femininity and attractiveness. Men usually associate head full of hair with youth and spirit. Although they may be aware of the pattern of baldness in their family, many are uncomfortable discussing this issue. Therefore, thinning of hair is a sensitive issue for both sexes. For the sufferer, this may represent loss of control and feelings of isolation. People who experience hair thinning often find themselves in situations where their physical appearance contradicts their self-image and are usually worried that they appear older than them or less attractive to others. Psychological problems due to baldness, if any, are usually most severe at the onset of symptoms.

Hair loss caused by cancer chemotherapy has been reported to cause changes in self-concept and body image. Body image does not return to its previous state after hair regrowth for most patients. In such cases, patients have difficulty expressing their feelings (alexithymia) and may be more prone to avoid family conflicts. Family therapy can help the family to overcome this psychological problem if it arises.

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Cause

Although not fully understood, hair loss can have many causes:

Hair loss pattern

Male hair loss patterns are believed to be due to a combination of male genetics and dihydrotestosterone hormones. The cause of female hair loss patterns remains unclear.

Infection

  • Dissecting cellulitis
  • Fungal infections (such as tinea capitis)
  • Folliculitis
  • Secondary syphilis
  • Demodex folliculorum , a microscopic mite eating sebum produced by sebaceous glands, denies essential hair nutrients and can cause depletion. Demodex folliculorum does not exist on any scalp and is more likely to live in an overly oily scalp environment.

Drugs

  • Temporary or permanent hair loss may be caused by some medications, including for blood pressure, diabetes, heart disease and cholesterol problems. Anything that affects the body's hormonal balance can have a noticeable effect: these include the contraceptive pill, hormone replacement therapy, steroids, and acne medications.
  • Some treatments used to cure mycotic infections can cause very large hair loss.
  • Drugs (side effects from drugs, including chemotherapy, anabolic steroids, and birth control pills)

Trauma

Alopecia traction is most commonly found in people with horses or cornrows that pull their hair with excessive force. In addition, a tight brushing and heat style, rough scalp massage can damage the cuticle, the hard outer casing of the hair. This causes the individual strands to become weak and broken, reducing the overall volume of hair.

  • Trichotillomania is a hair loss caused by a compulsive withdrawal and a hair bending. The onset of this disorder tends to start around early puberty and usually continues into adulthood. Due to the constant extraction of hair roots, permanent hair loss can occur.
  • Trauma such as childbirth, major surgery, poisoning, and severe stress can cause a hair loss condition known as telogen effluvium, where large amounts of hair enters the resting phase at the same time, causing subsequent shedding and depletion. This condition also appears as a side effect of chemotherapy - while targeting the splitting of cancer cells, this treatment also affects the hair growth phase with the result that almost 90% of hair loss immediately after chemotherapy begins.
  • Radiation to the scalp, such as when radiotherapy is applied to the head for the treatment of certain cancers there, may cause baldness of the irradiated area.

Pregnancy

Hair loss often follows birth in the postpartum period without causing baldness. In this situation, the hair is actually thicker during pregnancy due to the increase in circulating estrogen. Approximately three months after delivery (usually between 2 and 5 months), estrogen levels decline and hair loss, often specifically seen around the hairline and temple area. Hair usually regenerates normally and treatment is not indicated. A similar situation occurs in women who consume clomiphene that stimulates fertility.

Other causes

  • Alopecia areata is an autoimmune disorder also known as "spot spotting" that can cause hair loss from just one location ( Alopecia areata monolocularis ) to every hair in the whole body ( Alopecia areata universalis ). Although it is thought to be caused by hair follicles becoming dormant, what triggers alopecia areata is unknown. In most cases, this condition corrects itself, but it can also spread throughout the scalp (alopecia totalis) or throughout the body (alopecia universalis).
  • Localized or diffuse hair loss can also occur in cicatricial alopecia (lupus erythematosus, lichen plano pilaris, folliculitis decalvans, central cicatricial alopecia centrifugal, postmenopausal alopecia frontal fibrosing, etc.). Tumors and skin growth also cause localized baldness (sebaceous nevus, basal cell carcinoma, squamous cell carcinoma).
  • Hypothyroidism and side effects of related drugs can cause hair loss, usually frontal, which is primarily associated with thinning of the outer third of the eyebrows (also seen with syphilis). Hyperthyroidism (overactive thyroid) can also cause hair loss, which is more parietal than frontal.
  • Temporary hair loss can occur in areas where sebaceous cysts are present for long periods of time (usually one to several weeks).
  • congenital alopecia triangle - This is a triangle, or oval in some cases, patch-shaped hair loss in the temple area of ​​the scalp that occurs mainly in young children. The affected area mainly contains vellus hair follicles or no hair follicles at all, but does not expand. The cause is unknown, and although it is a permanent condition, it has no other effect on the affected individual.
  • Thinning hair gradually with age is a natural condition known as involucional alopecia. This is due to an increase in the number of hair follicles that move from growth, or anagen, phase to a resting phase, or telogen phase, so that the rest of the hair becomes shorter and fewer in number.
  • Unhealthy scalp environment can play an important role in hair thinning by contributing to miniaturization or causing damage. Air and water pollutants, environmental toxins, conventional stretching products and excessive amounts of sebum have the potential to accumulate on the scalp. These ruins can block the hair follicles and cause damage and consequently the miniaturization of hair. It can also physically restrict the hair. growth or damage to the hair cuticle, which leads to weakened hair and breaks easily before its natural life cycle ends.

Other causes of hair loss include:

  • Alopecia mucinosa
  • Deficiency of biotinidase
  • Chronic inflammation
  • Diabetes
  • Lupus erythematosus
  • Pseudopelade from Brocq
  • Telogen effluvium
  • Tufted folliculitis

Genetics

The genetic form of autosomal recessive local hypotricosis includes:



Female Pattern Hair Loss
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Pathophysiology

Growth of hair follicles occurs in cycles. Each cycle consists of a long growth phase (anagen), short transition phase (catagen) and short resting phase (telogen). At the end of the resting phase, hair loss (exogenous) and new hair begins to grow in the follicle begin the cycle again.

Typically, about 40 (0-78 men) of hair reach the end of their resting phases every day and fall off. When more than 100 hairs fall off every day, clinical hair loss (telogen effluvium) can occur. Growth of growth phase causes abnormal loss of anagen hair (anagen effluvium).

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Diagnosis

Since they are not usually associated with increased levels of loss, male pattern and female hair loss patterns generally do not require testing. If hair loss occurs in young men without a family history, drug use may be the cause.

  • The pull test helps evaluate the spread of scalp hair. Gentle appeal is given to a group of hair (about 40-60) in three different areas of the scalp. The number of extracted hairs is calculated and examined under a microscope. Usually, less than three hairs per area should come out with every pull. If more than ten hairs are obtained, a tensile test is considered positive.
  • The pitch test is done by pulling the hair out "by the roots". The picked hair roots are examined under a microscope to determine the growth phase, and are used to diagnose telogen defects, anagen, or systemic diseases. Telogen hair has small, non-protective tubers in their roots. Telogen effluvium showed an increased percentage of hair after examination. Anagen hair has a veil attached to their roots. Anagen effluvium shows a decrease in telogen-phase hair and an increase in the number of broken hairs.
  • Scalp biopsy is used when the diagnosis is uncertain; biopsy makes it possible to distinguish between scar tissue and nonscarring forms. Hair samples are taken from an area of ​​inflammation, usually around the border of the bald.
  • Daily hair count is usually done when the tensile test is negative. This is done by counting the number of missing hairs. Hair from the first morning of combing or during washing should be calculated. Hair collected in clear plastic bags for 14 days. Notes noted. If the hair count is & gt; 100/day, it is considered not normal except after shampooing, where the hair count will reach 250 and become normal.
  • Trichoscopy is a non-invasive method of examining hair and scalp. Tests can be done with the use of a handheld dermoscope or video dermoscope. This allows the differential diagnosis of hair loss in most cases.

There are two types of identification tests for female pattern baldness: Ludwig Scale and Savin Scale. Both track the progress of the spreading thinning, which usually begins on the crown of the head behind the hairline, and gradually becomes more pronounced. For male pattern baldness, the Hamilton-Norwood scale tracks the progress of receding hairline and/or thinned crown, to a horseshoe-shaped hair ring around the head and to total baldness.

In almost all cases of depletion, and especially in cases of severe hair loss, it is advisable to seek advice from a doctor or dermatologist. Many types of thinning have genetic or underlying causes, which can be diagnosed by a qualified professional.

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Management

Hide hair loss

Head

One method of concealment of hair loss is a "comb", which involves restyling the remaining hairs to cover the bald area. Usually a temporary solution, only useful while the area of ​​hair loss is small. When hair loss increases, the comb becomes less effective.

Another way is to wear a hat or wig - wig or wig. Wigs are a natural or artificial hair layer that is made to resemble a distinctive hairstyle. In many cases, the hair is artificial. Wigs vary greatly in quality and cost. In the United States, the best wigs - which look like real hair - cost tens of thousands of dollars. Organizations also collect individual donations from their own natural hair to be made into wigs for young cancer patients who lose hair due to chemotherapy or other cancer treatments in addition to any type of hair loss.

Eyebrow

Although unusual as the loss of hair on the head, chemotherapy, hormone imbalance, hair loss form, and other factors can also cause hair loss in the eyebrows. Loss of growth beyond one-third of the eyebrows is often associated with hypothyroidism. Artificial eyebrows are available to replace missing eyebrows or to cover uneven eyebrows. Eyebrow embroidery is another option that involves using a knife to add pigments to the eyebrows. It provides a natural 3D view for those who worry about the artificial look and it lasts for two years. Micropigmentation (permanent makeup tattoo) is also available for those who want the look to be permanent.

Drugs

Treatment for various forms of hair loss has limited success. Three drugs have evidence to support their use in male pattern hair loss: minoxidil, finasteride, and dutasteride. They usually work better to prevent further hair loss, than to regrow the lost hair.

  • Minoxidil (Rogaine) is a non-prescription drug approved for male pattern baldness and alopecia areata. In fluid or foam, it is rubbed onto the scalp twice a day. Some people have an allergic reaction to propylene glycol in minoxidil solution and minoxidil foam is developed without propylene glycol. Not all users will regrow hair. The longer the hair stops growing, minoxidil is less likely to regrow hair. Minoxidil is not effective for other causes of hair loss. Growth of hair takes 1 to 6 months to start. Treatment should proceed indefinitely. If treatment is stopped, hair fall back. Hair that grows back and the vulnerable hair disappears, while Minoxidil is used, will disappear. The most common side effects are mild scalp irritation, allergic contact dermatitis, and unwanted hair in other parts of the body.
  • Finasteride (Propecia) is used on male pattern hair loss in pill form, taken 1 milligram per day. This is not indicated for women and is not recommended in pregnant women. Treatment is effective within 6 weeks of treatment. Finasteride causes an increase in hair retention, hair weight, and some increase in regrowth. Side effects in about 2% of men, including decreased sex drive, erectile dysfunction, and ejaculation dysfunction. Care should proceed as long as positive results occur. After treatment is stopped, hair fall back.
  • Injections of corticosteroids into the scalp can be used to treat alopecia areata. This type of treatment is repeated every month. Oral pills for extensive hair loss can be used for alopecia areata. Results may take up to a month to be viewed.
  • Immunosuppressants applied to the scalp have been shown to reverse alopecia areata temporarily, although the side effects of some of these drugs make the therapy questionable.
  • There is some evidence while that anthralin may be useful for treating alopecia areata.
  • Hormonal modulators (oral contraceptives or antiandrogens such as spironolactone and flutamide) may be used for female pattern hair loss associated with hyperandrogenemia.

Surgery

Hair transplants are usually performed under local anesthesia. A surgeon will move the healthy hair from the back and side of the head to the depletion area. This procedure can take between four and eight hours, and additional sessions can be made to make the hair thicker. Transplanted hair falls within a few weeks, but grows back permanently within a few months. Hair transplant, take small leather plugs, each containing a few strands of hair, and implant spark plug into the bald part. Spark plugs are generally taken from the back or side of the scalp. Multiple transplant sessions may be required.

  • Choice of surgery, such as follicular transplant, scalp flap, and hair loss reduction, is available. This procedure is generally chosen by those who are self-conscious about their hair loss, but they are expensive and painful, with the risk of infection and scarring. After surgery has occurred, six to eight months are required before new hair quality can be assessed.
    • Scalp reduction is a process of decreasing the area of ​​bald skin on the head. In time, the skin on the head becomes supple and sufficiently stretched so that some can be removed surgically. After the hairless scalp is removed, the enclosure is covered with a scalp covered with hair. Scalp reduction is generally done in combination with hair transplants to provide a natural-looking hairline, especially those with extensive hair loss.
    • Hair drops can sometimes be used to lower the medium hairline due to hair loss, although there may be a scar that looks after further hair loss.
  • Wigs are an alternative to medical and surgical care; some patients wear wigs or wigs. They can be used permanently or temporarily to cover hair loss. High quality, natural looking wigs and hairpieces are available.

Chemotherapy

Hypothermia caps may be useful for preventing hair loss during some types of chemotherapy, especially when tazanes or anthracyclines are used. It should not be used when cancer is present in the skin of the scalp or for lymphoma or leukemia. Generally there are only mild side effects from treatment.

Embracing baldness

Instead of hiding hair loss, some may embrace it by shaving their heads. The shaved head will grow in the same way and with the same speed as the shaved face. The general public has received a shaved head too, although female baldness may be considered less socially acceptable in different parts of the world.

Alternative medicine

Food supplements are usually not recommended. Only one small trial saw palmetto showed temporary benefit in those with mild to moderate androgenetic alopecia. There is no evidence for biotin. Evidence for most other products is also insufficient. There is no good evidence for gingko, aloe vera, ginseng, bergamot, hibiscus, or sorphora in 2011.

Many people use unproven care. Egg oil, in India, Japan, Unani (Roghan Baiza Murgh) and traditional Chinese medicine, traditionally used as a treatment for hair loss.

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Research

Research looks for links between hair loss and other health problems. While there is speculation about the relationship between early male hair loss patterns and heart disease, an article review from 1954 to 1999 found no conclusive relationship between baldness and coronary artery disease. Dermatologists who conducted the review suggested that further research is needed.

Environmental factors are being reviewed. A 2007 study showed that smoking may be a factor associated with age-related hair loss among Asian men. This study controls age and family history, and finds a statistically significant positive relationship between moderate or severe male hair patterns and smoking status.

Vertex baldness is associated with an increased risk of coronary heart disease (CHD) and its relationship depends on the severity of baldness, while frontal baldness is not. Thus, vertex baldness may be a marker of CHD and is more closely related to atherosclerosis than in frontal baldness.

Aging hair follicles

The key aspect of hair loss with age is aging hair follicles. Normally, renewal of the hair follicle is maintained by the stem cells associated with each follicle. Aging hair follicles seem to be triggered by a sustained cellular response to DNA damage that accumulates in renewing stem cells during aging. This damage response involves the proteolysis of collagen type XVII by neutrophil elastase in response to DNA damage to hair follicle stem cells. Collagen proteolysis leads to the removal of damaged cells and then to the miniaturization of the terminal hair follicles.

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Etymology

The term alopecia ( ) comes from Classical Greek ??????, al? P? X , which means "fox". The origin of this use is because this animal releases its mantle twice a year, or because the ancient Greek fox often loses hair due to scabies.

The term bald probably comes from the English word balde , which means "white, pale" or Celtic balls , meaning "patch or white inflammation" , as in the horse's head.

Bulimia hair loss - My story of balding and of how I eventually ...
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See also

  • Alopecia in animals
  • Lichen planopilaris
  • List of conditions caused by problems with junctional protein

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References


Suffering from postpartum hair loss after baby? Monat can help ...
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External links


  • Hair loss in Curlie (based on DMOZ)

Source of the article : Wikipedia

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