Hair Loss Disorders

What is Alopecia?

Alopecia areata is an autoimmune condition that causes hair loss. While hair loss might be predominantly from the scalp, it can occur all over the body. It generally produces a patchy form of hair loss distinctly different from pattern baldness. It often appears randomly.

These issues are believed to be triggered by an autoimmune condition wherein the body attacks the hair follicles. Alopecia is most often seen in people with a family history of the disorder, who have asthma, or who have received cancer treatment using certain immunotherapy drugs.

There are several alopecia areata subcategories. They include

• Alopecia totalis: This typically starts as alopecia areata, but the bald patches across the scalp spread, leading to complete or near-complete baldness
• Alopecia universalis: The most advanced state of alopecia – near-total or total hair loss all over the body.
• Diffuse alopecia areata: The presentation of this condition differs from alopecia areata in that the hair loss is dispersed evenly across the scalp, so it is more challenging to diagnose. There are no bald patches.
• Involutional alopecia: A natural condition in which the hair gradually thins with age. More hair follicles go into the resting phase, and the remaining hairs become shorter and fewer in number.
• Trichotillomania: Seen most frequently in children, this is a psychological disorder in which a person pulls out one’s own hair.
• Telogen effluvium: A temporary hair thinning over the scalp that occurs because of changes in the growth cycle of hair. A large number of hairs enter the resting phase at the same time, causing hair shedding and subsequent thinning.

Causes of Hair Loss

Doctors don’t know why certain hair follicles are programmed to have a shorter growth period than others. However, several factors may influence hair loss:

• Hormones, such as abnormal levels of androgens (male hormones normally produced by both men and women).
• Genes,from both male and female parents, influence a person’s predisposition to male or female pattern baldness.
• Stress, illness, and childbirth can cause temporary hair loss. Ringworm caused by a fungal infection can also cause hair loss.
• Drugs, including chemotherapy drugs used in cancer treatment, blood thinners, beta-adrenergic blockers used to control blood pressure, and birth control pills, can cause temporary hair loss.
• Burns, injuries, and X-rays can cause temporary hair loss. In such cases, normal hair growth usually returns once the injury heals.
• Autoimmune disease may cause alopecia areata. In alopecia areata, the immune system revs up for unknown reasons and affects the hair follicles. In most people with alopecia areata, the hair grows back, although it may temporarily be very fine and possibly a lighter color before normal coloration and thickness return.
• Cosmetic procedures, such as shampooing too often, perms, bleaching, and dyeing hair, can contribute to overall hair thinning by making hair weak and brittle. Tight braiding, using rollers or hot curlers, and running hair picks through tight curls can also damage and break hair. However, these procedures don’t cause baldness. In most instances, hair grows back normally if the source of the problem is removed. Still, severe damage to the hair or scalp sometimes causes permanent bald patches.

Diagnosis Process

Like other conditions, diagnosing hair loss involves a complete medical workup since numerous medical factors could contribute to the condition. You’ll likely discuss family history, medical history, activities, how you care for your hair, and eating habits. Moreover, you will likely undergo blood tests, hair sample analysis, and a scalp biopsy.