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Alopecia

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Alopecia refers to hair loss from the scalp or other parts of the body. It can result from various causes, including genetic factors, medical conditions, medications, and environmental factors. Understanding the different types of alopecia, their causes, symptoms, diagnosis, and treatment options is essential for effective management. Sometimes divided into scarring and non-scaring alopecia

Types

Type of Alopecia	Description	Causes	Common Symptoms
Androgenetic Alopecia (Male and Female Pattern Baldness)	Most common form of hair loss, characterized by gradual thinning of hair.	Genetically determined and hormonally influenced.	Men: Receding hairline and bald spots. Women: Diffuse thinning, particularly on the crown.
Alopecia Areata	An autoimmune condition causing patchy hair loss, which can progress to more severe forms.	Autoimmune response where the body attacks its own hair follicles.	Patchy hair loss, usually on the scalp but can occur on the body. Can progress to total scalp hair loss (Alopecia Totalis) or body hair loss (Alopecia Universalis).
Telogen Effluvium	Temporary hair thinning due to a disturbance in the hair growth cycle.	Often triggered by physical or emotional stress, illness, or hormonal changes.	Sudden, diffuse hair shedding. Hair may come out in clumps during washing or combing.
Traction Alopecia	Hair loss caused by prolonged tension on the hair.	Common in individuals who wear tight hairstyles like braids, ponytails, or hair extensions.	Gradual hair thinning and breakage, particularly around the hairline.
Scarring Alopecia (Cicatricial Alopecia)	Permanent hair loss due to inflammation and scarring of the hair follicles.	Conditions like lupus, lichen planopilaris, burns, radiotherapy, fungal infections, or infections like TB, syphilis, HSV, etc.	Hair loss with scarring, making hair regrowth impossible. Inflamed skin, redness, and scaling may be present.
Non-Scarring Alopecia	Hair loss without permanent damage to the follicles; can regrow if the underlying cause is treated.	Endocrine disorders, pregnancy, fungal infections (Tinea capitis), drugs (Carbimazole, Warfarin, Heparin, Lithium, OCP), malnutrition (iron, zinc), or aging.	Diffuse hair thinning, shedding, or patches of hair loss depending on the underlying cause. Hair may regrow once the cause is addressed.

Causes of Alopecia

Genetic predisposition.
Autoimmune diseases.
Hormonal imbalances (e.g., thyroid disorders, polycystic ovary syndrome).
Medications (e.g., chemotherapy, beta-blockers, anticoagulants).
Nutritional deficiencies (e.g., iron, vitamin D).
Physical or emotional stress.
Infections (e.g., tinea capitis).
Trauma or prolonged tension on the hair.
Inflammatory skin conditions.

Symptoms of Alopecia

Gradual thinning of hair on the scalp.
Patchy hair loss on the scalp or other parts of the body.
Sudden loosening of hair, often in handfuls.
Full-body hair loss.
Scalp itching, burning, or discomfort.
Visible patches of broken or short hair.

Diagnosis of Alopecia

Medical History and Physical Examination:
- Detailed history of hair loss pattern, duration, and associated symptoms.
- Examination of the scalp and hair to identify characteristic patterns and signs.
Laboratory Tests:
- Blood tests to check for hormonal imbalances, nutritional deficiencies, and autoimmune markers.
Scalp Biopsy:
- Skin biopsy to examine the hair follicles and surrounding tissues under a microscope.
Trichoscopy:
- Non-invasive method using a dermoscope to visualize the scalp and hair follicles in detail.

Treatment Options for Alopecia

Medications:
- Topical treatments (e.g., minoxidil).
- Oral medications (e.g., finasteride for androgenetic alopecia).
- Corticosteroids (for alopecia areata).
- Immunotherapy (e.g., diphencyprone for severe alopecia areata).
Procedures:
- Hair transplant surgery.
- Scalp micropigmentation.
- Platelet-rich plasma (PRP) therapy.
Lifestyle and Home Remedies:
- Gentle hair care practices.
- Reducing stress through relaxation techniques.
- Healthy diet rich in vitamins and minerals.
Alternative Treatments:
- Essential oils (e.g., rosemary oil).
- Acupuncture.
- Herbal supplements.

Summary

Alopecia encompasses a range of hair loss conditions, each with distinct causes, symptoms, and treatment options. Accurate diagnosis is essential for effective management, which may include medications, procedures, lifestyle changes, and alternative treatments. Understanding the underlying factors and addressing them appropriately can help manage alopecia and improve patient outcomes.

PLEASE NOTE LEGAL ADVICE: The contents are under continuing development and improvements and may contain errors of omission or fact. Feedback vital and always welcome at drokane at gmail.com. This is not to be used for the assessment, diagnosis or management of patients. It should not be regarded as medical advice. It is only for educational purposes. Please adhere to your local protocols. If you are unwell please seek healthcare advice from your doctor. This does not replace senior or specialist advice. If you do not accept this then please do not use the website. If you need medical advice, please consult a doctor or other appropriate medical professional. If you are a medical professional and you need advice then speak to your senior or colleagues.

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