Is treating baldness realistic?
Hair loss means losing hair from any part of the body. When you lose hair on your head, it’s called “baldness.” Some people worry about hair loss because of how it looks, but sometimes it can be a sign that something else is wrong in the body.
Hair grows in a cycle. First, hair grows for a long time—this is called the growth phase and can last years. Then, hair goes through a very short change, called the transition phase. After that, it rests for a few months in the resting phase. At the end, the hair falls out so a new hair can grow in its place. This happens over and over again.
It’s normal to lose about 50 to 100 hairs from your head every day.
Sometimes, people lose more hair than usual. This can happen if the hair stops growing too soon or if too many hairs go into the resting phase at once. Doctors use special names for these problems.
Doctors might say hair loss is in one spot (focal) or all over (diffuse). They also look to see if the skin where hair is lost has a scar or not.
- (androgenetic alopecia)
Others commons aetiologies of alopecia are:
- Alopecia areata
- Certain systemic disorders, such as cutaneous lupus erythematosus and hormonal disorders
- Medications, especially chemotherapy
- Fungal infections, such as ringworm of the scalp (tinea capitis)
- Physical stress such as high fever, surgery, serious illness, sudden weight loss, or pregnancy (all of which can lead to telogen effluvium)
- Psychological stress
- Injury (trauma)
- Trichotillomania (mental disorder characterized by habitual pulling out of healthy hair)
- Traction alopecia (hair loss caused by constant pulling, for example, from wearing braids, curlers, or a ponytail)
- Burns and radiation
- Pressure alopecia (for example, after a procedure in which prolonged pressure is applied to the scalp and causes damage to the hair follicles)
Androgenetic alopecia is a type of hair loss that happens more as people get older. It affects many men and women, especially older adults.
A hormone called dihydrotestosterone can cause this type of hair loss. Family genes also play an important role.
Hair loss can begin at any age, even during teenage years.
For boys and men, hair usually gets thinner at the forehead or the top of the head. Some will lose just a little hair.
Others may lose almost all the hair on top but still have hair on the sides and back. This is called “male pattern baldness.”
For girls and women, the hair on the top of the head gets thinner. The hairline at the forehead usually stays the same.
This is called “female pattern hair loss.”
Alopecia areata is a kind of hair loss. It causes round or odd-shaped patches where hair falls out suddenly.
Sometimes, even more hair can be lost later. This happens because the body’s immune system gets confused.
The immune system starts to attack the hair by mistake. This is called an autoimmune reaction.
Centrifugal central scarring alopecia is a main cause of scarring hair loss for Black women. It can happen when the scalp is hurt by hot combs, chemical straighteners, or weaves.
Some people are more likely to get this because of their genes and hair type.
Hair loss can get worse over time. Scar tissue may form on the top and back of the head.
In cutaneous lupus erythematosus, patches of hair can fall out. Hair loss can be permanent if the hair follicle is destroyed.
This kind of lupus can happen even if a person does not have full-body lupus. The body attacks its own tissues in this disease.
Systemic lupus erythematosus affects many organs. It can cause wide hair loss but usually does not leave scars.
Chronic cutaneous lupus erythematosus often causes hair to fall out in patches. Sometimes, the hair loss is permanent or leaves scars.
Hormonal imbalance If women have too many male hormones, or are very sensitive to them, they can lose hair on their scalp. They might also get more acne and extra hair on their face or body, like men do.
The most common reason for this is polycystic ovary syndrome (PCOS). Women with PCOS often have more hair on their face and body. Some may lose hair on the top of their head, which is called female pattern baldness.
If there are a lot of male hormones, women might notice other changes. Their voice may get deeper, muscles may get bigger, and their periods can become irregular. Sometimes, the clitoris can get larger and they may want sex more often.
Rarely, a tumour in the ovaries or adrenal glands can make too many male hormones and cause these changes. Taking certain medicines or having a special problem with the adrenal glands can also cause this.
Oily hair and heat from the sun can make baldness start earlier, especially in young adults. Wearing helmets a lot, like in kitchens or construction, can also lead to early hair loss. These cases are easier to treat, especially for people younger than 65.
Food troubles: Eating disorders are a less common cause of alopecia. Symptoms vary depending on the eating disorder:
- Excess vitamin A: rash, chapped lips, painful swelling of the limbs, listlessness, loss of appetite and weight loss
- Iron deficiency: anaemia, with increased exhaustion and reduced ability to exercise
- Zinc deficiency: skin rash, diarrhoea, frequent infections, loss of appetite or difficulty healing
Drug use: Male or female pattern baldness can happen after using anabolic steroids.
Medicines for cancer, called chemotherapy, can stop hair from growing. This causes hair to fall out during the growth phase.
Other medicines, like blood thinners or those for high blood pressure, acne, thyroid, or seizures, can also cause hair loss.
These medicines often make more hair go into the resting phase, which leads to extra hair falling out.
Ringworm of the scalp (tinea capitis) Ringworm of the scalp is a fungus that can cause hair loss in children. It often starts as a dry, scaly patch on the head.
The patch gets bigger over time. Hair may break off at the roots, leaving very short hairs on the scalp that look like tiny black dots.
Sometimes, hair breaks above the scalp and leaves short, broken pieces. If the infection is not treated, hair loss can become permanent.
Traction alopecia: This kind of hair loss happens when hair is pulled too tightly by braids, curlers, or ponytails. Hair usually falls out near the forehead and temples.
Seeing a doctor can help you know if you need a physical exam. The doctor will check your scalp and hair to find the cause.
Warning signs Here are the particularly worrying signs:
- Signs of a body-wide problem can show up in different ways.
- In women, this might mean getting a deeper voice or hair in places where men usually have hair. Periods can become irregular. There might be more acne or smaller breasts. Muscles may get bigger. The clitoris can become larger. Some women may also want sex more often.
When to see a doctor:
- People with hair loss and signs of a body-wide problem should see a doctor right away.
- Women who start to look or sound more masculine should also get medical help quickly.
- Others with hair loss should talk to a doctor soon, unless symptoms get worse fast.
What does the doctor do The doctor first asks questions about the person's symptoms and medical history and then performs a clinical examination. Information from the medical history and physical examination often suggests a cause for the hair loss and what tests may need to be performed.
Doctors can ask these questions about alopecia:
- Did it start gradually or suddenly?
- How long ago?
- Is it increasing?
- Is the hair falling all over your head or in a specific area?
Doctors ask about other symptoms, like itching or flaking skin. They want to know about hair care routines, like using braids, curlers, or hair dryers.
They ask if someone often pulls or twists their hair. Doctors also ask about recent medicine, drug, or toxin exposure, or if the person is very stressed.
They want to know about big weight changes, eating habits, and if someone follows strict diets. They also check for obsessive-compulsive habits or family history of hair loss.
During the exam, doctors look at the scalp and see where the hair is missing. They check the skin for any changes or scars.
They measure the width of the scalp in different places. Sometimes, they use a microscope to look at the hair.
Doctors check hair all over the body, like eyebrows, eyelashes, arms, and legs. They look for rashes or signs of certain diseases.
For girls, doctors also check for signs like a deep voice, extra hair, acne, or a larger clitoris. The thyroid is checked too.
What are the Treatments ?
Treatment of specific causes Sometimes replacement methods Specific etiologies of alopecia are treated wherever possible: Medications causing alopecia are changed or stopped.
Medication or surgery can be use to treat hormonal disorders,depending on the cause.
Taking Iron or zinc supplements: Doctor's may prescribe eating supplements , if people are deficient in some minerals or vitamins.
Reduce the vitamin A. Doctore can also prescribe to reduced the consuption of A vitamin, in people with alopecia caused by excess vitamin A.
Alopecia areata can usually be treated with corticosteroids that are injected into the skin, applied to the scalp (topical), or given by mouth. Other topical and oral medications may be administered. Cutaneous lupus erythematosus, lichen planus pilaris, and frontal fibrosing alopecia can usually be treated with corticosteroids that are injected into the skin or applied topically, or with other topical or oral medications.
Eliminating the physical traction or stress experienced by the scalp.This is the way to treat Alopecia due to traction or stress to the scalp.
Anti-fungal medications administered orally.
Ringworm of the scalp is treated with special medicine called anti-fungal pills.
Trichotillomania, a habit of pulling out hair, is hard to treat. Some people get help with therapy or certain medicines.
If hair loss happens after stress, like weight loss, surgery, sickness, or having a baby, it often gets better on its own. Using minoxidil on the scalp can help some people. If hair doesn’t grow back, other treatments or medicines might be needed.
Both boys and girls with pattern baldness can use medicine to slow or stop hair loss. Minoxidil is a liquid you put on your head twice a day. It can help hair grow back, but it takes time—about 8 to 12 months. It can sometimes cause skin itching or a rash. Sometimes, it causes hair to grow on the face. Minoxidil can also be taken as a pill.
Finasteride is a pill that blocks certain hormones. It is usually for men, but some women may use it after menopause. Women who can have babies should not use finasteride because it can be harmful. Finasteride works in about 6 to 8 months, but everyone is different. It can sometimes cause side effects like less interest in sex, bigger breasts, or trouble with erections. Some people may feel sad or worried when taking it.
If you stop using these medicines, hair loss usually starts again. Some women may get help from another medicine called spironolactone.
Hair transplant: Transplantation is a more permanent solution. In this procedure, hair follicles are taken from an area of the scalp and grafted into the alopecic area. This technique involves the transplantation of only 1 to 2 hairs per session.
Another surgical option involves taking alopecic areas of skin from the scalp and stretching the areas with hair over a larger area.
Hair transplant Wigs:
Wigs are a good choice for people who lose hair for a short time, like during cancer treatment.
It’s smart to talk to a wigmaker before starting chemotherapy, so the wig is ready when needed.
When hair grows back, it might look or feel different than before.
Other options
Laser phototherapy is another way to treat hair loss for both boys and girls. It can help hair grow. You can buy these devices or get treatment from a doctor.
A new treatment called PRP uses your own blood. The doctor takes your blood, separates the special part with platelets, and injects it into the scalp. This can help new hair grow.
Some people use powders or special products to make hair look thicker. Others use a type of tattooing called scalp micropigmentation to hide thin spots.
Conclusions:
- Male and female pattern baldness are the most common types of hair loss
- Doctors check for other health problems if a woman looks or sounds more like a man.
- Sometimes, doctors use a microscope or do a small scalp test (biopsy) to find out why hair is falling out.
- Doctors treat the main cause if they can. If not, they use medicines, hair implants, laser therapy, or PRP shots to help.
- Treatments work for about 72% of men, 86% of women, and 98% of people under 25 years old.