Alopecia is the abnormal loss of hair in any of its locations. It also applies when, without real loss, the patient notices a change in quality such as fragility, refinement or loss of volume . The causes are multiple and range from genetic -for genetic or familial predisposition of the affected person- to environmental -for nutritional deficiencies in food or external aggression-. To better understand the different causes, it is best to describe the different types of alopecia. Basically the alopecias are divided into two large groups, scarring alopecias and non-scarring alopecias .
They are rare , they can be congenital, caused by certain infectious agents, caused by malignant tumors that affect the scalp or due to other skin diseases or general -such as cutaneous lupus erythematosus, scleroderma, lichen planus, pseudopelada of Brocq and folliculitis decalvant-. In these cases, fortunately rare, there is destruction of the hair follicle and residual scarring fibrosis so that the total recovery of the hair is more difficult.
Non-scarring alopecias, types and prevention
They are much more frequent and in them the chances of recovery are much greater because there is no definitive destruction of the hair follicle. Within this group the most frequent forms are:
Alopecia areata. Rounded areas of hair loss of varying size. It can appear at any age although they are frequent in childhood. When the process affects the entire scalp it is called Alopecia areata universal. They are often associated with autoimmune processes, especially in the thyroid or emotional stress situations. In this case, it is most appropriate to intervene promptly in the case that they do not tend to spontaneous resolution to try to prevent universal alopecia.
Male and female androgenetic alopecia. It consists of a refinement and progressive loss of hair from the frontoparietal area of the scalp with receding hairline (inputs) that is progressive and can reach the crown area (vertex). It has a clearly familiar character and in women they can manifest as of menopause, although both men and women can start early during the first years of adult life. It can be prevented by initiating prompt treatment soon if the person recognizes early symptoms early, especially if he has a family history of baldness.
Diffuse alopecia. There are two main types: anagen effluvium and telogen effluvium . The anagen effluvium occurs within days or weeks after the triggering agent - for example, antineoplástica- chemotherapy administration and may lose up to 90% of the hair. They are difficult to prevent although, in general, the prognosis is good and the hair can be fully recovered.
The telogen effluvium occurs a few months after the responsible event - such as a birth or an episode of high fever -, a hundred hairs are lost daily and it lasts longer in time and can become chronic. A variant is the seasonal telogen effluvium that usually occurs in the autumn months after hair exposure in the summer months to aggressive external agents.
Treatments for alopecia
Treatments range from topical or intralesional corticosteroids in cases of alopecia areata to the application of FDA-approved products and EMA for androgenetic alopecia such as topical or intralesional use of minoxidil and finasteride in tablets at different doses according to the cases. In general, our best advice is that if you have any doubt, go to a dermatologist you trust.