Alopecia

By. Mr. P. Dhilip Kumar

Definition
Alopecia means loss of hair from the head or body
Types of Alopecia:
Alopecia areata: this presents sudden hair loss causing
patches to appear on the scalp or other areas of the
body.
Alopecia totalis: It is also called complete baldness in the
affected area of the head and body.
Alopecia Universalis: It is a term used when the entire
body suffers from complete hair loss which is similar to
the effect caused by chemo therapy.
Causes
Androgenic alopecia caused due to the efeects of hormones in males.
Diabetes mellitus
Dissecting cellulitis
Fungal infections like tinea capitis
Hair treatments with chemicals in relaxers and hair straightners.
Hereditary disorders
Hormonal changes
Hyperthyroidisn & hypothyroidism
Hypervitaminosis A
Iron deficiency or malnutrition
Lupus erthematosus
Medications like side effects of chemotherapy drugs and steroids and birth control pills
Radiation therapy
Scalp infection
Secondary syphilis
Pathophysiology
Due to any of the above causes

Disruption in the growth phase of the hair

The resting phase of the hair is widened

Excessive fall of hair more than 100 counts per day

Alopecia
Sign & symptoms
Characteristic skin lesions
Presence of scarring
Hair thining
Loss of hair in the frontal & parietal areas of the scalp
Diagnosis
History regarding gender such as female or male
pattern hair loss
Family history of alopecia.
The pull test: gentle traction is exerted on the group of
hair on three different areas of the scalp. The no. of
extracted hairs is counted and examined under a
microscope, if more than 10 hairs come out in each
pull then the test is termed positive.
Contd..
The pluck test: here the individual pulls the hair out by the
roots. The root of the plucked hair is examined under a
microscope to determine the presence of defect of telogens
in the hair or systemic diseases.
Scalp biopsy: the biopsy from the bald patch is taken to find
for any scarring or inflammation.
Daily hair counts: it is done by counting the number of hairs
lost by collecting the hair in the plastic bag. If the count is >
100 per day it is abnormal
Trichoscopy: it is the non-invasive method of examining the
hair loss with a hand held dermoscope or video dermoscope.
Treatment
Minoxidil (Rogaine) this is used to treat androgenic alopecia.
Finasteride (Propecia) it is indicated only for men is used to
resume hair growth.
Egg oil: it is effective for hair care as it nourishes the scalp and
promotes new growth.
Corticosteroids like cortisone injection is used to treat alopeci
areata.
Anthralin is a cream applied on the scalp and washed off daily to
increase hair growth.
Hormonal modulators like oral contraceptives or anti androgens
like spirinolactone and flutamide are used to treat female pattern
hair loss.
Surgical Management
Hair transplant: tiny plugs of hair transplanted in
areas oh hair loss
Scalp reduction: this process is done by decreasing the
areas of bald skin on the head. After hairless scalp is
removed the space is closed with hair covered scalp.
Wigs: as an alternative to medical and surgical
treatment somr patients wear a wig on hair piece. This
can be used temporarily or permanently to cover the
scalp.