Hair Loss Types | Alopecia Areata | Hair Alopecia

Hair loss

Hair loss is also called as alopecia.
Alopecia can be divided into patchy and diffuse alopecia.

Patchy alopecia

1. Alopecia areata

It is characterized by lesions symptomatic with circular patch with broken off hair at the edges.
Lesions might be single or multiple.
The alopecia may progress with coalescence of individual patches and the entire scalp may be involved (alopecia totalis). Hair loss may occur at other sites such as eyebrows, eye lashes, beard and body hair.

Treatment:
In majority, lesions regress spontaneously.
Re-growth usually occurs within 3mths and only those patches that persist beyond this period require treatment.
Topical corticosteroids may hasten recovery.
Systemic corticosteroids daily can produce re-growth of hair.

2. Tinea capitis

Irregular patch of alopecia with scaling and broken off stubs of hair within the patch is seen.
Multiple patches may develop.
Occasionally the patch may be inflamed.

Treatment:
Topical antifungal therapy is ineffective.

3. Lichen planopilaris

Lichen planus affecting hair follicles produce a patchy, scarring alopecia.

Minute, purple papules may be seen around hair follicles at the edges of the patches. See also: Causes of Lichen planus

4. Folliculitis Decalvans

It is a rare cause with pustules around follicles which heal with scarring and destruction of hair follicles.

5. Skin diseases

Skin diseases that produce alopecia are discoid lupus erythematosus and morphoea.

6. Trichotillomania

It is seen in people with psychiatric illness of plucking her hair.

7. Traction alopecia

It is produced by tying a tight pony tail. This is most prominent along hair margins because distant hair is subject to most traction.

Diffuse alopecia

1. Androgenetic alopecia

Loss of hair due to androgenic hormones causes diffuse alopecia. The male type has a typical pattern showing frontal recession of the hairline and thinning of the vertex.
In females condition presents with considerable thinning of the vertex hair.

2. Telogen effluvium

This is seen in post-partum and post-febrile stages.

Treatment:
Since there is no abnormality of the follicles, they begin to re-grow immediately after the old hairs are lost.

3. Drug-induced alopecia

Chemotherapy drugs, thiouracil, carbimazole, heparin, lithium, pyridostigmine and ettretinate can cause hair loss.

4. Alopecia due to systemic lupus erythematosus

5. Idiopathic diffuse hair loss

It is mostly seen in women.

Other treatment procedures:
Surgery for alopecia is useful in diseases where there is a clear distinction between areas affected by disease and areas that are spared e.g. androgenic alopecia, where the occipito-temporal fringe is never affected.
Transplantation of hair from this area to bald areas is effective.

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