Overview of all the known variants of alopecia
Different types of hair loss vary in terms of severity, the pattern of hair loss, causative factors, age at which it starts, and affected a body part. According to this classification following are the common types of alopecia:
It can affect any body part but most common scalp and can affect people at any age. It is an autoimmune disorder in which the hair growth cycle is disturbed by the body’s immune response.
It is a genetic disorder and is also termed as male pattern or female pattern baldness.
In this type, the growth phase of the hair cycle is disturbed, and hairs shed more than they are growing, resulting in hair thinning and ultimately hair loss.
The rapid hair loss due to certain medications like chemotherapy or radiation.
Hair loss caused due to fungal infection. It is not permanent and can be reversed by treating the infection.
A rare permanent type of alopecia due to inflammatory destruction of hair follicles, forming scar tissue.
What is Alopecia Areata ?
A condition in which the hair follicles are attacked by the body’s immune system. It causes the hair to fall out in patches and prevents new hair from growing. It can occur at any age but most common in young adults and teenagers.
The hair loss is sudden, painless, and can start from any body part like eyebrows, beard, lashes, or scalp. In most people, the patches are small and remain unnoticeable, while in others, it can progress to total hair loss.
The condition can resolve fully but has a tendency to recur. There is also a strong correlation of heredity in alopecia areata as one in five patients have a positive family history.
The landscape of Alopecia Areata
This type of hair loss has the following three different types according to the extent of hair loss:
Alopecia areata (patchy)
It is the most common type and is characterized by small patch or patches of hair loss.
Alopecia areata totalis
It is the type in which there is a total loss of hair on the scalp.
Alopecia areata Universalis
It is the rarest form and is characterized by hair loss all over the body, including the scalp.
How can an Alopecia Areata be treated ?
Multiple patches of hair loss can be a cause of concern, and affected individuals want them to be cured as soon as possible. Adults in teenage are more keen to get it treated. However, it is seen that this type of hair loss usually resolves itself with time and hair regrows back.
But those who want to manage their patchy hair loss can choose any of the following options:
Corticosteroids are the most common and initial treatment option that can be used as a topical cream, intralesional injections, or tablets. Steroids suppress the immune reaction, and new hair growth can be seen after a few weeks.
5% topical minoxidil is known to stimulate hair growth by accelerating the natural hair cycle. It will be more effective when combined with steroids.
As the condition is autoimmune, immunosuppressants are also an effective management option for treating hair loss. But they must be used with utmost care and in the case where other treatment options are not working as they suppress the immune system.
This option is best suited for long-standing patchy alopecia areata which is not resolving and has been for more than one year. The results of FUE hair transplant are excellent and permanent. It is also the best management option for hair loss on eyebrows other than the scalp.
The follicles are taken from the back of the scalp (donor site) and transferred to the affected site. The process of hair growth takes 10 to 12 months, but the hair regrowth gives confidence as the results are 100% permanent and stable.
What is Androgenetic Alopecia ?
It is the common type of hair loss in men and women, affecting almost 50% of men over 50 years of age and women over 65 years of age. It is commonly referred to as male pattern hair loss in males and female pattern hair loss in females.
In men, the hair loss starts from temples with time hairline recedes, which progress to partial or total baldness. In females, it only causes hair thinning.
What Causes Androgenetic Alopecia ?
As the names suggest, there is the role of androgens and genetics in causing hair loss. In genetically susceptible individuals, the activity of 5 alpha dihydrotestosterone (a potent metabolite of testosterone) is reduced, which affects hair growth.
The conversion of testosterone to 5 alpha dihydrotestosterone is catalyzed by an enzyme of five alpha-reductase. This DHT targets hair follicles in genetically prone individuals causing them to shrink, affecting hair growth.
It is also known to reduce hair growth by altering the normal hair growth cycle. Studies have shown this type of alopecia more prevalent in men due to higher levels of testosterone in comparison to females, and a higher five alpha-reductase in the scalp is also linked with male pattern hair loss.
Treatment options for Androgenetic Alopecia
Affected individuals must be more concerned about treating androgenetic alopecia because it cannot resolve on its own. The following treatment options are considered after evaluating the extent and cause of hair loss.
It is a well researched topical substance used for hair regrowth. It was approved as an effective treatment for androgenetic alopecia by the FDA in 1984. It is available in two strengths 2% and 5%, with 5% is in use for male pattern hair loss.
It is a 5 alpha-reductase inhibitor, which reduces the conversion of testosterone to DHT in the scalp and improves hair loss. Finasteride is also an approved medication for treating androgenetic alopecia in males by the FDA in 1997.
The effect of reduction in hair loss and improvement in hair growth is seen within 3 to 6 months.
It is a standard gold treatment for male pattern hair loss. The donor follicle or hair is taken from the back of the scalp and transferred to the balding site, which will grow after a few months.
The benefit of this treatment option is that transplanted hair is not affected by alopecia causing factors, and you’ll have hair for a lifetime.
Alopecia of any type at any age can be a source of anxiety and depression among individuals. The affected individuals are intensely suffered emotionally, socially, and psychologically.
But with advancements in medical science, you can find treatments of every type of alopecia, although some treatments take time for hair regrowth. Apart from medical management, hair transplant in now taking the world in managing baldness.
There are a lot more benefits to opting for hair transplants over medical management with fewer side effects. It is the best choice for both androgenetic and patchy alopecia as it is a permanent remedy, and the hair is not affected by recurrence as in patchy hair loss.
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