Alopecia

The word "alopecia" is the medical term for hair loss.

Hair loss can be caused by any number of conditions, reflected in a specific diagnosis.

Alopecia can be caused by number of factors starting from genetics to the environmental factors. Androgenetic alopecia (male or female pattern baldness, AGA for short) is by far the most common form of hair loss, Probably the most common non-AGA alopecias are telogen effluvium, alopecia areata, and hair loss due to cosmetic overprocessing.

The extreme forms of alopecia areata are alopecia totalis, which involves the loss of all head hair, and alopecia universalis, which involves the loss of all hair from the head and the body.

Diagnosis
Male-pattern and female-pattern hair loss do not generally require testing. If hair loss occurs in a young man with no family history, drug use could be the cause.

• The pull test
• The pluck test
• Scalp biopsy is used when the diagnosis is unsure; a biopsy allows for differing between scarring and nonscarring forms.
• Trichoscopy is a noninvasive method of examining hair and scalp. The test may be performed with the use of a handheld dermoscope or a video dermoscope. It allows differential diagnosis of hair loss in most cases.

There are two types of grading scales for female pattern baldness: the Ludwig Scale and the Savin Scale. Both track the progress of diffused thinning. For male pattern baldness, the Hamilton-Norwood scale tracks the progress of a receding hairline and/or a thinning crown, through to a horseshoe-shaped ring of hair around the head and on to total baldness.

• Medications which may work better to prevent further hair loss than to regrow lost hair:
• Finasteride (Propecia) is used in male-pattern hair loss in a pill form taken on a daily basis. It is not indicated for women and is not recommended in pregnant women. Side effects include decreased sex drive, erectile dysfunction, ejaculatory dysfunction, gynecomastia, and myopathy. Treatment should be continued as long as positive results occur. Once treatment is stopped, hair loss resumes again.
• Minoxidil: This is an effective method to treat male-pattern and female-pattern hair loss. However, only 30-40% of patients experience hair growth. Hair regrowth can take eight to 12 months. Treatment is continued indefinitely because, if the treatment is stopped, hair loss resumes again.
• Corticosteroids injections of into the scalp can be used to treat alopecia areata. This type of treatment is repeated on a monthly basis. Oral pills for extensive hair loss may be used for alopecia areata. Results may take up to a month to be seen.

• Surgery
• Hair Transplantation
• It is usually carried out under local anaesthetic.
• Two techniques- FUE and FUHT
• Once surgery has occurred, six to eight months are needed before the quality of new hair can be assessed.
• Hairline lowering can sometimes be used to lower a high hairline secondary to hair loss.
• Scalp reduction