Conditions

Alopecia (Hair loss)

Almost all forms of hair loss are called alopecia even though the clinical definition is the loss of all scalp hair. There are many different forms of hair loss and each form has different contributing factors. However, doctors still don't know the actual cause of the most common forms of hair loss.

Alopecia is primarily a cosmetic problem with little effect on the overall health of the body (although hair loss can be a sign of other health problems). The cosmetic aspects of alopecia can be devastating to self-esteem and should be addressed. With today's treatments, it is possible to slow-down and even stop hair loss.

Signs and Symptoms:

The only real symptom of alopecia is, of course, the loss of the hair itself. However, since there are many different forms of alopecia, the hair loss can progress at different levels and can be either temporary or permanent. (See Diagnosis)

Diagnosis:

There are two major forms of alopecia ­ scarring and non-scarring. The form of alopecia determines the ability to reverse the affects and what sort of treatments can help.

The scarring form of alopecia tends to be less reversible. This type usually results from infections that cause inflammation around the hair follicles, which eventually leads to the replacement of hair follicles with scar tissue. This is usually the result of a deep bacterial and fungal infections (such as ringworm) or an infection of the herpes zoster virus. A culture of the scalp tissue, usually taken near the problem area, may be able to track down the organism responsible for the infection and help guide in treatment.

Scarring alopecia may also result from physical trauma, such as, chemical or thermal burns. Other possible causes can include lupus, syphilis, tuberculosis, and sarcoidosis. Some tumors can cause scarring of the scalp (very rare ­ more often this is caused from the radiation treatment for brain tumors).

Nonscarring alopecia is the more common form of hair loss. This is where androgenic alopecia (better known as male pattern baldness) is classified. Male pattern baldness is when the hair begins to thin and recede back from the forehead, over the top, and down the sides. This condition usually becomes apparent in the man's late thirties or early forties, however it can start as early as the late teens. The exact cause is unknown, but hereditary factors and sex hormones are involved.

Hormone-related hair loss can also occur in women, especially after menopause, during and after pregnancy and even during puberty. This form of alopecia tends to be primarily a thinning of the hair and is not normally as extensive as it is for men.

Often severe illness can cause temporary hair loss. High fevers tend to be the main trigger. The same type of alopecia has also been associated with certain medications, most notably drugs used for cancer chemotherapy. Other drugs that can contribute to hair loss include: birth control pills, allopurinol, anticoagulants, some anti-inflammatory drugs, and some blood-pressure medications. Also, even though vitamin A is necessary for healthy skin and hair, excessive amounts of vitamin A can lead to toxicity and hair loss.

Glandular problems, mineral deficiencies, malnutrition, and surgery may also contribute to hair loss.

Sometimes hair falls out in patches, usually coin-sized, while the surrounding areas appear normal. This condition is known as alopecia areata. Some doctors believe that this is caused by an immune-system problem. The hair tends to return at intervals, but recurring hair loss is common.

Fashion-related hair loss is also a form of nonscarring alopecia. Hair that is repeatedly pulled into tight braids or ponytails or is subjected to strong dyes, bleaches, or other harsh chemicals can suffer considerable damage. The form of alopecia is normally temporary.

A species of tiny mite, Demodex follicularum, may be another contributing factor in balding. These mites are present in virtually all hair follicles by the time a person reaches middle age, and in most cases, are harmless. Researchers believe that some people lose their hair because their body reacts to the presence of the mites and initiates the inflammatory response as it tries to reject the mites. Thus, blocking the hair follicles and killing the mites. Unfortunately, this also kills the hair.

Treatment Options:

Treatment options for alopecia vary depending on the form your hair loss takes. Often a combination of treatments may be needed.

Traditional Treatments:

Since many forms of hair loss are a result of an underlying health problem, treating that problem often reverses the hair loss. Your doctor may do a scalp biopsy to determine the health of your scalp. He or she may then treat you for such things as hypothyroidism, parasitic infestation, protein deficiency, mineral deficiency, hormonal changes, or ring worm.

Male pattern baldness, often responds to the following drugs:

• Minoxidil (Rogaine) - originally prescribed as a blood-pressure regulator but caused hair growth as a side effect and was adapted for topical use to treat alopecia. Unfortunately, it rarely results in a significant regrowth of hair, and it must be used on an ongoing basis.
• Finasterid (Propecia) - works by changing dihydrotestosterone into testosterone, which is somewhat less androgenic. This reduces the hormonal contribution to hair loss. Side effects include decreased sex drive, rash, and breast tenderness.
  Warning: This treatment is not suitable for women. A woman who is pregnant or might become pregnant should not even touch a broken tablet, as this can lead to malformation of sex organs in a developing male fetus.
• Steroid injections and/or application of skin irritants ­ both have had sporadic results. In general the sooner this treatment is started, the better the results.

Complementary and Alternative Therapies:

There are a variety of alternative treatments for alopecia. One of the major factors in hair loss is thought to be nutritional deficiencies. Eating a diet high in protein however, limiting the amount of animal proteins may help delay balding. In addition to a healthy diet, nutritional supplements can help treat alopecia.

Nutritional Supplementation:

• Multivitamin and mineral supplement ­ helps avoid nutritional deficiencies that can lead to balding.
• Take daily 500 mg flaxseed oil ­ can help if your skin is dry and flaky. Take two or three times daily.
• 200 mg inositol ­ stimulates hair growth in some individuals with nonscarring types of hair loss. Take twice daily.
• Raw thymus 500 mg ­ stimulates immune function and improves functioning capacity of glands.
• Ultra Hair from Nature's Plus ­ a combination formula that is known to stimulate hair growth.
• Choline ­ should be taken in equal parts with inositol.
• Vitamin E (with mixed tocopherols) ­ necessary for healthy skin (including the scalp and hair follicles). Start by taking 200 IU daily. After two weeks, increase the dosage to 400 IU daily.
• Biotin -­ 300 mcg daily. Deficiencies have been linked to skin disorders and hair loss.

Alternative Therapies:

• A rinse made from apple cider vinegar and sage may help hair growth.
• Ginkgo biloba can improve the circulation to the scalp.
• Green tea, pygeum, and saw palmetto may aid in reducing hair loss. Saw palmetto, in particular, has been reported to cause some reversal in male pattern baldness cases. Choose a standardized extract containing 90 % essential fatty acids and sterols. 160 mg, twice daily.
• Tea tree oil combats bacteria and mites that may contribute to hair loss. Massage 10 drops into the scalp, then shampoo in the usual fashion.
• A Chinese herbal remedy, Fo-ti, has been used in tea form to arrest hair loss and slow graying.
• Some people experience remarkable success with scalp massages.
• Aromatherapy ­ use essential oil of rosemary and cayenne to stimulate hair growth. Make a massage oil with rosemary oil and add one or two drops of cayenne oil. Use the oil to massage your entire scalp. You can also add rosemary oil to your shampoo.

General Recommendations:

• Eat a diet high in soy foods. Soy appears to inhibit the production of dihydrotestosterone.
• Use shampoos and conditioners that contain biotin and silica. Other ingredients to look for are: aloe vera gel, vitamins C and E, or jojoba oils.
• Avoid diets that neglect any of the food groups, as deficiencies are a major contributing factor to hair loss.
• Keep your hair clean but avoid excessive washing and harsh chemicals.
• Consider topical applications of polysorbate 60 or polysorbate 80, which have been shown to break up impacted sebum that can choke off new hair growth.
• If blood flow to the scalp is good, hair transplants may be an option. Talk with your doctor for more information.

Warnings:

Finasterid (Propecia) is not suitable for women. A woman who is pregnant or might become pregnant should not even touch a broken tablet, as this can lead to malformation of sex organs in a developing male fetus.