The alopecia areata, commonly known as “peeled”, is a disease of unknown cause that affects children, men and women, of any age, characterized by the sudden drop of hairs in localized areas, forming circular plaques without hair and without changes of the skin. Among the possible causes is the genetic predisposition that would be stimulated by triggering factors, such as emotional stress and autoimmune phenomena. It can reach the scalp and also other regions such as the area of the beard, eyelashes, eyelashes or any other hairy region.
“Peeling” can be spontaneously remission or become chronic, with the appearance of new lesions and evolution to total alopecia, which reaches the entire scalp and even for universal alopecia, when all the hairs on the body fall. These cases are of more difficult control and treatment.
Generally, the disease does not accompany any other symptoms, but may be associated with several factors. Repilation can occur on its own or after treatment in weeks or months, and sometimes the hairs are white and then darken. The recurrence of the lesions is common.
Androgenetic (Female Baldness)
Baldness, which already bothers men greatly, when it affects women can be cause of great anxiety and emotional suffering. It is usually accompanied by an associated depressive condition. The hairs have great importance in the feminine esthetics and are highly valued as characteristic of this sex. Their loss has enormous significance in relation to self-esteem and is a frequent motive for seeking treatment. Not always diagnosed early, women end up undergoing several innocuous treatments and, when the diagnosis is made, there has already been a significant final loss of hair that could have been avoided if treated properly at an early stage.
Androgenic alopecia (baldness) is a condition that affects mainly men, but it can also affect women for the same reason (explained above). Approximately 30% of women have some degree of baldness.
Unlike men, who lose their hair in full, women have a partial hair loss. The most critical area of women is the upper frontal region of the head. Another difference is that in women, hair from the lateral and posterior regions of the head may also be affected, an unusual occurrence in men. Most women with baldness tend to preserve hair from the front line, while men develop the “intake”.
The picture may become more intense if the woman has hormonal changes, such as polycystic ovarian syndrome or menopause. In some women, androgenic alopecia only begins to manifest after menopause when there is a decrease in the production of the female hormones. In others, it may already be detected after puberty. Yarn thinning, growth difficulty, and frontal rarefaction are characteristic early in female androgenetic alopecia.
Androgenetic (Male Pattern Baldness)
Dht It is the medical term for styling the male and female pattern of hair loss.
ALOPE: Term to designate hair loss, which there are several types (Alopecia areata, androgenetic alopecia …)
ANDROGENS: are some of the various hormones that control the appearance and development of male characters, including testosterone.
GENETICS: Inheritance of genes from the father’s or mother’s family.
Normally at puberty the body begins to produce the 5-alpha-reductase enzyme. When testosterone binds to 5-alpha-reductase, it is converted to dihydrotestosterone (DHT). The hair follicles are sensitive to DHT and then begin the process of male or female pattern of hair loss (baldness). It is the most common cause. It accounts for 95% of all types of hair loss.
Androgenic alopecia or male pattern baldness is a physiological manifestation that occurs in genetically predisposed individuals, not being considered a disease. Genetic inheritance may come from the paternal, maternal, or both. It can start at puberty or at 20 or 30 years. There is no cure, but recent treatments may temporarily prevent its accelerated advance.
It is the DHT that acts on hair follicles with inheritance for baldness and that initiates the progressive reduction of these. The end result of this process is the thinning of the hair strands until their definitive fall in the form of velus (down). This process is called miniaturization (see illustration below). Bald areas begin to appear, being localized or total. Only the sides and back of the head are preserved because the follicles in these areas do not have the genetics of baldness. Associated with this picture the scalp also becomes more oily, called seborrhea.
About 72% of patients who have seborrheic dermatitis show some degree of hair loss. The treatment begins with a good hygiene of the hair and the scalp through shampoos based on ketoconazole, octopirox, selenium sulfide, among others. The use of creams based on these same substances is also indicated and, when there is associated itching, can A topical product containing corticosteroids is used. The use of Low Level Laser Therapy (LLLT) has also been associated with the base treatment for the most resistant cases. When dermatitis exceeds the scalp’s limits and is severe, it may be necessary to use oral antifungals based on itraconazole or ketoconazole.
Severe diets or abnormal eating habits can develop important deficiencies of proteins, vitamins and minerals that are important for hair vitality. When pulled, the strands detach easily from the root. This can be reversed with diet normalization and a high dose replacement therapy of protein, vitamins, minerals and other nutrients.
Chronic diseases such as lupus erythematosus, rheumatic arthritis, diabetes mellitus, serious infections, among others, also cause hair loss. In these cases, it is necessary to treat the underlying disease in combination with the dermatological treatment to recover or maintain the hair.
Both hyperthyroidism and hypothyroidism can cause hair loss. Specific laboratory tests can confirm the diagnosis. These lost hair can be recovered if the thyroid is treated quickly.
Telogen effluvium is the intense fall of hair that is in the telogen phase.
There may be several causes for the onset of telogen effluvium, such as: postpartum, discontinuation of anti-conception pills or hormone replacement pills, infections and illnesses accompanied by high fever, physical and / or emotional trauma, postoperative , Thyroid diseases, nutritional deficiencies (iron, zinc and protein) or very restrictive diets (with or without medication). Considering that the fall of up to 100 threads per day is considered normal, in order to characterize the effluvium, the number of yarns falling must be greater than this. The disease is not accompanied by any other symptoms, but may be associated with other diseases, such as seborrheic dermatitis, which, when intense, may also be a triggering factor for telogen effluvium.
Vigorous brushing, dryers, lights, excess sun, hair clips and rubbers can also damage the hair. Excessive pulling of the threads breaks the fibers and damages the cuticle (hair cap) leaving them brittle, dry, dull and with forked tips (the same can occur due to chemical damage) and finally, the fall. Changing habits is required to recover damages.
Infections and High Fever
Infectious diseases (bacterial, parasitic, fungal or viral) can cause a diffuse fall of hair. About one to three months after infection or a febrile condition, the hair may fall in large volumes. Replacement occurs after the infection is treated naturally or through specific dermatological treatment.
The mycoses (tinea) begin with small circular plates without hairs that resemble a “peeled”, but have inflammation and scaling on the skin, in addition to scratching. Part of the hair does not fall, but the wires break close to the root. Ringworm is contagious, itchy (itchy) and more common in children. Oral and local antifungals heal completely.
Some drugs can cause temporary hair loss. Chemotherapy, better known, causes a total hair fall. Among the numerous drugs that can lead to hair loss are: certain anti-inflammatories, antibiotics, antidepressants, antihypertensives, anticoagulants, anticonvulsants, antivirals, anesthetics, high doses of vitamin A, anabolic, hormonal and also in the suspension of the contraceptive pill, besides From others. By eliminating responsible medication, hair is born again and grows normally. In some cases there is a need for dermatological treatment to stimulate the birth and growth of hair.
During pregnancy the woman does not usually lose hair but about two to three months after giving birth, many hairs enter the resting stage of the hair cycle and fall in large quantities. When pulled, they easily come out in the hands. This period of the cycle lasts from one to two months and tends to stabilize naturally. Otherwise, the help of a dermatologist is necessary because other causes may be associated, such as depression, vitamin deficiencies, stress, hormonal disorders, among others.
Many women and men use chemical treatments to lighten, dye, lengthen, straighten, curl or curl hair. These treatments do not usually damage the wires when used correctly.
The intensity and frequency in using these products is what determines the damage. In this case, temporary suspension of products is required. Brushing, dryers, lights and excessive shampoos can also damage the hair. Changing habits is required to recover damages.
Hair Loss in Children
Although less common than in adults, children also lose hair. In the United States, 3% of pediatric consultations are due to this problem. Fungi, traumas and some diseases are among the main causes. Parents should be vigilant and take their children to a dermatologist for an accurate diagnosis. Hair loss disturbs especially older children, leaving them with altered self-esteem.
Already in the first weeks of life, the baby may have diffuse or localized hair loss. It is a transient picture, which does not need treatment.
The most common causes of hair loss in children are alopecia areata, fungal scalp, telogen effluvium, hormonal, nutritional, traction (trichotillomania) and systemic bacterial infections (tonsilitis, otitis …).
Fungi can reach children of all ages – especially in poorer regions, because they live in clusters and in poor hygiene housing, but they occur more in children in the pre-school and school years, that is, 5 to 10 years.
There are two types of hair loss caused by fungi: the most commonly occurring tonsillitis was caused by a fungus acquired from other children or from sick adults, from the soil, from the sand, or from dogs and cats. In this case the microorganism “cuts” portions of hair near the scalp, leaving the child with one or more peeled. Already had it, more rare, is conatgiosa and serious. It causes several lesions on the scalp, inflames the hair follicle and can leave scarring and therefore permanent baldness where it occurs.
Alopecia areata is characterized by the sudden and usually rapid fall of hair from the scalp and / or any other region of the body, leaving the skin smooth. It is an autoimmune disease that affects children, young people and adults. In childhood it occurs mainly in boys and girls from 5 to 11 years. It causes more often round or oval lesions.
It is common to be triggered by factors such as stress for the loss of a loved one.
Traditional alopecia is due to frequent trauma to the hair follicle caused by the caregiver’s actions. The classic example is the mother who always does the same braid on her daughter, forcing her hair. From so much pressure, the hair follicle ignites and atrophies. The hairs are not born anymore.
Trichotillomania, a psychiatric disorder, may also occur in children. In situations of tension and stress, they move the hair and pull it out, forming areas of baldness.
Telogen effluvium, on the other hand, is characterized by an increase in the amount / proportion of hair in the last phase, the telogen, and the consequent acceleration in the rate of fall. It can be acute or chronic. The acute form usually occurs two to three months after a high fever. The chronicle is characterized when hair loss occurs for more than six months. Among the causes are: protein malnutrition, chronic anemia and hypothyroidism.
And the anagen effluvium, in short, is characterized when all the hairs that are in the phase of growth or multiplication (anagen phase) begin to fall. It occurs in older children and tinkers with their vanity and self-esteem. In the most severe situations, they may even be affected by depressive states. Ideally, at the first indication of excessive hair loss, parents should seek a dermatologist. Most of the cases fortunately already have effective treatment.
Many women and men use products with chemicals out of legal specifications to lighten, dye, lengthen, straighten, curl or curl hair. The damage to the threads is unpredictable and often so severe that they lead to intense hair loss, as well as burns to the scalp. Even under proper conditions, if use is frequent, these products can also damage the hair and cause hair loss. Shampoos themselves, when unsuitable, bring changes to hair and cause hair loss.
No type of treatment prevents hair loss. To avoid psychological shock, as soon as the hair begins to fall, it is best to shave them off to not visualize the overwhelming loss of hair. A capillary prosthesis (wig) should be provided at the beginning of treatment. Fortunately, hair is born again between 6 and 12 months after the end of chemotherapy. The hair may be born different from the former in its appearance but, over time, it can regain the original thickness and color.
Consciously or unconsciously the hair on the scalp, mustache, eyelashes and eyebrows are pulled or rolled up until they are pulled out of the hands. This practice is more common among children but can be found in adults and most often is linked to emotional disturbances. Treatment requires psychological help from a therapist or psychiatrist.
Besides these causes there are other less common ones that have not been commented here, but that a specialist can identify them with precision. Know that most causes are reversible, when diagnosed and treated early.
Hair transplantation can reverse most cases of baldness partially or completely, naturally.
The prostheses (wigs and appliques) have evolved quite as much in the appearance as in the fixation and are indispensable in the losses of abrupt hair; As in the case of chemotherapy.
Beware of the market for “charlatans” who offer treatments and magic formulas through shampoos and topical products. Unpredictable complications can occur, so avoid! If your hair presents problems, seek a dermatologist. Managing hair loss, whether temporary or permanent, is the key to achieving important results and avoiding psychological imbalances that further compromise the situation.