Alopecia is a condition manifested by hair or hair loss on different parts of the body. This problem can have a significant impact on the psychological well-being and quality of life of the sufferer, affecting aesthetics and self-esteem. But what exactly is alopecia? What are its main causes and how can we intervene? In this article we will explore the types of alopecia, its causes and possible remedies.
What is alopecia?
Alopecia is a disorder that manifests itself in the loss of hair and can occur anywhere on the body, most commonly on the scalp. This condition can be temporary or permanent, and its severity varies from slight thinning to complete hair loss.
There is a tendency to believe that alopecia only affects the elderly, but in reality it can also affect young adults and teenagers, especially if they have a genetic predisposition.
Let us first take a look at the hair growth cycle:
- Growth phase: anagen. This is the longest phase (2-6 years), shorter in men and longer in women. As the years go by, the duration of the anagen phase decreases and with it also the maximum length that hair can reach.
- Regression or transition phase: catagen. In this phase, which lasts about 3 weeks, the activity of the follicle stops and the detachment of the bulb, which lies at the base of the follicle and is responsible for its reconstruction during the hair/hair growth cycle, occurs. The hair starts to rise to the surface.
- Resting phase: telogen. In this last phase, which lasts 2-3 months, the hair/hair falls out, under pressure from the new, growing hair.
Alopecia can be divided into two categories:
- Cicatricial, characterised by the permanent destruction of hair follicles, which means that hair can no longer grow back.
- Non-cicatricial, in which there is a temporary reduction or interruption of hair growth without definitive damage to the follicles.
One of the most common forms is androgenetic alopecia, a hereditary condition also called ‘common baldness’, both male and female, affecting only the head area. It manifests itself with a progressive thinning of the hair (so-called miniaturisation of hair follicles) in different areas depending on gender:
- Men: forehead, upper part of the head (the so-called ‘cleric’) and temples.
- Women: upper part of the head.Thinning starts in the central area, widening the hair line.
Alopecia areata, on the other hand, is an autoimmune disease that affects hair follicles. It can occur during periods of high stress or be associated with other autoimmune diseases, such as thyroid problems, especially hypothyroidism, but also hyperthyroidism, autoimmune gastritis or vitiligo. It consists of an abnormal reaction of the immune system, which attacks follicles as if they were foreign elements, causing hair to fall out in limited areas. This disease can also affect eyelashes, eyebrows, beard or other areas of the body and has a sometimes sudden onset, with the typical patch appearing within a day. Sometimes it also manifests with fissuring or roughness of the nails.
Causes of alopecia
The causes of hair loss are numerous and complex. Among the most common are:
- Genetic factors. Genetic predisposition is one of the main causes of androgenetic alopecia. In this type of alopecia, hair loss is linked to the action of dihydrotestosterone (DHT), a hormone derived from testosterone that acts on hair follicles, reducing the hair growth phase.
- Hormonal imbalances. Hormonal changes, especially in women, can affect hair health. Conditions such as menopause, polycystic ovary syndrome or childbirth can alter the hair growth cycle.
- Medications and medical treatments. Certain drugs, such as chemotherapies or those used to treat autoimmune diseases can damage hair follicles and cause temporary hair loss. This phenomenon is known as anagen effluvium. Exposure to toxic substances can also have the same effect.
- Systemic disorders and stress. Chronic illnesses, infections, high fever or periods of intense psychological stress can trigger hair loss, often suddenly.
- Physical and chemical trauma. Some aggressive beauty practices, such as excessive use of straighteners, hairdryers, chemical dyes or too tight braids, can cause a form of traction alopecia.
- Drastic diets and nutritional deficiencies. Together with changes in hormones, stress and systemic disorders, it causes a form of temporary hair loss called telogen effluvium. This occurs when a very large number of hairs enter the resting phase of the hair growth cycle. Normally, only a small percentage of hair is in this phase, but in the case of telogen effluvium, a large number of hairs stop growing and fall out, usually within a few months of the triggering event.
- Alcohol abuse. Alcohol abuse can contribute to hair loss for several reasons, linked to the negative effects that alcohol has on the body and, consequently, on hair follicles. Let us look at the main effects:
Interference with the body’s absorption of nutrients essential for healthy hair, such as B vitamins, vitamin C and vitamin D, minerals (zinc, iron, magnesium) and proteins.
Dehydration. Alcohol is a diuretic, which means it promotes dehydration. Chronic dehydration reduces the hydration of the skin and scalp, causing brittleness in the hair and a less favourable environment for its growth.
Effects on the immune system. Chronic alcohol abuse can impair the immune system, increasing susceptibility to infections and autoimmune diseases such as alopecia areata.
Increased oxidative stress: Alcohol increases the production of free radicals and oxidative stress, which damage the body’s cells, including hair follicles. This cell damage can interfere with the normal hair growth cycle, causing hair to fall out.
Symptoms of alopecia
Alopecia can manifest itself in different forms depending on the type and the underlying cause. Here are the main signs and symptoms:
- Localised or diffuse hair loss: loss may occur in a circumscribed area (alopecia areata) or over the entire scalp (telogen effluvium).
- Progressive thinning: in androgenetic forms, hair becomes progressively thinner and more brittle, with loss concentrated on the upper part of the head.
- Bald patches: areas without hair are formed, often round or oval in shape, particularly in alopecia areata.
- Thinning hair: before falling out, hair may become thinner and thinner. This symptom is particularly common in androgenetic alopecia.
- Loss of hair in other areas of the body, such as eyebrows, eyelashes, beard or other areas.
- Itching or irritation: sometimes itching, tingling or irritation of the scalp may be experienced before hair loss.
- Sudden loss: In most cases, hair loss is gradual, but in some cases, such as in stress alopecia, hair may fall out rapidly and in large quantities.
It is important to consult a specialist when hair loss becomes significant (more than 100 hairs per day) over a prolonged period (more than a month).
Remedies and treatments
Alopecia is one of the most common conditions treated in dermatology. It often requires an examination by a specialist doctor, who, if he or she deems it necessary, will subject the patient to tests and examinations to formulate the correct diagnosis and determine the most appropriate treatment.
The treatment of alopecia depends on the underlying cause. Some forms, such as androgenetic alopecia, require specific drug therapies, but there are also products that can help combat hair loss, such as:
- Anti-hair loss gels or sprays to be applied to the scalp, formulated with selected ingredients, such as glycerine, which helps the hair retain moisture, or panthenol, a derivative of vitamin B5 which nourishes the hair by preventing weakening of the hair shaft, or biotin, also known as vitamin B8, which can stimulate the hair bulb and thus create optimal conditions for hair regrowth. These products stimulate epidermal elasticity and tone, improving the general condition of the scalp.
- Food supplements containing sulphur amino acids, trace minerals such as iron, copper, selenium and zinc, and vitamin B5. Selenium and zinc contribute to maintaining healthy hair and nails, while copper, selenium and zinc protect cells from oxidative stress, also improving hair resistance to external factors.
Daily scalp care and a healthy lifestyle can make all the difference in preventing hair loss. Following a balanced diet, rich in vitamins and minerals, is essential for maintaining healthy hair. Moreover, as stress is a common trigger for many forms of alopecia, practices such as yoga, meditation and muscle relaxation can help reduce stress and, consequently, hair loss.
When lifestyle changes and preventive treatments are not enough to combat hair loss, a number of pharmacological medical interventions are possible. A further step is laser therapy. This non-invasive treatment uses low-intensity laser light to stimulate hair follicles and promote hair growth.
In more severe cases, i.e. in people suffering from advanced androgenetic alopecia, when other medical or natural therapies have failed, the dermatologist may indicate hair transplantation. This is an outpatient surgery that allows hair follicles to be transferred from less affected areas of the scalp to the bald area. For this reason, it is indicated for those who still have a good amount of hair in the donor areas, usually at the back and sides of the scalp, from which follicles are taken for the operation.
Sources:
https://www.aad.org/public/diseases/hair-loss/types/alopecia/symptoms