Alopecia is the loss of hair, caused by different reasons like fungal infection, family history, prolong illness or autoimmune disease.There may be damage to the hair shaft or follicle.It can be a small bare patch or a more diffuse pattern.
When it is due to an autoimmune disorder, the body attacks its own hair follicles, it suppress and stop the growth of hair.T cell lymphocytes cluster around affected follicles, causing inflammation and subsequent hair loss.
There are three stages in hair follicle growth in mammals – anagen, catagen and telogen. Anagen is the period of active growth.This is followed by a period of apoptosis or regression.Finally there is telogen or a period of rest before the next phase of anagen begins.In this phase generally the hair fiber is shed.
Classification of Alopecia
• Alopecia areata: It is an autoimmune disorder.The immune system attacks hair follicles.It is a non-scarring, inflammatory disease in which there is complete hair loss. Alopecia areata is a systemic disease because apart from affecting the hair follicles, it also often affects the nails and the eyes.
Alopecia areata is occasionally associated with other autoimmune conditions such as allergic disorders, thyroid disease, vitiligo, lupus, rheumatoid arthritis, and ulcerative colitis. Alopecia areata occurrence is occur in most of the adults between 30 to 60 years of age. Alopecia areata is not contagious.
• Androgenetic alopecia: Mainly affects men and hair loss caused is permanent.
• Alopecia totalis: If the patient loses all the hair on the scalp, the disease is then called Alopecia totalis.
• Alopecia universalis: If all body hair, including pubic hair is lost, the diagnosis then becomes Alopecia universalis.These are quite rare condition.
People of all the races are affected.
It is common in both sexes. It can occur at any age; however 15-29 are peak years of occurrence.
The exact cause is unknown.It is thought to be a genetic predisposition, T- cell mediated autoimmune reaction. Alopecia patients have a positive family history.
Various studies have shown that human leukocyte antigen DQ7 and human leukocyte antigen DR4 were present more in patients with alopecia totalis and alopecia universalis.
A patient of alopecia areata complains of itching and pain over bald area that suggests involvement of peripheral nervous system.
Other factors may trigger the onset of the disease:
Chronic illness (diabetes, hypertension).
Iron deficiency anemia.
Exposure of hair to heat.
Increased levels of the male hormones (in men as well as in women).
Chemical treatment of hair.
Rapid weight loss due to dieting.
Medications, such as chemotherapy, large doses of Vitamin A, oral contraceptive pills
Small bald patches appears of different shapes usually appear round and oval.
Alopecia areata mainly affects the scalp and beard.
The area of hair loss may be painful.
The hair tends to fall out over a short period of time, with the loss commonly more on one side of the scalp than the other.
Nails may have pitting or trachyonychia
Complete case history.
Nutritional assessment chart.
Fluorescent antinuclear antibody (FNA) test determine if there is a problem with your immune system.
Steroid injections and creams.
Medicines are given according to the causes such as minoxidil, finasteride.
Surgery: hair transplant, scalp reduction, strip or flap graft.
Head Massage increases circulation of scalp. It is done with essential oils of rosemary, lavender, thyme and cedar wood.
Avoid brushing wet hair.
Avoid hair color as it contain chemicals.
Consume well balanced diet.
In majority of patient prognosis is good about 90% of patients have shown results of re-growth of hair.Recurrence is common.
Touching the head is painful
Bald patches at or near the forehead
Scalp covered with dry scabs and scales, looking rough and dirty, extending sometimes even to forehead, face and ears.
Itching of the head
Hair loss especially after fever.
Hair loss due to syphilis.
Hair matted and tangles easily.
Falling out of hair after typhoid.
Indicated in bald spot due to hair fall.
Scalp sensitive and sore.
Humid scald head, itching and burning.
Cold sweat on the head.
Early graying of hair.
Hair falls off after abdominal diseases, after parturition.
Burning, scalding, and itching of the scalp, especially on getting warm from exercise.
Thick and indurated skin due to eczema.
Worse from warmth and better by cold applications.
Hair falls out if touched mostly on forepart of head, temples and beard.
Scalp very sensitive.
Hair loss especially in anemic females.
Round bald patches on scalp.
Falling off the hair in large bundles on the forehead and on the sides above the ears.
The roots of the hair seem to be dry.
Hair dry, falling off.
Itching; scratching causes burning.
Scalp sore to touch, itching violently.