What is it about ?
The abnormal hair loss is called alopecia. Hair grows from hair follicles. The amount of hair follicles is hereditary, and so is your hair. With age, the number of hair follicles decreases and your hair becomes thinner.
Hair grows in a well-defined pattern. During their growth phase, they grow an average of half a millimeter per day. Then the growth slows down and eventually enters the degradation phase, during which the hair falls out. This cycle then begins again from the beginning. It is therefore quite normal for new hair to grow and the oldest to fall out.
If you lose more than 100 hairs per day, it becomes abnormal and it is called hair loss or alopecia. Usually, this is a disorder determined by genetic factors where male hormones play a role. This reaction may be caused by an infection with fungi (yeast infection), a disease of the thyroid gland, anemia, the birth of a child, stress, certain medications (for example chemotherapy), or even an external cause such as hair treatment.
Where and how often?
About 60% of men, sooner or later, lose some or all of their hair. Alopecia can start at a young age, but it usually begins after 40 years. The younger the hair loss begins, the more likely it is to go completely bald. In women, alopecia is much rarer. In them, the hair becomes more and more sparse, but the baldness is never total.
How to recognize it?
We make a distinction between multiple alopecia and diffuse alopecia:
- In case of’local plaque alopecia, one or more bald areas are observed. In the presence of dandruff or redness of the scalp, it is advisable to think of a yeast infection (tinea capitis). In case of hair loss in irregular patches, it is possible that it is a trichotillomania (obsessive and compulsive disorder characterized by an urge to pull the hair out).
But most often bald patches are smooth. This is called “alopecia areata” or alopecia areata. In the past, it was thought that stress was the cause, but this hypothesis is not at all confirmed. In fact, we just don’t know the cause. Hair almost always comes back spontaneously. It happens that at the beginning the hair is quite white.
Telogen effluvium refers to a state in which a larger quantity of hair than usual simultaneously passes from the growth stage to the inertia stage, which results in loss of this hair after 2 to 4 months after the appearance the causative factor (eg insufficient functioning of the thyroid gland (hypothyroidism), undernutrition, stress, lack of red blood cells (anemia), childbirth, illness with high fever, etc.).
- We are talking aboutdiffuse alopecia when hair loss spreads all over the scalp. In men, it begins at the forehead and temples, and the implantation of the hair slides backwards. In women, the hair becomes thinner. In these cases, the hair no longer grows back.
How is the diagnosis made?
Usually, the examination is limited to a simple examination of bald patches. Blood tests and microscopic examination of pieces of skin in the affected area are of little value, but can sometimes rule out an underlying condition. Occasionally, a fungus can be detected. To do this, you have to take a little affected skin and send it to the laboratory. In women with severe diffuse alopecia, it is sometimes necessary to do a hormonal analysis and exclude other causes.
What can you do ?
The ideal is to have it checked if there is no underlying cause. If not, you can only wait patiently. Most of the time, fallen hair simply grows back within 6 months. Products available in the market for treating hair loss are generally expensive and have no effect. It is unnecessary to take vitamins or trace elements like iron and zinc.
What can your doctor do?
Usually, your doctor won’t be able to do wonders either. In case of “alopecia aerata”, for lack of a better alternative, we sometimes resort to lotions with cortisone.
Diffuse alopecia in humans can be treated with minoxidil solution for topical use. The effect persists, but only as long as the treatment is continued.
In women, minoxidil lotion can also be applied at lower concentrations.
Another possibility is hair implantation: new hairs are implanted between the hairs still present. The results are quite good. In case of annoying baldness, you can of course resort to a hairpiece or a wig. There is a refund under certain conditions.
Want to know more?
- Alopecia, baldness: hair loss is hard – mongeneraliste.be – SSMG – Société Scientifique de Médecine Générale
- Alopecia areata (image) – Global Skin Atlas
- Tinea capitis (image) – Global Skin Atlas
- Trichotillomania (image) – DermIS – Dermatology Information System