How Is Hair Loss Normally Diagnosed and Treated?
Hair loss, or alopecia, can occur in men, women and children with causes that stem from illnesses, medications, genetics and lifestyle choices. While hair loss does not pose any immediate health risks, it can affect the self-esteem of some individuals. While some are not bothered by their hair loss, some patients may seek help from the variety of medications and treatment options that are currently available.
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Types
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The most common type of alopecia is androgenetic alopecia, or male-pattern baldness.The hair loss often becomes noticeable at the crown of the head as well as the area surrounding the hairline. In its later stages, androgenetic alopecia can lead to permanent, partial or complete baldness.
Another form of permanent alopecia is cicatricial, or scarring alopecia, which can occur as a result of scalp inflammation that can damage and scar the hair follicles, preventing new hair from growing. Scarring alopecia is commonly seen in patients with lupus erythematosus or lichen planus.
Temporary forms of alopecia include alopecia areata and traction alopecia. Those with alopecia areata can experience sudden hair loss that begins with circular bald patches on the head as well as other parts of the body. Traction alopecia can occur as a result of the patient's hair styling choices such as wearing tight cornrows, hair rollers, braids or pigtails. If left untreated, traction alopecia can scar the scalp, permanently damaging the hair and its roots.
Telogen effuvium is another form of temporary alopecia that occurs when a patient experiences sudden physical or emotional trauma. The normal hair cycle growth can become disrupted and become prematurely dormant during the trauma, causing the patient's healthy growing hair to fall out of its roots. Mayo Clinic states that the hair follicles eventually recover and grow new hair within a month.
Diagnosis
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Diagnostic tests are often performed in conjunction with a thorough physical examination and medical history. The doctor may suggest diagnostic exams in order to rule out any other medical conditions that may have caused the patient's hair loss, such as diabetes, lupus and thyroid disease.
In order to determine a patient's hair-shedding process, the doctor may perform a pull test by pulling out several hair strands to see how many can be pulled. The pull test allows the doctor to rule out telogen effluvium.
Skin samples from the scalp or from several plucked hairs may also be sent to a lab in order to test it for possible infections that are responsible for the hair loss.
In the case of a difficult diagnosis such as alopecia areata or scarring alopecia, a punch biopsy may be necessary. With the use of a circular tool, the doctor removes a small portion of the scalp's deeper layer to test the specimen.
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Causes of Hair Loss
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Hair loss can be caused by prescription medications such as anti-depressants and drugs used for the treatment of gout, arthritis and high blood pressure. Medical treatments such as chemotherapy or radiation therapy can also cause patients to experience hair loss.
Hormonal changes and imbalances that are related to pregnancy, childbirth, menopause as well as excess testosterone levels are also possible culprits for alopecia. Hair loss can also be induced by nutritional deficiencies, scalp infections and over styling of the hair.
Prevention and Non-Surgical Treatments
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Alopecia can be prevented by eating a balanced diet, and the gentle handling of hair by avoiding tight hairstyles and excess blow drying. Nonprescription treatments such as Rogaine or Minoxidil can help encourage new hair to grow while minimizing hair loss.
Oral prescription medications such as Proprecia or Finasteride can be taken as a treatment for pattern baldness in men. Mayo Clinic states that if taken consistently, the drugs can slow hair loss. Other prescription medications include Dritho-Scalp and Anthralin. When applied topically, it can stimulate new hair growth for patients with alopecia areata.
Medical treatments for hair loss include monthly corticosteroid injections into the scalp, combined with corticosteroid medication to treat significant hair loss that is associated with alopecia areata.
Surgical Treatments
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Many patients resort to surgery when other methods have failed to produce results. A common surgical treatment for androgenetic alopecia includes hair transplant surgery. Skin grafts are taken from the back or sides of the patient's scalp and transplanted to the balding sections on the scalp.
Hair transplant surgery can be combined with scalp reduction surgery to create a natural appearance of the hairline for patients with severe hair loss. During scalp reduction surgery, the bald portion of the scalp is removed, and the portions of scalp with hair growth is stretched upwards over the removed area.
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References
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