In my first post on hair loss I looked at two genetic types of hair loss, Androgenic Alopecia patterned baldness and Involutional Alopecia (aka aging). Here I will explore three further types that yes, our genes can predisposition us to, but they may or may not manifest themselves and if they do, they can be triggered by many different influencing factors and our ability to cope with them.
Alopecia Areata
This is an autoimmune condition that often starts suddenly and causes patchy hair loss in children and young adults. About 90% of people with the condition, will have their hair return within a few years. It is a type of hair loss that occurs when your immune system mistakenly attacks hair follicles.
Alopecia Areata is most common in people younger than 20, but children and adults of any age may be affected. Women and men are affected equally. Fortunately, the damage to the follicle is usually not permanent. Experts still do not know exactly why the immune system attacks the follicles and is often attributed to stress. From what I have read it is more complex than stress, but a combination of different factors of which stress, physical or emotional can be one. There is also a long list of factors that can trigger autoimmune conditions examples include, diet, smoking, illness, trauma, pollution, changes in lifestyle as so no… in a nut shell; life!
Alopecia Areata cannot be “cured” but it can be treated. Most people who have one episode may have more episodes of hair loss. Treatments: You should seek medical advice, not all doctors will be experts so you may need to ask to be recommended to a specialist. Click here for more information on finding a specialist and associations in the US, or for advice on NHS-Treatments UK click here.
Treatments that appear to be on offered:
- Corticosteroids. These are anti-inflammatory drugs that are prescribed for autoimmune diseases. They can be given as an injection into the scalp or other areas. They can also be given in pill form or rubbed on the skin as an ointment, cream, or foam. The downside is that it may take a long time to work.
- Topical immunotherapy. This is used when there’s a lot of hair loss, or if it happens more than once. Chemicals are applied to the scalp to produce an allergic reaction. If it works, this reaction is actually what makes the hair grow back. It also causes an itchy rash, and usually has to be repeated several times to keep the new hair growth.
- Minoxidil can also be successful for some, it usually takes about 12 weeks before you see growth.
- Other treatments for Alopecia Areata include medications that are sometimes used for other autoimmune disorders. These medicines have differing amounts of success in re-growing hair
Professional tips: Similar to previous advice clever cutting, colouring and styling will help to disguise the patches. You might like to offer assistance in cataloguing the hair loss progress or hair recovery by taking photos of the affected areas. Choose a discrete location with good lighting, these photos can be very helpful for the medical specialist to review and for the individual to get a better look at what is happening.
Alopecia Universalis
This is a condition is characterized by the complete loss of hair on the scalp and body. It is an advanced form of Alopecia Areata. Although the exact cause of Alopecia Universalis is unknown, it is an autoimmune condition in which the person’s immune system mistakenly attacks the hair follicles. The hair will disappear from all over the body. There is currently no cure for Alopecia Universalis, but sometimes hair regrowth occurs on its own, even after many years.
While genetic studies have found that Alopecia Areata and Alopecia Universalis are associated with several immune-related genes, they are likely ultimately caused by the interaction of multiple genetic and environmental factors. This means that even if someone inherits a genetic predisposition to the condition (susceptibility), they may not develop the condition unless something in the environment triggers its onset. However, the exact role of environmental factors is yet to be determined. Factors that may trigger the onset or recurrence of hair loss may include a viral infection, trauma, hormonal changes, and emotional or physical stress.
Alopecia Universalis
Telogen Effluvium
This is personal as I have suffered this at various points in my life where I had large changes. Some of you may be familiar with the short floating multiple hairs that can appear around the parting, crown or temples; it is highly likely you have experienced Telogen Effluvium. It is temporary hair thinning all over the scalp that occurs because of changes in the growth cycle of hair. A large number of hairs enter the resting phase at the same time, causing hair shedding and subsequent thinning.
The diffuse hair loss caused by Telogen Effluvium can be triggered in different ways:
Postpartum hair loss, many women see hair loss within a few months of delivery, generally speaking around four months postpartum. This is not true hair loss, but rather “excessive hair shedding” caused by a drop in the hormone oestrogen.
Pregnancy hair loss, a small number of women may experience hair thinning and shedding due to stress or shock. The first trimester may stress the body as the balance of hormones shifts dramatically to support the growing baby. Stress may put more of the hairs on your head, 30 percent or more, into the telogen or “resting” phase of the hair life cycle. So, instead of losing the average 100 hairs a day, you may lose 300 hairs a day. Hair loss due to hormonal shifts may not happen right away. Instead, it may take two to four months to notice thinning. This condition doesn’t generally last longer than six months and doesn’t result in permanent hair loss.
Physical trauma, such as being involved in a car accident, losing a significant amount of blood, undergoing surgery, or drastic weight loss, can all trigger Telogen Effluvium. Exposure to toxins such as heavy metals can also cause this condition, as the impact of an environmental change can cause the hair follicles to enter into the resting phase and not grow as they usually would.
Stress physical, mental and emotional; this type of Telogen Effluvium can be sudden, it is possible that the hair thinning will not be noticeable until several months later. If the environment is stable, the hair can easily return to normal in less than six months. This is me; in a short space of time, I was moving country, changing jobs, studying for two qualifications and exercising a lot, my body reacted, to be honest I didn’t really notice it (I as too busy!) until it started to grow back.
Treatments: None as the hair usually returns back to its normal growth cycle. If concerned or worried seek medical advice.
Professional tips: Reassurance that this is a temporary condition and their hair will return to its normal grow cycle. This is also where a hand-held scalp/hair microscope is useful; you can assess the hair to check that the hair loss is even and not isolated to one area which can be an indication of a different problem.
Next week I will cover Hormonal hair loss, Chemotherapy hair loss and Cicatricial Alopecia (scaring alopecia).
Caroline
