Dr. B.S. Chandrashekar discussing about types, treatments, grades of hair loss & also highlighting the concerns of hairloss in male & females
Published: Feb 22, 2021 12:11:19 PM IST
Updated: Feb 22, 2021 08:00:28 PM IST
What is Hair loss?
Hair loss or alopecia is the thinning of hair on the scalp. It can be temporary or permanent and can affect the scalp or other parts of the body. It may be due to hair shedding, poor quality hair, or hair thinning.
The most common form of hair loss occurs gradually and is referred to as "androgenetic alopecia," referring to a combination of hormones (androgens are male hormones) and heredity (genetics) is needed to develop the condition. Hair loss disorders comprise an extensive group of conditions that can be classified as scarring and nonscarring alopecia.
Primary scarring alopecia is caused by inflammatory diseases of the scalp that lead to the destruction of pilosebaceous structures and replacement of the pilosebaceous structures with scar tissue, leading to irreversible hair loss. Primary scarring alopecias directly affect the hair follicles, whereas secondary scarring alopecia target the dermis and consequently destroy the follicles.
What are the different types of hair loss? Androgenetic Alopecia
The most common type of hair loss,it is hereditary but can be managed with medication or surgery.
Male Pattern Hair Loss
In men, hair loss can begin any time after puberty and progress over the course of years or decades. Many men with male pattern hair loss eventually become bald.
Female Pattern Hair Loss
In women, hair slowly thins all over the scalp, but the hairline usually doesn’t recede. Female pattern hair loss can cause hair to thin dramatically, but only rarely does it lead to baldness.
Telogen effluvium, a type of hair loss, occurs when large numbers of follicles on the scalp enter the resting phase of the hair growth cycle, called telogen, but the next growth phase doesn’t begin.
Anagen effluvium is rapid hair loss resulting from medical treatment, such as chemotherapy. After chemotherapy ends, hair usually grows back on its own.
Alopecia areata is an autoimmune condition, which means the body’s immune system attacks healthy tissues, including the hair follicles.
Tinea capitis, also called scalp ringworm, is a fungal infection of the scalp that’s a common cause of hair loss in children.
Other type of hair losses include Cicatricial Alopecia, Lichen Planopilaris, Folliculitis Decalvans,Dissecting Cellulitis of the Scalp, Frontal Fibrosing Alopecia, Central Centrifugal Cicatricial Alopecia, Hair Shaft Abnormalities, Loose Anagen Syndrome, Trichotillomania, Hypotrichosis
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What are the Grades of Alopecia?
In 1975, Dr. O’Tar Norwood revised Hamilton's classification after studying patterned hair loss in 1,000 males. It is the most widely used classification for hair loss in men and it defines two major patterns and several less common types. Norwood observed that thinning starts in the temples as well as the crown/vertex and slowly progresses to encompass the entire top of the scalp, and so he based his classification on this patter.
The various grades of hair loss in men described by Norwood include the following.
In Type I hair loss it shows minimal to no hair loss along the fronto-temporal expanse.
In Type II hair loss there is fronto-temporal recession that does not extend further than a line drawn through a coronal plane 2 cm anterior to the external auditory canal.
In Type III hair loss there is fronto-temporal recession that extends posterior to the coronal plane that lies 2 cm anterior to the external auditory canal.
The Type III Vertex shows hair loss that primarily affects the vertex (or crown) region with or without accompanying fronto-temporal recession that does not exceed that described in Type III.
The Type IV hair loss reveals greater fronto-temporal loss than exhibited in Type III along with marked hair loss in the crown area but with a moderately dense swath of hair that bridges the intervening expanse between the two areas.
The Type V hair loss shows more extensive hair loss in both the fronto-temporal and vertex areas with only a small bridge of dense hair between the two areas.
The Type VI hair loss reveals a complete absence of any remaining hair that separates the two now confluent areas of alopecia. In addition, the hair loss is more extensive laterally and posteriorly.
The Type VII shows the most severe expression of male-pattern alopecia with only a narrow-horseshoe configuration that remains along the posterior and lateral border of the hairline.
Grades of hair loss in women
In 1977, Ludwig proposed a classification based on the stage of evolution these consisted of three grades of hair loss, which include:
Grade I: Perceptible thinning of the hair on the crown, limited in the front by a line situated 1-3 cm behind the frontal hairline
Grade II: Pronounced rarefaction of the hair on the crown within the area seen in Grade I.
Grade III: Full baldness (total denudation) within the area seen in Grades I and II.
What are the treatments for hair loss?
Effective treatments for hair loss include some medications like Minoxidil, Finasteride, spironolactone and oral dutasterides. In case of surgeries, Hair transplant helps to make the most of the hair.
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