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Alopecia

Hair loss from any cause is broadly called alopecia. There are many reasons for this, requiring specialist assessment in a consultation and treatment offered accordingly.

You may notice one of the below patterns of hair loss:

Diffuse (generalised thinning of the hair),
Hair shedding (hair on the pillows, clothes etc)
Localised (separate bald patches)
Receding hairline (hairline moving back at the temples or forehead).

Medically hair loss is broadly divided into non-scarring and scarring alopecia, where in the latter there is irreversible destruction of the hair follicles, thus lost hair cannot be restored. Therefore to prevent this, early assessment and treatment is vital.

What is the cause of alopecia?
It can range from stressful circumstances/illness to nutritional deficiencies, attack of hair follicles by our own immune system, genetics, fungal infections.

What are the common forms of alopecia?
Some common forms of alopecia have been described briefly below, but more information specific to your condition will be provided during the consultation.

Telogen effluvium
Telogen effluvium is hair shedding leading to generalised thin hair all over the scalp. It can be either sudden and rapid after illness, post child birth, or after a stressful event; or can be slow and progressive due to long standing medical illness or nutritional deficiencies.

Patterned hair loss or androgenetic alopecia
This is a very common form of hair loss occurring in older adults, but can develop rarely in young adults and children, which requires further investigation.
In men it presents as thinning of hair on the crown along with a receding hairline. Typically hair on the sides and back of the scalp is not affected.
In women it presents as thinning of hair on the top of the scalp, due to which the parting looks wider.
There can be a family history of similar hair loss, and in some hormonal disturbances can contribute?

Alopecia areata
It presents as smooth bald patches appearing suddenly on the scalp, due to attack of the hair follicles by our own immune system (called autoimmunity). It can develop in those personal or family history of autoimmune disorders such as vitiligo, thyroid disease, diabetes.

Tinea capitis
This is a fungal infection of the scalp, commonly seen in children, presenting with scale, pus, discharge and hair loss in a part of the scalp. It can lead to permanent, irreversible hair loss, therefore early treatment is essential.

Scarring alopecia
This is a group of conditions where inflammation causes permanent destruction of the hair follicles. It can present as redness and scale with a receding frontal hairline, or as inflamed patches on the scalp.
Although hair that is lost cannot be recovered, treatment can prevent further spread and damage.

How is alopecia diagnosed?
Diagnosis is made clinically, and sometimes a scalp biopsy is also required (a small sample from your scalp). Blood tests to check for nutritional deficiencies maybe required.

What is the treatment of hair loss?
Treatment options offered in the clinic include:

1. Creams or foams – they could be either prescribed or some can be bought over the counter
2. Injections – local injections into the scalp
3. Tablets – these are prescribed and some of them require regular blood monitoring.
4. Platelet rich plasma (PRP) –
5. Hair supplements