What is it?
Alopecia is defined as the process of decrease in hair quality (color, thickness) and quantity or its loss. Alopecias can be classified into scarring, divided into hereditary and acquired, and non-scarring divided in turn into hereditary and acquired. More than 120 different hereditary non-scarring forms have been investigated, mostly genetic in nature. They can occur either in isolation or with involvement of other organs. Among the acquired forms are found:
- androgenetic alopecia, which affects only hair of the frontal and upper areas of the head;
- telogen effluvium, in which the hair falls abundantly without forming any patch;
- alopecia areata, which forms glabrous patches in its manifestation;
- total alopecia areata, disappearance of hair all over the head;
- universal alopecia areata, which affects the hairs of the whole body;
- psychogenic alopecia;
- trichotillomania, the voluntary breaking of hair, common in children and adolescents.
Scarring forms lead to complete destruction of the hair follicle and include congenital forms such as aplasia cutis and dystrophic epidermolysis bullosa and acquired forms such as discoid lupus, lichen plano pilare and Brocq's pseudoarea.
Which are the symptoms?
In alopecia the most relevant sign is the hair loss that can be more or less relevant. With regard to androgenetic alopecia, in general it does not show a considerable increase in the volume of hair loss and, on the contrary, many individuals become bald, losing very little hair per day. The first sign of the occurrence is the progressive thinning of the stem, initially not appreciable to the naked eye, then more and more obvious. rarely show other associated symptoms such as seborrhea, burning and itching. in acquired scarring the symptomatology is more pronounced.
How is it diagnosed?
The diagnosis is based mainly on clinical and anamnestic data. Trichoscopy is of great help, since it allows the epiluminescence observation of the scalp and the observation of the diameter of the hair stems, their density and possible inflammation. In doubtful and scarring forms, biopsy with histological examination is necessary.
How is it treated?
Effective remedies against alopecia are local treatments that allow to
- slow down the excessive hair loss bringing it back to a physiological level;
- to favor, with nutritive and stimulating treatments and with correct hygienic practices, the normal regrowth of hair where the follicles are still active.
It must be remembered, in fact, that effective remedies to alopecia can be prepared only if the hair follicles have not already atrophied. Therefore:
- in case of temporary alopecia, effective remedies can be worked out by personalizing trichological treatments and minimizing damages;
- in case of scarring alopecia, with atrophied follicles, there are no remedies that stimulate regrowth, but one can intervene only with self-hair transplantation;
- in case of scarring alopecia, with follicles not yet atrophied, there are also no remedies to save hair, but it is possible to intervene with
- treatments that slow down the process of hair loss.
With the exception of cases of exclusive medical competence, in order to contrast alopecia and hair loss it is possible to intervene with these techniques that can be combined depending on the case.
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