Discovering an unexpected bald patch or noticing a sudden loss of eyelashes can be startling. Such unforeseen hair loss, whether experienced by you or a loved one, could be indicative of alopecia. The certified dermatologists at Northstar Dermatology in Texas undertake a meticulous diagnostic process to identify alopecia, subsequently curating an individualized plan aimed at hair regrowth or halting further hair loss. If alopecia is affecting your confidence and well-being, seek expert evaluation and treatment by reaching out directly or scheduling an appointment online.
Alopecia is the medical term that describes any type of hair loss. Many people conflate the term “alopecia” with alopecia areata, which is actually a very specific type of patchy hair loss caused by an autoimmune response to the hair follicle. Alopecia, generally speaking, refers to any cause of hair loss ranging from alopecia areata to hereditary hair loss.
There are several different types of alopecia or hair loss. Broadly speaking, alopecia may be split into two categories, scarring hair loss and non-scarring hair loss.
Scarring types of hair loss are less common and typically caused by an immune response to the hair follicle, leading to signs and symptoms such as redness, scaling, itching or burning of the scalp. These types of hair loss eventually lead to loss of the follicle, scar tissue formation, and irreversible hair loss.
We are more familiar with non-scarring types of hair loss. The most common amongst these are telogen effluvium and androgenetic (or hereditary) hair loss. Telogen effluvium describes a generalized shedding of the hair that typically follows some sort of physiologic stressor such as severe infection, chronic
illness, surgery, significant weight loss, or childbirth. Hair loss typically starts 3 months after the inciting event and lasts for approximately 6 months. Fortunately, the prognosis is good, and it’s generally expected to have full regrowth of the hair.
Hereditary or androgenetic hair loss is extremely common, and may be due in part to genetics as well as individual response to androgen hormone levels. Up to 80% of individuals may experience hereditary hair loss at some point, however the onset, rate and severity of hair loss will vary between individuals.
Before undergoing treatment for any type of hair loss, it’s important that you consult with your physician first. A physical examination and lab testing may be necessary to rule out any underlying medical causes of your hair loss.
When treating hereditary hair loss, several options exist. A great over the counter treatment is minoxidil 5% foam or liquid, typically marketed under the brand name Rogaine. This medication may be applied to the scalp once or twice daily. Treatment benefits may be delayed 6 months, and you may experience increased shedding in the meantime. Higher concentrations of minoxidil are available by prescription
from a board-certified dermatologist. Minoxidil may thicken many of the existing microscopic hairs leading to a thicker appearance to the scalp. Recently, oral minoxidil has also been used as an effective treatment modality.
There are also several oral medications proven to treat hair loss. Spironolactone is used for female pattern hair loss and relies on reducing androgen levels. Similarly, for both men and women, there is finasteride and dutasteride which works by blocking androgen effects on the hair follicle. Other clinically studied medications for hair loss include tofacitinib, Olumiant (baricitinib), and Litfulo (ritlecitinib) for severe alopecia areata. While generally safe, these medications do carry their respective side effect profiles, which should be discussed with your doctor.
Finally, corticosteroid injections into areas of thinning or balding can promote regrowth. A series of repeated treatments every 4 – 8 weeks is typically needed.
Hair loss may be a sensitive topic given the heavy emphasis on hair and its aesthetic qualities. There are a lot of companies that capitalize on these insecurities, marketing expensive and ineffective products. I caution patients to maintain reasonable expectations. There is no quick fix, and it’s not possible to turn back time completely to have the hair we had when we were 18. Fortunately, however, we exist at a time where more and more is being discovered about hair loss and its effective treatment. As always, seek appropriate medical advice so that you may go forward in your evaluation and treatment confidently and safely.
