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Medical Conditions Causing Hair Loss There are many situations where hair shedding can be related to internal disorders. These all need specialist assessment and include such disorders as anaemia, iron deficiency, zinc deficiency, thyroid deficiency, etc. Many of these conditions lead to a very similar pattern of hair loss as that seen in androgenetic alopecia. The word "alopecia" simply means hair loss. There are many different types of hair loss and they all have slightly different names given to them. This term describes normal hair loss which occurs in men from early adult life and in women from the menopausal years. In other words, both men and women lose their hair as time goes by but men start to lose their hair at a much earlier stage. Very elderly women almost always have a reduced hair density. A variety of internal medical disorders (see below) can mimic this type of problem and it is sometimes worth considering blood tests for these disorders.
This term describes a condition where bald patches of smooth skin appear in the scalp. These patches can vary in size and occasional patients find that almost all the scalp is involved. This can affect children or adults. Often there is a forgotten episode of hair loss in childhood or a family member with a similar problem. The cause of alopecia areata is an attack on the hair follicles by white blood cells called lymphocytes. These lymphocytes are attacking the hair follicles in the mistaken belief that they represent foreign tissue (a little bit like the process which occurs in organ transplant rejection). The reasons why this occur are not known. Some patients find that spontaneous improvement occurs once again after a few months, other patients find that the problem continues long term whilst a further group of patients find that the problem progresses and worsens so that more and more hair is eventually lost. Treatment is very difficult. Taking steroid tablets internally can improve the situation temporarily but this type of treatment is very hazardous in the long term and is not usually recommended. Various skin-surface treatments are effective in some patients (but many other patients find them unhelpful). Treatments are specialised and need to be prescribed by a dermatologist. This name refers to widespread hair thinning following a major medical event. The most common such event is pregnancy and giving birth. Other such events include any serious illness or operation. The hair typically starts to shed a few weeks after the event and continues for a couple of months before making a good recovery in most patients.
There are many causes of abnormal nails. The most important cause of progressive, multiple nail disease is a fungal infection. These infections sometimes spread from other areas on the skin previously affected by fungus e.g. simple athletes foot. Some patients have nail infections without any past athletes foot. The finger nails and/or the toe nails may be involved. The affected nails are usually darker than normal, thicker than normal, more crumbly and roughened on the surface. Nail clippings can be sent for testing to identify the fungus and indicate which treatment is needed. Usually anti-fungal therapy in the form of tablets or sometimes nail lacquer applications are needed. However, there are other skin diseases which, as well as causing a rash, can also cause changes in the nails. The commonest of these is psoriasis which can affect the nails and sometimes the joints of the fingers and toes. The nail changes in psoriasis are very similar to the changes in fungal nail disease and tests are usually needed to clarify the situation. Hand eczema can also lead to nail changes especially if wet-work (e.g. in hairdressers, bar workers, housewives) is a feature of the disease. This most typically occurs when the skin of the finger tips and nail fold areas is affected by the eczema. |
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