Androgentic Alopecia 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 can mimic this type of problem and it is sometimes worth considering blood tests for these disorders.
Whilst generalised thinning of the hair might be inevitable there are medical deficiencies and other conditions which need an expert consultation
to diagnose and treat.
Hair loss conditions usually respond best to very early treatments so an urgent consultation here
can prevent progression.
Alopecia Areata is 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 iseventually 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). Smooth patches of baldness should be treated urgently to give the best possible chance of re-growth. An expert consultation
should help lead to more rapid treatment.
by Dr John Ashworth