Hair loss is called "alopecia" in medical terms. Although hair is not vital, it has very important psychological functions.
Hair loss can be particularly stressful for women. Each hair has a life cycle. These are an active phase (anagen phase) lasting approximately three years or more, followed immediately by a transitional phase (catagen phase) lasting a few days, and then a resting phase (telogen phase) lasting about three months. Hair grows approximately 0.4 mm per day. Under normal circumstances, we lose approximately 50-150 strands of hair from our heads each day. In cases of abnormal hair loss, this number increases, and the patient complains of excessive hair accumulation on combs, bathroom and sink drains, and clothing.
Causes of Hair Loss
Hair loss is classified into two categories based on whether it is reversible or not: non-scarring (reversible) and scarring (irreversible).
The most common cause of recurrent hair loss is male pattern (androgenetic) alopecia. This condition, which begins with thinning hair, is more severe in men. This genetically based disease is treated with medication (minoxidil) in the early stages and hair transplantation in the later stages.
A significant cause of non-scarring alopecia, mistakenly known as ringworm of the scalp, is alopecia areata. In its most common form, this condition involves patchy hair loss on the scalp. While it can resolve spontaneously, severe cases may be treated with corticosteroids, minoxidil, and light (PUVA) therapy.
In another condition called telogen effluvium, characterized by the sudden and significant shedding of hair, the hair thins and becomes sparse within 3-4 months. This can occur physiologically in the neonatal period and postpartum. Furthermore, severe infectious diseases, serious chronic illnesses, major surgical procedures, hypothyroidism, medications used for epilepsy, hormones, and heavy metals can all cause this condition. Treatment primarily involves eliminating the factors that lead to this condition. In addition, iron, protein, and zinc deficiencies, radiation therapy, syphilis, and fungal infections can also cause non-scarring hair loss.
It is important to remember that, especially in women, wearing hair in a bun at the back of the head or constantly holding sunglasses on the head like a hair clip can also cause tension-type alopecia.
In scar alopecia (irreversible), the hair follicle is destroyed, making regrowth impossible. It can occur as a result of severe chemical or thermal burns, skin cancers, radiation therapy, some severe fungal infections, and certain serious dermatological diseases.
Diagnosis
• Disease duration, age of onset, recurrences, and spread
• Symptoms (Burning, itching, tingling before disease activation or coinciding with hair growth)
• Worsening due to stress
• Genetic predisposition
• Common findings on physical examination should include the following:
• Oval or round, localized hair loss
• Short, tapering hairs may be found in affected areas (EXCLAMATION MARK: hairs)
• It appears as a single or multiple patches on the scalp and face. However, it can also occur in hairy areas.
• It can manifest as complete hair loss (A. Totalis) or complete body hair loss (A. Universalis).
• No scars.
• Clinically significant inflammation is rare but can occur.
Treatment
The success of treatment depends on the age of onset and the extent of the disease. If it starts in early childhood, the prognosis is poor. If the patient does not respond to treatment within 2-6 months, another treatment may be tried.
Non-Surgical Treatments:
Treatment options include corticosteroids, PUVA, topical minoxidil, hair prostheses, psychological support, squaric acid dibutyl ester, diphenylcyclopropenone, and cyclosporine. For fungal alopecia, medication may be necessary for 6-12 weeks, sometimes supplemented with shampoos (containing selenium sulfide or ketoconazole). For male pattern alopecia, topical minoxidil (a blood pressure-lowering medication), 5% procapil, or oral finasteride (for men only) may be used. Many men and women with male-pattern and female-pattern hair loss are generally happy and do not require treatment. For those who do seek medical treatment, topical minoxidil (a blood pressure-lowering medication) or oral finasteride (for men only) may be used.
Surgical
Partial hair replacement surgery can be performed in selected cases.
Prevention
Some types of hair loss can be prevented by reducing stress, eating a good and balanced diet, being more aware of hair care techniques, and (if possible) avoiding the use of medications that cause hair loss. Hair loss due to fungal infections can be prevented by keeping the hair clean and not sharing items such as hats and combs with others. Male pattern alopecia can also sometimes be prevented with the use of certain medications.
Conclusion and Recommendations
Regardless of the cause of hair loss, if someone is experiencing this, they should consult a dermatologist without panicking. It's important to remember that sometimes the solution can be quite simple.
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