HAIR LOSS TYPES: ALOPECIA AREATA DIAGNOSIS AND TREATMENT

Hair loss is a widespread condition affecting both men and women. The medical term for excessive hair shedding is alopecia. There are various hair loss types, ranging from temporary to permanent. By understanding the different hair loss types and getting an accurate diagnosis, appropriate treatment can be pursued. This comprehensive guide will examine the hair loss types, patterns, causes, diagnosis and available treatments for the many hair loss types people may experience.

The Normal Hair Growth Cycle

Hair grows from follicles located beneath the skin’s surface. Hair follicles cycle through repetitive periods of growth and rest:

• Anagen phase – Active hair production occurs in this growth phase, lasting 2-7 years on the scalp.
• Catagen phase – Marks the end of active growth as follicles regress. Lasts about 2-3 weeks.
• Telogen phase – Resting phase when hair detaches and sheds from the follicle. Lasts approximately 3-4 months.

At any given time, 85-90% of hair follicles are in anagen while 10-15% are in telogen. Excessive hair loss happens when this normal cycle is disrupted. The various hair loss types have different disturbance triggers and patterns.

Overview of Major Hair Loss Types

There are many forms of alopecia. Some of the most common hair loss types include:

Telogen Effluvium: Hair loss types

This refers to excessive shedding where a higher number of follicles than normal prematurely enter telogen rest phase. It causes noticeable thinning of hair volume. Common triggers include high fever, malnutrition, surgery, thyroid disorders, medications, severe stressors, and more.

Anagen Effluvium: Hair loss types

This is rapid, abnormal hair loss resulting from disruption of actively growing anagen follicles. Powerful medical therapies like chemotherapy often induce anagen effluvium. Hair loss is widespread but reversible within 3-6 months of stopping the causative medication or treatment. However, regrown hair may be thinner or differ in texture.

Androgenetic Alopecia: Hair loss types

This progressive hair loss types are genetically driven, following predictable patterns based on age and androgens like testosterone. In men, it causes the typical male pattern baldness with receding hairline and crown thinning. In women, it leads to diffuse thinning hair on top of the scalp without recession of the frontal hairline. It gradually worsens over time without treatment.

Alopecia Areata: Hair loss types

This common autoimmune disorder results in patchy, non-scarring hair loss types. The body’s immune system attacks the hair follicles, halting hair production. It can affect any hair-bearing site. The course is unpredictable with periods of remission and recurrence.

Traction Alopecia: Hair loss types

This is hair loss from persistent pulling or tension on hair over time. Tight hairstyles like braids, weaves, cornrows, tight ponytails or buns often induce traction alopecia around the temples and along the edges of the scalp. It can become permanent if styling practices continue.

Trichotillomania: HAir loss types

This hair loss types are self-induced, caused by repetitive urge to pull out one’s own hair. It leads to patchy incomplete hair loss. Therapy is required to treat the underlying psychiatric condition causing the behavior.

Scarring Alopecias: Hair loss types

This group of disorders damages hair follicles through inflammation, leaving scar tissue that prevent hair regrowth. Examples include lichen planopilaris, discoid lupus erythematosus, and folliculitis decalvans. Steroids, immunosuppressants, or surgery may sometimes help.

Focusing on Alopecia Areata: Hair Loss Types

Alopecia areata is a common autoimmune cause of patchy, non-scarring hair loss types. It carries a lifetime risk of around 2% and can occur at any age, often starting in childhood. Examining its pathophysiology and evolving treatment landscape is key for properly managing this form of patchy hair loss types.

Etiology and Pathogenesis

Alopecia areata is driven by an immune attack on the hair follicles, mistakenly seen as foreign by the body’s own immune system. The pathogenesis is not fully understood but involves a complex interplay between genes, the environment, and immune factors:

• Genetic susceptibility – Many affected individuals have a family history. Certain genes raise risk, including HLA genes and those linked to other autoimmune disorders.
• Environmental triggers – Viral illness, stressors, hormones, or trauma may trigger onset in genetically vulnerable people.
• Autoantibodies – Antibodies produced by the immune system bind structures in hair follicle cells, interrupting hair production.
• Perifollicular inflammation – Inflammatory cells and chemicals likely contribute to hair growth disruption.
• Regulatory T-cell abnormalities – Dysfunction in cells that maintain tolerance to body’s own tissues also plays a role.

Genetic predisposition combined with one or more triggers leads the immune system to attack the hair follicles as foreign, resulting in patchy hair loss types. Hair regrowth is possible, but recurrence over time is common.

Patterns of Presentation

There are several patterns in which alopecia areata hair loss may manifest:

• Patchy hair loss – One or more circular bald patches appear suddenly on the scalp or other hair-bearing sites.
• Alopecia totalis – Total loss of all hair on the scalp.
• Alopecia universalis – Loss of all head and body hair.
• Ophiasis pattern – Band-like hair loss around scalp periphery, often the back of the head. Indicates poorer prognosis.
• Diffuse hair loss – Widespread thinning over the whole scalp without complete bald areas.

Only the hair follicles are affected – the skin looks normal without scarring or inflammation. Nail pitting or ridging may accompany hair loss.

Diagnosis

Doctors can often make a clinical diagnosis of alopecia areata based on the pattern of hair loss types and examination findings. These include:

• Sudden onset of circular bald patches
• Smooth areas of hair loss without scarring
• Exclamation point hairs – short hairs tapered at the end
• Loose hair that is easily pulled out
• Nail abnormalities in some cases
• Patient or family history of other autoimmune disorders

Sometimes, a scalp biopsy is performed to confirm alopecia areata and rule out other hair loss causes. There are no blood tests specific to alopecia areata.

Disease Course and Prognosis

The course of alopecia areata is unpredictable with periods of remission and recurrence. However, some factors provide clues about prognosis:

• Early age of onset – Developing first patches in early childhood predicts higher likelihood of recurrence and increased severity.
• Rapid progression – More extensive hair loss progression tends to occur if over 50% scalp area affected at initial presentation.
• Pattern of hair loss – Ophiasis pattern and alopecia totalis have poorer prognosis compared to patchy hair loss.
• Nail involvement – Presence of pitting or ridging indicates higher disease activity.
• Trigger factors – Eliminating potential triggers may improve remission likelihood.

Psychological support is key when coping with alopecia areata’s unpredictable course. Consistent treatment also promotes regrowth potential.

Treatment Modalities for Alopecia Areata: Hair loss types

While alopecia areata has no cure yet, various treatments can stimulate hair regrowth during periods of remission. Treatment options include:

Corticosteroids

Injecting potent steroids like triamcinolone directly into bald patches helps reduce inflammation and regrow hair. Topical and oral steroids may also be used.

Immunosuppressants

Drugs like methotrexate, cyclosporine and azathioprine which suppress the aberrant immune response may promote hair regrowth.

JAK Inhibitors

Small molecule drugs like ruxolitinib and tofacitinib that inhibit inflammatory JAK signaling pathways show effectiveness for alopecia areata.

Phototherapy

Light therapy with targeted UVB radiation helps calm inflammation in bald areas when used with other treatments.

Alternative medicine

Options like acupuncture, aromatherapy, capsaicin, and herbal preparations have limited evidence but potential based on small studies.

Hair transplantation

This surgically redistributes unaffected follicles from the scalp to cover patches. Provides cosmetic benefit but surrounding hair may still fall out later.

Wigs and cosmetics

These camouflage bald spots but have no effect on the course of alopecia areata. Some patients find them helpful.

Supportive care

Counseling, mindfulness, and stress management provide emotional health support to cope with alopecia-related distress.

Combination approaches over long durations optimize hair regrowth results. Open communication with one’s dermatologist allows customizing therapy.

Hair loss types: Emerging and Future Treatments

Exciting new treatment avenues being explored through alopecia areata research include:

Novel JAK inhibitors

Several other JAK inhibitors besides ruxolitinib and tofacitinib are entering clinical trials, like baricitinib and brepocitinib. Early phase results appear promising.

Stem cell therapy

Studies injecting activated mesenchymal stem cells or derived growth factors report some hair regrowth potential. More robust evidence is still needed.

Interleukin inhibitors

Drugs blocking inflammatory interleukin pathways, like IL-15 inhibitors, may reduce immune attack on hair follicles.

Other immunomodulators

The use of monoclonal antibodies, protein kinase inhibitors, and agents regulating cytokines/chemokines are being investigated.

Gene therapies

Technology like CRISPR to edit disease-linked genes or gene delivery through viral vectors could someday treat alopecia areata at the genetic level.

Ongoing research brings hope that consolidation therapy targeting multiple immune pathways may someday cure alopecia areata.

Hair loss types: Coping with an Alopecia Areata Diagnosis

Being diagnosed with alopecia areata poses emotional challenges for many patients. Hair loss can damage self-image and confidence. Helpful coping strategies include:

• Learning about alopecia areata as an autoimmune disorder, which is not the patient’s fault.
• Seeking support from alopecia areata foundations, support groups and communities.
• Pursuing counseling if struggling with self-esteem, depression or isolation due to hair loss.
• Trying wigs, scarves, hats and other stylish head coverings to aesthetically camouflage hair loss.
• Being open with loved ones about the alopecia diagnosis to build empathy and understanding.
• Partnering with a dermatologist to find appropriate medical therapies and stay optimistic.
• Practicing self-care through sufficient sleep, a healthy diet, stress reduction, exercise, etc.
• Accepting the condition as one with periodic ups and downs to avoid frustration over time.

Adjusting to an alopecia areata diagnosis takes time, but various coping strategies make it more manageable. Focusing on the journey and inner positivity allows you to move forward.

Conclusion

In summary, the hair loss types range widely – from temporary shedding to permanent scarring alopecia. Alopecia areata is an autoimmune disorder that causes non-scarring, patchy hair loss mediated by mistaken immune attack on hair follicles. Driven by a complex interplay of genes, triggers, and immune factors, alopecia areata follows an unpredictable course. While not yet curable, treatments like JAK inhibitors, immunosuppressants, light therapy and more can promote hair regrowth during periods of remission. Ongoing research brings hope that targeted immunotherapy may someday provide a definitive cure.