Alopecia is a general term for hair loss. Alopecia areata is a specific common cause of hair loss that can occur at any age. It usually causes small, coin sized, round patches of baldness on the scalp, although hair elsewhere such as the beard, eyebrows, eyelashes and body hair can also be affected.
The more common androgenetic alopecia is the type of progressive hair loss that most men and some women are familiar with. It affects about 50% of men over the age of 50, and about 50% of women over the age 65.
What causes androgenetic alopecia?
There is a definite genetic influence with androgenetic alopecia inherited from one or either parent. There is also a hormonal influence. Dihydrotestosterone (DHT) is the main hormone responsible for androgenetic alopecia. DHT causes scalp hair loss by inducing a change in the hair follicles on the scalp. The hairs produced by the affected follicles becomes progressively smaller in diameter, shorter in length and lighter in colour until eventually the follicles shrink completely and stop producing hair.
How is androgenetic alopecia diagnosed?
The diagnosis is fairly obvious and there will nearly always be a family history. It affects men earlier than women and more commonly; and men will become aware of scalp hair loss or a receding hairline, beginning at any time after puberty.
In women the age of onset is much later most commonly in the 50’s or 60’s. If it starts earlier some blood tests may be needed by your doctor to rule out conditions that cause excess male hormones for example Polycystic Ovarian Syndrome or under active thyroid function or low iron stores.
What can be done about it?
If there is a doubt as to whether the diagnosis is androgenetic alopecia or alopecia areata then a consultation with the doctor is necessary to establish a correct diagnosis. Blood tests or a skin biopsy (tissue sample) from the scalp may be required but if the skin of the scalp looks normal then a biopsy should not be necessary.
If the diagnosis is androgenetic alopecia, as in normal male pattern hair loss several possible treatments are available.
Medical management includes: Minoxidil 4% hair solution can be used which puts the hair cycle in a temporary anagen (growth) stage. The problem is whenever the patient stops using the minoxidil the hair cycle will almost immediately reverse and the hair falls out again so improvement is only seen while the patient remains on the drug. For female patient minoxidil 2% is available. Male patients can also take a drug called finasteride orally to prevent hair loss. Finasteride reduces the levels of dihydrotestosterone on the scalp which may slow hair loss and possible help regrowth of hair. Continuous use for 3 to 6 months is required before a benefit is seen and any beneficial effects on hair growth will be lost within 6-12 months of discontinuation of treatment. Again this works well but there are potential side effects with this drug that need to be discussed with the doctor during the consultation.
Home or medical derma-rolling with mesotherapy can produce very promising results. The home kit (10 treatment 1 weeks apart) is available for purchase in the clinic as are derma rollers (80 euros). Medical Derma rolling with Mesotherapy costs 250 euros per treatment. Several treatments may be required. Surgical treatments: Hair transplantation is available and new methods give very good results. An important thing to remember is that if you have hair loss the scalp and the tips of the ears are a lot more exposed to the sun. Take you skin care seriously and protect the ears and scalp with a good sunscreen and or a hat.
Contact Adare Cosmetics Clinic for advice on treatments for hair loss.