The Alopecia

What is alopecia?

Alopecia is a disease that involves an abnormal loss of hair, greater than 100 hairs a day. But it can also be defined as the premature fall or absence of hair in one or more parts of the body. Losing one’s hair is common in anyone, it is when one exceeds 100 hairs a day that one can start talking about alopecia.

Alopecia and baldness are synonymous. Universal alopecia is hair loss throughout the body; While total alopecia is the hair loss on the scalp.

Alopecia is an inevitable issue from a certain age for men and women, and the numbers do not lie. By the age of twenty, 60% of people begin to feel the first signs of alopecia. One in four men over the age of twenty-five will begin to suffer from baldness, and when they turn fifty, the figure rises to fifty percent. In the case of women, it should be noted that at least 50% of them have suffered from alopecia during their lifetime. Although we try to hide hair problems, the reality is that they are very present in our daily lives. In Spain, more than 40% of the population suffers from alopecia and it is a factor that affects physically and psychologically and that depends on many circumstances.

Types of alopecia:

Androgenetic alopecia:

Also known as baldness, it is the most common in men; 80-90% of cases of alopecia. It is produced mainly by genetic causes, hereditary, because of age and, especially, by male hormones (androgens). You can inherit both father and mother and it can start at any age, from puberty.

The degree of sensitivity to dihydrotestosterone (DHT) is a natural metabolite (substance produced by the body or used when food, drugs or chemicals break down, or their own tissues such as fat or muscle tissue. called metabolism, produces the energy and materials necessary for growth, reproduction, maintenance of health and elimination of toxic substances) of the male hormone testosterone causes weakening of the follicle. DHT causes hair atrophy, hypertrophy of the hair sebaceous gland and a decrease in hair density, thinning and losing color.

DHT first causes a shortening of the growth phase of the capillary cycle, which leads to the miniaturization of the hair and finally the hair becomes thin, short, colorless, leaving less and less hair on the head.

To fight against this, there are only two products, a topical (minoxidil) and an oral (finasteride). The 3rd option, definitive, is the hair transplant.

Scarred alopecia

It brings together a large number of diseases that attack hair, destroy hair follicles, atrophy and replace it with scar tissue, this hair loss is irreversible.

Symptoms: There are cases that experience itching, pain, irritation or tenderness; it usually manifests as redness, pustules with pus and desquamation of the scalp; you can lose your hair quickly. In other cases, the hair is lost gradually, without realising it. A biopsy can be done to determine the cause. Sooner or later, they cause hair loss, although there are diseases that have little to do with the hair, but end up touching them, such as syphilis or tuberculosis.

The types of cicatricial alopecia exist according to the causes that produce them:

• Infectious (bacterial, viral, mycotic)
• For dermatoses: skin diseases (lichen, lupus, etc.)
• For neoplastic diseases (tumors, cancer)
• For hereditary diseases
• Decanting clinical syndromes: diseases that directly attack the hair and cause it to fall (fibrous frontal alopecia, follicular follicle, etc.).
• By physico-chemical agents (radiation, burns, etc.)

Norwood scale

The Norwood scale allows us to rank the different types of alopecia for men, depending on the affected areas

• Type I-II: Initial baldness: localized forehead.
• Type III-IV: The average baldness is located in the anterior region and the crown and the upper part of the head.
• Tipo V: Wide baldness and extended fall with limitations.
• Tipo VI-VII: Severe baldness and almost generalized hair loss

Phases of the capillary cycle

The hair follicle or bulb completes 3 phases, the so-called capillary cycle:

1. Anagen or growth phase (from 2 to 6 years old): The formation of hair and growth in the papilla
2. Catagen, transition or involution phase (approximately 2 to 3 weeks). The hair does not grow anymore and is detached from the hairy papilla (where it feeds).
3. Telogen phase, free fall or at rest (approximately 2 to 4 months). The hair begins to fall, although its root remains in the follicle. When finished, a new cycle begins.