EXPERT FILE

Alopecia

Alopecia

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Définition :
Broadly speaking, alopecia refers to the loss of head of body hair, from any part of your body. Considered as normal for a loss of up to 100 hairs per day, it becomes pathological beyond this value.
Alopecia :
reduction in hair density (progressiv decrease in hair volume).
Telogen effluvium :
hair growth cycle anomaly leading to rapid and exessive hair.

Alopecia, a frequent condition

Hair loss is more frequent in men, though women may also be concerned. It affects approximately 15% of 20-year-old men, 30% of 30-year-old men and one in two 50-year-old men, versus 30% of 50-year-old women.

We lose on average 50 to 100 hairs per day. Hair that falls out can be replaced by new growth:

- The anagen phase is the hair growth phase, it lasts on average 3 years (the duration may vary with gender and from one individual to the next). This is the longest part of the hair growth cycle.

- The catagen, or regression phase, lasting 3 weeks on average, during which the hair stops growing.

- The telogen, or hair loss phase, lasting 3 months on average: the hair falls naturally due to friction, brushing and pressure from a new root forming in the scalp. A new hair growth cycle can then start with a new hair.

This is the normal life cycle of a hair.

When should I consult?

You should consult if your hair starts to fall out in clumps, for no apparent reason, or if you wish to test a treatment to hide baldness.

A diagnosis can then be made, sometimes using a trichogram, which consists in plucking a few hairs from 3 specific areas of the scalp to study the roots or hair diameter under the microscope or a micro-fiche reader. This can help identify some causes of hair loss and can also serve to determine the magnitude of hair loss and to monitor treatment efficacy.

DIFFERENT TYPES OF ALOPECIA

TRANSIENT HAIR LOSS OR TELOGEN EFFLUVIUM
This is temporary and reversible. It is very frequent and may be caused by numerous factors: labour, menopause, seasonal changes, extreme fatigue, very strict diet, emotional shock, depressive state, medicines, post-surgery, etc. The hair falls out in clumps. If "hair loss" lasts beyond 3 to 6 months, the following tests should be performed: CBC, ferritinaemia and TSH to look for iron deficiency or dysthyroidism.
PERSISTENT HAIR LOSS, OR ANDROGENETIC ALOPECIA
80% of persistent hair loss falls into this category. It mainly affects men (50% have this condition at 50 years), though 15 to 20% of women are also concerned during their life. Androgenetic alopecia is genetic (family history) and occurs when the concentration of the hormone DHT (dihydrotestosterone) is too high. DHT binds to the androgen receptors on the hair follicles, thus blocking the normal growth cycle, causing it to become thinner and eventually to fall out. In this case, contrary to telogen effluvium, the hair does not fall out in clumps, but rather becomes more sparse.
JOHNSTON'S ALOPECIA OR PELADE
This is an autoimmune disease in which the body reacts against the pilosebaceous glands. It may occur in cases of stress or emotional problems. In most cases, the hair grows back after a few months.
TINEA
This is a fungal infection of the scalp. It causes circular bald spots along with desquamation (shedding of small fragments of skin) of the scalp. A few areas covered with brittle hair are left.

MANAGEMENT OF ALOPECIA

A - Telogen effluvium:

In all cases, regrowth is spontaneous and total.

The preferred treatment is supplementation with thioaminoacids, vitamins and minerals: to recreate high-quality hair and to help regrowth (e.g.: Novophane Capsules)

 

B - Androgenetic alopecia in men

Topical:

  • Minoxidil 2% skin solution
  • Minoxidil 5% skin solution
  • Micrografts
  • Wigs
  • Hair growth supplements

Per os:

  • Finasteride 1mg/day
  • Vitamins, thioaminoacids, minerals (Novophane Capsules)

 

 

C - Androgenetic alopecia in women

Topical:

  • Minoxidil 2% skin solution
  • Micrografts
  • Wigs
  • Hair growth supplements

Per os:

  • Vitamins, minerals and thioaminoacids (Novophane Capsules)

ADVICE IN THE EVENT OF HAIR LOSS

  • Wash your hair when it is dirty. Contrary to common belief, this does not aggravate hair loss, as long as you use a suitable shampoo.
  • Do not smoke - Do not drink
  • Avoid excessive exposure to sun and UV radiation
  • Avoid vigorous rubbing, heat (hair dryer or curling iron), along with repeated or chronic pulling
  • Limit dyeing or bleaching to once per month and do not combine with a permanent or straightening
  • Eat a balanced diet (iron, vitamins and thioaminoacids)

FAQ

    1. Do scalp massages reduce the rate of hair loss? Yes, massaging the scalp stimulates blood micro-circulation. As a result the hair roots are better nourished, the toxins stored in the vessels are eliminated, along with any excess sebum that could suffocate the hair.
      1. Is it true that cutting one's hair accelerates regrowth? Unfortunately, this is untrue. Cutting your hair regularly does, however, help keep them in good health.
      2. From what point does hair loss become a concern? Finding a dozen hairs each morning on your pillow is no cause for alarm, it is normal to lose between 50 and 100 hairs per day. Beyond this, however, you should see a dermatologist.

      Bibliography

      • L’alopécie. http://dermato-info.fr/article/L_alopecie
      • Troubles des phanères : alopécie. Annales de dermatologie et de vénéréologie (2012) 139, A204—A208
      • Shapiro, J. (2007). Hair loss in women. New England Journal of Medicine357(16), 1620-1630.
      • Ludwig, E. (1977). Classification of the types of androgenetic alopecia (common baldness) occurring in the female sex. British Journal of Dermatology97(3), 247-254.
      • www.vulgaris-medical.com/encyclopedie-medicale/alopecie
      • www.passeportsante.net/fr
      • www.abimelec.com/chute-de-cheveux.htm
      • Gilhar, A., Paus, R., & Kalish, R. S. (2007). Lymphocytes, neuropeptides, and genes involved in alopecia areata. The Journal of clinical investigation117(8), 2019-2027.
      • Centre Sabouraud 

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