Is Hair Loss Self-Treatable?
Is Hair Loss Self-Treatable?
Several medical conditions cause hair loss. However, the most common is androgenetic alopecia (common male pattern baldness). It is responsible for hair loss in as many as 50% of white men and women older than 40, and in a somewhat smaller proportion of Asians, blacks, and American Indians. Pharmacists can recommend nonprescription minoxidil products that may help treat androgenetic alopecia. Before making any recommendations, it is important to differentiate androgenetic alopecia from other causes of hair loss.
Androgenetic alopecia is the only self-treatable member of a group of conditions known as nonscarring alopecias. Another nonscarring alopecia is alopecia areata, an inherited autoimmune condition of varying severity. In some patients, hair loss is confined to one or more small oval patches; in others, the scalp is virtually denuded except for a few tufts of hair. Alopecia areata may extend to the entire scalp (alopecia totalis) or to the surface area of the whole body (alopecia universalis). The condition is marked by exacerbations and recoveries. When hair regrows, it may assume a white discoloration.
Another nonscarring alopecia is caused by trichotillomania, a psychiatric/psychological condition in which the patient is compelled to pull, tug, or yank at single strands or tufts of hair until they exit the follicle. Patients describe a release of tension when the hair is pulled. Preadolescent and early adolescent girls are the most likely to suffer from trichotillomania, which may be related to obsessive-compulsive disorder, but it is seen in males and females of all ages. The bald area manifests as a bizarre geometric shape. The patient may leave only a small fringe around the head (known as the "Friar Tuck" sign). Hair also may be pulled from a secondary site, such as the eyelashes, eyebrows, underarms, body, or pubis. Patients who ask for help should be urged to seek counseling.
Some grooming methods may cause a nonscarring alopecia. Creating ponytails, braids, tight curls, or cornrows involves pulling hair in unnatural positions. Some of the hair is gathered tightly and secured with a ribbon, elastic band, or the braid itself. The continual outward pressure on hair causes many strands to be pulled from the scalp prematurely. This traction alopecia, which requires referral, often produces patterned hair loss on the temporal regions, periauricular zones, and frontal scalp.
Medications such as cytotoxic agents, colchicine, heparin, oral anticoagulants, vitamin A, and captopril can all induce nonscarring hair loss. A patient who suspects that he or she may have medication-induced hair loss should be directed to seek physician care.
Scarring alopecias may be induced by tinea capitis, discoid lupus erythematosus, cellulitis, burns, freezing, scleroderma, and the use of caustic chemicals such as hair relaxers or straighteners. If the scalp appears inflamed or scarred, the patient should be referred for appropriate care.
Several medical conditions cause hair loss. However, the most common is androgenetic alopecia (common male pattern baldness). It is responsible for hair loss in as many as 50% of white men and women older than 40, and in a somewhat smaller proportion of Asians, blacks, and American Indians. Pharmacists can recommend nonprescription minoxidil products that may help treat androgenetic alopecia. Before making any recommendations, it is important to differentiate androgenetic alopecia from other causes of hair loss.
Androgenetic alopecia is the only self-treatable member of a group of conditions known as nonscarring alopecias. Another nonscarring alopecia is alopecia areata, an inherited autoimmune condition of varying severity. In some patients, hair loss is confined to one or more small oval patches; in others, the scalp is virtually denuded except for a few tufts of hair. Alopecia areata may extend to the entire scalp (alopecia totalis) or to the surface area of the whole body (alopecia universalis). The condition is marked by exacerbations and recoveries. When hair regrows, it may assume a white discoloration.
Another nonscarring alopecia is caused by trichotillomania, a psychiatric/psychological condition in which the patient is compelled to pull, tug, or yank at single strands or tufts of hair until they exit the follicle. Patients describe a release of tension when the hair is pulled. Preadolescent and early adolescent girls are the most likely to suffer from trichotillomania, which may be related to obsessive-compulsive disorder, but it is seen in males and females of all ages. The bald area manifests as a bizarre geometric shape. The patient may leave only a small fringe around the head (known as the "Friar Tuck" sign). Hair also may be pulled from a secondary site, such as the eyelashes, eyebrows, underarms, body, or pubis. Patients who ask for help should be urged to seek counseling.
Some grooming methods may cause a nonscarring alopecia. Creating ponytails, braids, tight curls, or cornrows involves pulling hair in unnatural positions. Some of the hair is gathered tightly and secured with a ribbon, elastic band, or the braid itself. The continual outward pressure on hair causes many strands to be pulled from the scalp prematurely. This traction alopecia, which requires referral, often produces patterned hair loss on the temporal regions, periauricular zones, and frontal scalp.
Medications such as cytotoxic agents, colchicine, heparin, oral anticoagulants, vitamin A, and captopril can all induce nonscarring hair loss. A patient who suspects that he or she may have medication-induced hair loss should be directed to seek physician care.
Scarring alopecias may be induced by tinea capitis, discoid lupus erythematosus, cellulitis, burns, freezing, scleroderma, and the use of caustic chemicals such as hair relaxers or straighteners. If the scalp appears inflamed or scarred, the patient should be referred for appropriate care.
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