- Anagen (growth phase, lasting 2 to 6 years);
- Catagen (transitional growth phase and beginning of the resting phase, lasting 2 to 3 weeks);
- Telogen (resting phase, lasting 2 to 3 months).
It is normal for the resting phase to occur, as at that moment the old and lifeless hairs are pushed by the new growing hairs. This fall may be influenced by individual situations, such as stress and lack of vitamins .
Alopecia manifests itself in about 50% of men and 40% in women over 50 years of age. Some cases due to genetic influence may appear in adolescence.
The values are higher in men because hair loss is related to testosterone (male sex hormone). The substance undergoes enzymatic processes that can result in thinning of the hair strands, causing hair loss.
The women’s body also produces the hormone, but in significantly smaller quantities. Despite having less testosterone, they suffer greater hormonal variations (especially during pregnancy and menopause ), which also generates alopecia.
But, in addition to hormonal rates, other conditions can assist in weakening the strands, such as inflammation, thyroid changes, stress and inappropriate use of chemicals.
Treatment consists of identifying the source of alopecia. With care properly indicated by the doctor, the hair usually grows back. However, if the condition is genetic, the fall can be persistent.
In such cases, it is possible to resort to transplants, lasers, among other treatments, ensuring an improvement in the patient’s quality of life and self-esteem.
The disease can be found at ICD-10 under the codes:
- L63 – Alopecia areata;
- L64 – Androgenic alopecia;
- L66 – Scar alopecia.
What is alopecia areata?
Alopecia areata is a chronic inflammation of hair follicles, which causes hair loss. The causes are not well defined, but the condition is characterized by the loss of hair in tufts, leaving circular flaws through the scalp or other regions of the body.
Among the possibilities, it is pointed out that stress and autoimmune factors can trigger or aggravate the hair loss episodes.
In this context, treatment may include the use of oral or injectable drugs, which act to control hair loss and stimulate hair growth.
What are the types of alopecia?
There are more than one type of alopecia and they can be classified according to the causes of the problem. Understand:
This type of alopecia is characterized by hair loss in the form of small circles.
Depending on the condition, the loss may be less or greater. There are cases in which the total loss of the wires occurs. But, in general, they return after a few years.
It occurs due to the autoimmune destruction of the hair follicles located in the skin. It usually arises due to other illnesses, such as thyroiditis, diabetes , lupus , vitiligo , rhinitis, etc.
Androgenetic alopecia (baldness)
This type of fall causes the hair to become thinner, from the middle of the head to the entire back region. It is associated with genetic predisposition , that is, when there is someone in the family who already has the disease.
Baldness can affect men and women and is also related to age, being more frequent in adulthood.
Scar alopecia causes permanent hair loss and generates scars that destroy the hair’s ability to regenerate. It is usually caused by chemical, physical or chemotherapy burns, but it is also related to diseases such as tuberculosis and leishmaniasis.
Temporary or permanent loss of hair, the main causes are chemical procedures performed such as straightening, stretching and even burns.
It occurs when there is an action on the scalp, in situations such as post-surgery, use of dyes, infections, extreme temperatures, hairs that are too tightly attached to braid hairstyles, dreadlocks, among others. If the problem is detected early, it is possible to revert it.
This type of fall starts on the sides and back of the head, being more common in men. Seborrheic alopecia can evolve and reach the entire scalp. The earlier the fall begins, the more worrying the condition is.
Total alopecia (totalis)
This condition causes the loss of all hair strands, but the other parts of the body that contain hair do not change at all. It is usually caused by genetic inheritance, but in some cases it has an emotional background.
Universal alopecia (universalis)
This is a more serious version of total alopecia, in which in addition to the hair strands, the person also loses all body hair, including eyebrows, eyelashes and pubic hair.
It is characterized by the breakage and fall of hair strands, having several causes, such as stress, childbirth and serious illnesses. This type of hair loss is common to the female audience and responds well to hair treatments that make the hair grow healthy again.
The effluvium can be subdivided into:
In this case, the hair falls out after a stressful experience, such as childbirth or major surgery. This condition reaches the anagen and catagen phases, causing the wire to go directly to the resting phase (where the wires tend to fall).
The telogen effluvium is reversible, being possible to make a treatment and obtain the growth of the wires again.
It is characterized by unusual hair loss, even during the initial phase of the growth cycle (anagen) through which the hair passes.
Its causes may include treatments performed during the fight against cancer , such as radiotherapy and chemotherapy. This is because these methods are aggressive and end up reaching all the cells of the body, including healthy ones.
What is the difference between alopecia areata and common hair loss?
The difference between both is that alopecia areata is related to other diseases and, in some cases, there is no cure. Common hair loss, on the other hand, occurs due to some punctual situation (such as stress and postpartum).
Generally alopecia areata causes hair loss in various parts of the scalp, in the shape and size of a large coin. The hair does not grow back naturally in these cases.
On the other hand, in common hair loss, the strands usually become thick and healthy again in a short time.
Hair loss can be a common complaint among women. Called female alopecia, the condition causes an increase in the amount of hair that falls from the scalp, in addition to causing thinning and difficulty in growing them.
In women, hair loss appears on the top of the head, unlike men, where it usually occurs at the entrance of the hair (close to the forehead).
After noticing the fall of the wires, it is necessary to analyze the reason for them to fall. It can be from a new hair product used, genetic, nutritional, emotional factors and also hormonal changes in women (especially during pregnancy and menopause).
In such cases, it is necessary to remain calm. This does not mean that all hair strands will fall out at once.
In reality, they fall in tufts (small amounts), so there is time to reverse the situation.
Are there differences between hair loss in men and women?
Yea! Hair loss occurs differently for men and women, due to some factors:
One of the main factors that determines the differences in hair loss in men and women is age. In men, it usually starts at the beginning of puberty – although sometimes the symptoms can become more expressive only after the age of 40.
In women, on the other hand, the problem is usually somewhat punctual. Few suffer from falling in early adolescence due to hormones.
In cases where the woman has polycystic ovary syndrome (PCOS), due to illness, the fall occurs regardless of age.
In the menopause phase it is also common for hair to fall out, because of hormonal changes.
Locations where hair loss occurs
When hair loss occurs in men, the frontal entrances and the back part of the head are affected. In women, on the other hand, the loss begins at the top of the head and little by little the strands of the other parts start to fall, leaving hair thinner.
What are the causes of alopecia?
Alopecia can occur due to several factors, they are:
Use of medicines
Some medications can cause temporary hair loss, such as chemotherapy drugs, birth control pills, blood thinners, blockers to control blood pressure, among others.
Any type of stress, be it physical or emotional, can cause hair loss for a period. After everything has calmed down, the strands tend to grow again.
Using too many chemicals in your hair can also cause it to fall out. Washing frequently, making progressive brushes or dyeing too much weakens the hair, making it easy to break.
Underlying diseases and conditions
Hair loss can be influenced by other diseases that are manifesting, in fact a symptom is a symptom of another problem. Examples of diseases that influence hair loss are: anemia , thyroiditis , lupus, among others.
Postpartum hormonal reaction
Pregnancy is a process that affects the woman’s body a lot, and is also a type of physical stress to the various hormonal reactions caused in the body.
After the child’s birth, the female body undergoes a renewal process and it is common for the hair to fall as a result. But after the period, the strands grow back normally.
Bad eating habits
Failure to maintain a balanced diet of proteins , vitamins, iron and zinc can cause hair loss due to the lack of these components, essential to the body’s functioning. After replacement, the wires tend to grow back without any problem.
When parents have hair loss from a young age, it is likely that their children will also suffer from it. Genes influence a person’s predisposition, causing possible hair loss in both men and women.
When menopause begins, many hormonal changes occur that can affect the development of the hair strands, subsequently causing hair loss.
It is a hair loss that is usually temporary. With the use of indicated products and food, it is possible that the wires will grow back.
Trichotillomania makes people feel the urge to constantly pull their hair out. Some people are unaware of the problem and unconsciously pull their wires during some activity.
In some cases it is not only the hair strands that are pulled out, but also eyelashes, eyebrows and even nose hair. Trichotillomania is seen as a mental disorder that has treatment.
Too much vitamin A
Everything in excess ends up being bad for our health. Overdoing drugs or supplements for physical training that contain vitamin A can cause hair loss.
It is necessary to observe the reaction of the hair, and if it is found that the hair loss is due to excess vitamin A, it will be necessary to reduce consumption.
Ringworm on the scalp
Ringworm is an infection caused by fungi, which appear on the hair causing a lot of itching and causing the hair to fall.
This type of disease can be transmitted from person to person, through the sharing of combs, towels, hats and other objects that have contact with the hair.
This case can be treated and the hair grows back without problems.
Risk factors for hair loss
There are factors that can influence alopecia to occur, they are:
- Family history of baldness;
- Significant weight loss;
- Other diseases, such as diabetes and lupus;
- Excess of vitamin A;
- Lack of proteins and some minerals;
- Hormonal disorders;
- Vitamin B12 deficiency.
What are the signs and symptoms of alopecia?
The main symptom of alopecia is the sudden fall of hair and / or body hair . In summary, the condition can be noticed when it is possible to easily see the scalp in some areas of the head, where hair is missing.
Usually the scalp is without the presence of strands, with rounded flaws in single or multiple circles. The lack of hair can also be noticeable on the beard, eyebrows and other regions.
Some signs that can indicate the condition are:
- Hair loss, especially on the top of the head;
- Complete loss of all hair on the body;
- Faults and hair loss on the scalp and eyebrows;
- Circular or irregular failures;
- Broken hair strands, redness, itching and swelling;
- Thinner hair strands.
How is the diagnosis made?
To diagnose the problem, it is necessary to make an appointment with the dermatologist, who will do a clinical examination, such as trichogram or dermoscopy of the hair scalp.
During the exams, the dermatologist can take a sample of hair to be able to carry out the analysis, make the evaluations and obtain the results.
With the help of devices, the specialist analyzes the scalp and the health aspect of the strands, so a correct diagnosis and the definition of a specific treatment for each case is possible.
Learn a little more about each test used to diagnose alopecia:
The examination consists of observing and noting flaws and entries, in addition to the density and consistency of the hair. Any changes that are found will be noted by the professional.
When the case is diagnosed as alopecia, there is an evaluation of the ends of the hair, fissures and some more details to then indicate which treatment is best.
For this exam it is necessary to take a hair sample, 50 to 100 strands from some area of the scalp. After collection, the wires are placed on slides and taken for analysis under the microscope.
Using equipment, it is possible to enlarge the images 10 to 20 times and photograph the thickness of the threads, the scalp and the distribution of pigments and inflammatory processes. In this way, with the detailed images, the specialist is able to analyze the condition of the hair.
Is there a cure?
It depends . Alopecia is curable in only a few types. In genetic cases, for example, the problem may persist. But, in general, the fall can be solved with several treatment options, which can help the hair to grow back, in addition to preventing hair loss.
What is the treatment for alopecia?
Treatment will vary depending on the diagnosis. Many cases of hair loss do not need to be treated, as a good part of the wires will regrow in a short time. But if this is not your case, there are several treatments available to treat alopecia, check out:
The microneedling treatment involves a device that performs microperforations in the skin, inside the scalp.
These microperforations form a kind of wound, in which the organism receives stimulus to heal the wound. Thus, with the stimulus, hair growth is produced.
The device used resembles the ones used to make a tattoo.
In this procedure, low- and medium-power lasers are used to treat inflammation in the hair follicle that is compromising the hair shaft.
In this way, the laser increases the chance of healthy hair growth.
There are a variety of devices for treatment, from the simplest to those that count and thickness the thread.
More advanced cases can be treated through hair transplantation. This treatment consists of removing the hair strands from the back of the head (close to the neck) and implanting them in the scalp, where there are gaps.
There is no problem in removing these wires close to the neck, as they grow back normally. They can also be used for chest and even back hair.
There are two techniques on the market to perform hair transplantation:
With the aid of the surgical equipment, the hair follicles are removed one by one and placed directly in the hairless region. Recovery is quick and the scars are not visible, as the hair covers them easily.
Generally, this technique is a little more expensive, because it is performed using a robot, commanded by the specialist.
Follicular Unit Transplantation (FUT)
A strip of the scalp is removed, in which units of the hair follicles are selected and subsequently placed on the hair scalp, where the strands are missing.
Usually this technique is indicated to treat larger areas, which are without hair. It is an accessible technique, but it requires time to rest and leaves a more visible scar.
Outside Brazil it is common to use so-called “gadgets”, which are devices to use at home to help in the growth of the wires. Some are arriving in the country, like HairMax.
It is a type of low intensity device that increases the flow of oxygen and nutrients, thus stimulating the hair to leave the scalp healthier.
This treatment consists of an implant made with surgical nylon threads, similar in appearance to human hair, which are implanted in the scalp.
Using an anchoring system, the doctor in charge performs the implant in the hair quickly with a kind of pistol, using only local anesthesia.
The wires can be chosen according to the color the patient wants, being applied from 12 to 25 wires at a time, with little risk of rejection.
Medicines for alopecia
Several medications are available for the treatment of alopecia. The choice of which will be used must be made by the dermatologist, with the patient.
The medications aim to reduce flaws and prevent new ones from appearing, stimulating hair growth again.
Some of the commonly used medications are:
- Cyproterone acetate ( Androcur , Prostman ) – used in cases of androgenetic alopecia, or baldness ;
- Alpha-estradiol ( Alozex , Avicis , Tegan ) – used in cases of androgenetic alopecia, or baldness ;
- Betamethasone ( Lergidrin , Diprospan , BetaTrinta ) – used in cases of alopecia areata .
There are still other drugs that can be indicated in cases of alopecia and are considered more popular:
Used to treat androgenetic alopecia ( hereditary baldness ) exclusively , finasteride can be used in low doses, when prescribed by the doctor.
The drug prevents testosterone from turning into dihydrotestosterone, a form of the hormone that reacts with positive results on hair loss.
Finasteride was initially developed to treat cases where the prostate glands are enlarged, but during testing on patients, doctors noticed a side effect.
Patients began to show growth in the hair strands. Thus, a lower concentration version of the drug was developed for the treatment of baldness.
In some patients, finasteride has the side effect of reducing libido, problems during erection and sperm consistency. Therefore, you need a medical prescription and follow-up to use the medication.
Finasteride is known commercially by names like Fendical , Finalop and Finastil .
Used to stimulate the development of hair and hair, Minoxidil is a medicine that helps in the vasodilation of the follicles, making the hair grow again.
It is used in the treatment of male pattern baldness to combat flaws in the scalp and strengthen the hair.
In some people the substance can cause side effects, such as itching, burning and redness in the region where the product was applied.
Minoxidil is marketed under the name Regaine , in a capillary solution format and with a concentration of 5%.
Pantogar is a drug indicated for the treatment of telogen effluvium and diffuse alopecia in women. It helps in hair growth, providing nutrients for the hair to grow healthy and strong.
The duration of treatment with Pantogar is, on average, 3 to 6 months.
The drug can also be found in the form of Fall Lotion , Pantogar Men (supplement indicated for men) and Pantogar Neo (supplement to replace vitamins and minerals).
Anthralin and Diphentprone
These two drugs are mainly indicated to treat psoriasis , but clinical studies have shown that they are effective for alopecia, especially in cases where falls occur in specific regions.
It is as if these drugs could contain an immune response from the body, responsible for causing the fall.
Flutamide and Spironolactone
Flutamide and Spironolactone are also effective in the treatment of alopecia because they act by hormonal mechanisms. They inhibit the action of androgens (testosterone and derivatives) that work by causing the fall.
In such cases, controlling the drop is as if it were a side effect of these active ingredients. Therefore, they are not medicines to be used on their own, as they have many side effects.
NEVER self-medicate or stop using a medication without first consulting a doctor. Only he will be able to tell which medication, dosage and duration of treatment is the most suitable for his specific case. The information contained on this site is only intended to inform, not in any way intended to replace the guidance of a specialist or serve as a recommendation for any type of treatment. Always follow the instructions on the package insert and, if symptoms persist, seek medical or pharmaceutical advice.
Is there home treatment for alopecia?
There are natural or homemade treatments that can help strengthen the strands, moisturize the hair and reduce hair loss due to breakage. These procedures are indicated to keep the hair healthy, but do not resolve and fall due to alopecia. This is because hair loss does not occur due to poor hydration or nutrition of the hair, but because of chronic inflammatory conditions.
Living with diffuse hair loss
Some tips are important to live and feel better with the condition:
To help the body, try to reduce the stress of everyday life, distract the mind and focus on positive thoughts to help solve the problem.
Practice exercises or some activity of your choice to calm your mind and body. In addition, practicing alternative methods, such as yoga and acupuncture, can be a good option.
Read more: Meditation (guided, transcendental): how to do, to sleep, music
Take care of the food
Adopt a diet with a good source of vitamins. Fatty acids such as omega 3 help in the health of the skin, hair and nails. Therefore, give preference to foods that contain these acids, such as salmon, flaxseed oil, nuts and almonds.
Foods with vitamin B6, such as bananas, potatoes and spinach help to produce antibodies for the defense of our body. Vitamin B12, on the other hand, found in meat, poultry, fish and dairy products, helps in the formation and repair of cells.
Fruits, fresh vegetables and fortified grains, such as beans and lentils, are also welcome, as they add strength to the diet due to the presence of iron.
Read more: Foods for anemia that help in healing and prevention
Find out more
Try to find out about the condition so that there are no doubts or fears. So you will also be prepared for treatment. It also helps to reduce anxiety due to the problem you are experiencing.
Protect your head
The sun’s rays can cause burns and even spots of skin in the areas where the strands of hair are missing.
So invest in hats, scarves and wigs to protect your head from UV and UVA rays . The look can also help improve your self-esteem.
Seek help in therapy
Even though it is not a serious condition, alopecia can affect the emotional state, especially of women who are more attached to the hair.
If necessary, seek the help of a therapist, psychologist or support groups to deal with emotions and insecurities due to the condition.
Prevention: how to prevent hair loss?
There are not always ways to prevent alopecia, especially when it is related to genetic factors. But there are tips to prevent damage that can cause hair loss:
- Use your hair in a natural way and avoid chemicals – if it is not possible, hydrate whenever you can;
- Choose specific products for your hair type;
- Brush your hair with natural bristle brushes, as the damage is less to the strands;
- Be careful when brushing wet hair, as the hair is more fragile than normal;
In addition, it is important to make regular visits to the doctor to prevent other diseases from causing hair loss as a symptom.
If you notice a large amount of hair loss, do not hesitate to consult a dermatologist to diagnose the cause.
My hair fell in a circle. Is it a sign of alopecia?
Yes. Alopecia can cause well-defined falls, with loss of very specific threads, in circular shapes. Every hair loss should be investigated by specialists, but those that are expressive and cause holes and spaces without hair deserve more immediate attention for the possibility of alopecia.
Is diffuse hair loss curable?
It depends on the cause. Alopecia generates an acute and diffuse hair loss, which can result in large parts of the scalp or other regions without the presence of strands.
The condition needs to be properly diagnosed and thus treated. Each frame may require different treatments to control and replace the affected strands.
For example, androgenic alopecia has no cure, because it involves genetic conditions that cannot be changed. But the pictures can be controlled.
Is Alopecia areata treated?
Yes. The best treatment should be guided by a doctor or dermatologist, according to each patient. But, among the options, the use of topical medications, such as minoxidil, corticosteroids and anthralin, in addition to injectable corticosteroids, can be used. These substances reduce hair loss and stimulate the follicles, making the hair stop growing.
Is all alopecia capillary?
No. Alopecia is a condition in which there is loss of hair. Although one of the most well-known affected places is the scalp, the condition can cause hair reduction throughout the body, including beard, eyelashes and eyebrows.
Androgenetic alopecia is curable?
Androgenetic alopecia is a condition of genetic origin. This makes it impossible to cure it, but the treatment exists and can control the condition. Thus, with some care and treatment, patients can even reverse the manifestation of the disease, making the hair loss not noticeable.
With the use of appropriate medications, which stimulate hair growth and block hair loss, alopecia has good results.
Is there nervous alopecia?
Emotional conditions, such as stress and anxiety, can aggravate hair loss episodes. People who are predisposed to alopecia or already have the condition, may notice the intensification of hair loss in situations of stress and nervousness.
What disease causes hair to fall out of the body?
Episodes of hair loss, including hair, eyelashes, eyebrows and hair from other parts of the body, are pictures of alopecia. There may be different causes, such as stress, medication use or genetic conditions. Therefore, the correct diagnosis and treatment condition must be made by professionals in dermatology.