What is alopecia ?

Alopecia simply means hair loss. There are several different types of alopecia including alopecia areata (an autoimmune condition where hair loss often occurs in patches), telogen effluvium (a more diffuse pattern of hair loss that can occur from physical or emotional stress or medication), or androgenetic alopecia (a normal pattern of female or male hair loss). There are also some causes of hair loss that occur with scarring of the underlying skin, such as some forms of lupus in the scalp (discoid lupus), lichen planopilaris, and central centrifugal cicatricial alopecia.

How do I know what type I have ?

It is best to see a dermatologist to determine which type of hair loss you have. Clues that can help determine the type of the hair loss are the location of hair loss on the scalp and the appearance of underlying skin. In some cases, recent labs, medications, as well as the age and ethnicity of the individual can also be helpful. Two small scalp biopsies may be needed to confirm the diagnosis, if it is not clear from the clues above.

What is the treatment ?

The treatment of alopecia depends on the type. For e.g. in the case of alopecia areata, as well as other types of hair loss where inflammation is thought to play a role, usually steroid scalp injections are done (if there are no contraindications). In the case of alopecia due to a lab abnormality, e.g. low hemoglobin or anemia, it is important to correct the lab abnormality for hair loss to stop. In some cases of telogen effluvium, such as that related to a stressful event (e.g. child birth), a tincture of time is needed for the hair loss to stop.

General measures that may help slow down most types of hair loss, include keeping the scalp healthy with regular shampooing and the use of over the counter topical minoxidil (Rogaine).

When should I see a dermatologist about my alopecia ?

It is best to see a dermatologist within a short period from the time hair loss starts, so that the type of alopecia may be diagnosed and further work up and/or treatment may be initiated.