Introduction

Alopecia or hair loss is a problem that affects more and more men and women, millions of people around the world. Both the causes that cause it and the types of alopecia that exist are diverse. It usually causes hair loss on the scalp. Still, there are also cases where other areas are affected, and loss of facial hair (eyebrows, eyelashes, beard) or body hair also occurs.

It is a problem that especially affects the self-esteem of those who suffer from it, who see how their hair falls and their image changes and is diminished without avoiding it.

The most common and widespread type of alopecia is Androgenetic or Androgenic Alopecia, also known as common baldness, and which has a genetic component. Other prevalent types of alopecia (such as Alopecia Areata) cause partial or total loss of hair and whose causes are very different.

What is alopecia?

The term alopecia comes from the Greek ‘allopex’, which refers to abnormal hair loss. It is a generic term that indicates the loss of capillary density or the degradation of the hair, which can progressively lead to thinning or total disappearance.

Alopecia doesn’t just affect the scalp. It can affect:

To the entire scalp
To specific areas of the scalp
To other facial areas: beard, eyebrows, eyelashes
To body hair in different parts of the body
To the whole of hair and body hair, depopulating the patient of hair completely

There are different types of alopecia, and it can be an indicator of different diseases or pathologies. The most well-known and common types of alopecia are Areata and Androgenetic. The latter, in particular, affects 70% of men and 40% of the female population.

Who can suffer alopecia?

Men and women of all ages, including children, can suffer from alopecia or hair loss at some point in their life. In general, in men, hair loss is centered on the temples (what we know as recesses or frontal alopecia) and on the top of the head (the crown). In contrast, there is a generalized thinning in the top of the head in female alopecia, a more diffuse capillary fall.

What are the causes?

Hair loss can depend on many causes and factors, not all recognized or easily identifiable, so it is essential to contact a doctor or hair specialist with experience in dermatology and trichology. The specialist will be able to evaluate all the patient’s symptoms carefully, perform the necessary tests and capillary examination for the diagnosis of the problem, correctly identify the causes that have produced the hair loss, and, above all, indicate and advise what therapy or therapies to follow to eliminate or mitigate the problem.

Among the most common causes that can cause hair loss or alopecia we find:

Hormonal factors
Genetic predisposition
Childbirth
Stress, anxiety, nervousness
Nutritional deficiencies
Autoimmune diseases
Metabolic diseases
Endocrine diseases
Gynecological Diseases
Hypothyroidism

Also, we must bear in mind other external factors that contribute to its development, such as air pollution, atmospheric damage, or excessive exposure to UV rays.

Similarly, an inadequate diet (which causes a lack of essential nutrients for hair growth and development) or a continuous period of stress or anxiety can trigger hair loss and deterioration.

Does the lifestyle influence?

If we do not take care of our lifestyle and our daily habits, these can have a negative impact on our health or in the accentuation and worsening of some symptoms or diseases.

The same goes for hair. When we notice a more significant hair loss (and the genetic, hormonal or autoimmune causes are ruled out), we can identify the cause of this alopecia in many cases in a harmful combination of emotional stress, bad habits, and malnutrition that ends up taking its toll on our hair, weakening it, making it thinner and more opaque, and consequently, accelerating the loss.

Some myths need to be dispelled regarding the causes of hair loss. In fact, specialists emphasize that, unlike many people, hats and helmets or frequent washing do not influence hair loss.

According to the professionals, the best way to prevent hair loss is to know its origin/reason in time for a specialist to indicate the most appropriate and effective hair treatment in our case. Doing it at the beginning is much easier

The types of alopecia

As we have already seen, this is a generic term that indicates hair loss. It means “fox” in Greek (Alopex) because of the characteristic loss of hair in patches that the fox suffers during the spring.

There are, therefore, different types of alopecia, each of which has a different etiology and course from each other.

Among the most frequent and well-known alopecia are:

Androgenetic (AGA): It is the most common and characterized by generalized and progressive hair loss. It affects both men (AGA) and women (FAGA). It is mainly related to genetic predisposition and hormonal factors. In particular, it is due to the miniaturization of the follicle and the activity of an enzyme used to convert testosterone to dihydrotestosterone. Treatment can be performed with pharmacological therapy (with drugs such as Finasteride or Minoxidil) or with Hair Mesotherapy techniques (biostimulation, carboxytherapy, PRP, Dutasteride) or surgical (graft or hair transplantation).

Areata (AA): There are different types, the most common causing localized or irregular hair loss that forms patches (or patches) of hairless on the patient’s scalp. Alopecia areata is defined as a loss of hair in specific areas of the scalp or body. It can also affect the nail, and its extension can be variable. Although it is usually classified as an autoimmune disease, its origin is unknown and multifactorial. Its development is influenced by genetics and environmental stressors. Alopecia areata can be associated with other diseases such as atopy. The therapies available are, also in this case, pharmacological or injectable (hair mesotherapy).

On the other hand, surgical solutions such as hair grafting are not recommended, as the specialists. If hair loss is due to an autoimmune response of the organism, it will not help carry out the hair transplant since the hair will fall again. Thus, while tackling the root problem, other hair solutions that do not require surgery are recommended, such as Hair Integration Systems.

Universal: The most severe cases of alopecia areata can lead to universal alopecia areata, which brings with it a total loss of hair and body hair for the patient. This severe type of alopecia affects one in four thousand people, as highlighted by researchers from the GARD (Genetic and Rare Diseases Information Center). The thinning, generally, begins in some specific areas of the body or the head to lead to the total reduction of the follicles. Sometimes the onset and spread of Alopecia Universalis can also occur very quickly and suddenly. The cause is unknown, and it is considered an advanced form of alopecia areata, so even in this case, we are talking about autoimmune pathology. There is no natural cure, but sometimes hair growth can reactivate spontaneously,
Psychogenic: Hair loss and alopecia can also be caused by stress and anxiety, although there is still no clear scientific evidence on this. This could also be because excess stress or anxiety triggers an immune system response, which triggers a series of biochemical phenomena that can weaken the follicles and hair. Psychogenic alopecia may be suspected in cases where the patient is unfamiliar with androgenetic alopecia or other conditions that may have led to hair loss. In some cases, the specialist may require the patient to perform personality tests as well.
Scarring: In this case, permanent hair loss is due to some disease or trauma, such as lupus, bacterial infections, fungi, tumors, or wounds, explain the specialists of Hair Innovation Medical Group. The specialist must make the diagnosis through a biopsy and histological examination, and therapy may include other forms of alopecia, injection, pharmacological and surgical methodologies.

Which specialist can I contact?

The branch of medicine that treats the skin and scalp is Dermatology, so the specialist doctor who deals with hair care and, consequently, also with its loss, is the dermatologist.

Also important is the figure of the trichologist. Trichology is the science that studies hair, so the trichologist is a specialist in hair and its diseases. While the dermatologist specializes in skin pathologies, the trichologist specializes in those of the scalp and hair follicles.

For any medical treatment, it is always essential to contact accredited medical specialists and surgeons :

Always check the specialization of the doctor.
According to the professionals, the best clinic is the one with optimal facilities and equipment to perform the treatments. Also, the specialist must have experience and studies, certificates, and permits that enable him to practice.

What will the first visit with the specialist be like?

During the first visit, the doctor or specialist will have the opportunity to assess the degree of alopecia, the extent of the hair loss, and the condition of the donor area in case it is decided to opt for a hair transplant.

After collecting all the information on the patient’s health status and medical history, the dermatologist or trichologist will perform a physical examination and indicate the performance of some specific tests.

The tests that the specialist may require to formulate a correct diagnosis and treatment are the following:

Dermoscopy
Capillary trichogram
Phototrichogram
Sebometry
Blood test
Thyroid hormone measurement
Scalp biopsy

Treatments

Patients can resort to both medical and surgical therapy. In the first case, several active ingredients can help counteract the effects of different types of alopecia. In particular, PRP (Platelet Rich Plasma, extracted from the patient’s blood), which, thanks to platelet growth factors, can stimulate the hair follicles of the scalp thanks to the formation of capillaries (angiogenesis) that favor and guarantee blood flow to the hair follicle and, therefore, promote the growth of new hair.

According to the specialists in those cases in which we are faced with advanced androgenetic alopecia, the most common will be to opt for a micrograft or apply a capillary integration system. However, if we face the first symptoms, the best option is to bet on the line of both medical and cosmetic treatment.

About surgical therapy (capillary graft), there is the possibility of achieving a capillary micrograft, which consists of extracting hair from a healthy area of the patient’s scalp to implant it in the areas later to be repopulated. Transplantation can be done using two techniques:

Graft with strip technique or FUSS (Follicular Unit Strip Surgery): consists of the extraction of a strip of the scalp and the hair follicles present here isolated and transplanted in the reception area.
Graft with the FUE technique (follicular unit extraction): This technique is more recent than the first. It allows the hair follicles to be extracted from the scalp individually, thanks to a very small needle (0.07 mm) that collects the follicles without leaving scars on the scalp.

Hair transplantation has no particular contraindications since the patient’s hair is grafted, and there is no possibility of rejection. But not all patients are suitable, as we said before, to undergo a capillary micrograft. There are cases for which it is not indicated, such as alopecia of possible autoimmune origin, which can reduce the result of the same action. According to the specialists at the first results will be visible after three months. The result is already noticeable after approximately 6-8 months from the operation when the degree of growth of all the implanted follicular units can be evaluated. The optimal result will be one year after the intervention.

For those who do not want to undergo transplant surgery, there are other medical treatments, such as the one mentioned above: Platelet Rich Plasma, which according to the professionals, is one of the most demanded due to its regenerative and biostimulation properties. To combat baldness rich plasma infiltration involves a cycle of a few sessions, which will be established by the specialist based on the patient’s characteristics.

Another option is another type of Capillary Biostimulation treatment, which consists of the injection of vitamins, minerals, and active ingredients that the patient receives to stimulate the reactivation of the hair follicles. In this case, at least six sessions are needed to get a good result.

Results

In the case of hair transplants, the success rate of the surgical procedure is usually very high. According to professionals, 93% of patients are satisfied with the treatment, and 8 out of 10 notice a positive evolution of the hair.

When medical treatments are carried out, patients are usually in an earlier stage of baldness. For this reason, if the treatments are carried out as prevention and at the right time, they are generally effective.

Do not forget that baldness can affect the self-esteem of those who suffer from it, for this reason; recovering hair is usually synonymous with happiness and more self-confidence.

Frequent questions

After how long can I see the PRP results? It is a procedure that takes time to perform its function. Also, each patient responds differently.
If I have hair loss, but I am breastfeeding, can I have a treatment? You have to wait at least six months after the end of breastfeeding.
Can Menopause Make Hair Loss Worse? Without a doubt, menopause is a stressful time for the hair. Still, the causes of hair loss are numerous, so, first, a dermatological-trichological examination must be done to perform a clinical evaluation.
Can a child have hair loss? Yes, it is a common sign of multiple pathologies, some of which can affect children.
Is hair loss from this cause generalized or localized? Unfortunately, the answer is not unique, and there are variable patterns. The diagnosis cannot be made based on the affected areas alone, also because other forms of weight loss can affect them.
Does Social Security cover hair implants? Today micrografts are not protected by social security.
Can micrografts be done in the eyebrows? There are two very good options to treat the lack of eyebrows. This eyebrow implant offers good results and gives a natural and long-lasting appearance over time or micro-pigmentation.
Diagnosis of the type of Alopecia and taking Finasteride you must make a good diagnosis and determine the degree of Alopecia in which you are. Based on this, determine the most appropriate treatment in your case. This can combine pharmacology at a systemic level (to do this, perform a Hemogram before taking the drug), reinforce existing hair with PRP in monotherapy, or connect in Mesotherapy with Dutasteride. It will undoubtedly improve your hair significantly.
PRP hair treatment, does it work in all cases? Stress is one of the most common causes of hair loss, and PRP is a very effective treatment that promotes hair growth, either applied individually or combined with other drugs. But if you currently have active hair loss, you should normalize this process. Otherwise, you will not get a 100% benefit from PRP.