Trichology Today
Alopecia
is a condition of hair problem where thinning of hair density of balding
happens. It is most commonly resent in the people of young age from 13 to 30.
It is reversible but, it may reappear at any stage of life further. It is not
from side effects of medicines or treatment procedure like chemotherapy, it is
a microscopically-inflammatory on the scalp.
The
Trichological Society define the condition as,
“A condition affecting
either gender in which one or more bald patches appear which may coalesce to
involve significant areas of the scalp.”
Symptoms
The
symptoms that appear before the onset of actual hair loss include crawling
sensations and stubble hair. It is commonly found on both genders in regions
like scalp, bald and eyebrows. The reasons behind such conditions can be organ
specific autoimmune system or a side effect of psychosomatic problems. It is
also commonly found in people with a genetic memory of thyroid abnormality,
eczema, asthma or hay-fever.
The
patient will undergo several cycles of hair loss and recurrent growth
throughout their life. Excessive, unexpected and prolonged stress, surgery,
physical injury, grief, financial crises and other human emotions, usually
beyond the control of the individual, can be allegedly triggered, which could
have a disturbance in the caring and parasympathetic nervous system, adversely
affecting hair growth. Usually body chemistry changes also accompany the hair
loss. Apparently no specific reason for the condition has been determined (Frequency
of the Types of Alopecia at Twenty-Two Specialist Hair Clinics: A Multicenter
Study, 2019).
Diagnosis
Usually
the treatment is medical and can be supported with tests such as a clear hair
pull check and trichoscopy. Active disease in trichoscopy consists of broken hairs,
yellow dots, black dots, "exclamation mark" or tapering hairs. In
lesions, vellus hair is another sign of alopecia and may signify late or absent
illness (Pai GS, 2019). In addition to the diagnosis of alopecia, it has the
potential to avoid unnecessary biopsies and is helpful in choosing an ideal
biopsy site when a biopsy is still necessary.
In
addition, trichoscopy is a valuable instrument for photographic assessment of
treatment response at each monitoring. The
cause of alopecia respiration remains unknown, but genetic factors, auto-immune
mechanisms and psychological and emotional problems are all believed to affect
the disease immediately before the hair loss (Trichodynia – A condition worth
treatment-directed evaluation rather than “silencing”, 2019.). Disease
treatments include asthma sensitizers, steroid shots, dibutyl ester squaric
acid, diphenyl ester and hypnotherapy.
Biopsy
may be used where final diagnosis is needed. For a microscopic and/or serology
test, a 4 mm diameter skin segment is removed under local anesthesia. The
strong presence of heavy lymphocyte recruitment around the anagen skin ampoule
indicates an alopecia diagnosis.
Treatments
Various
tricological solutions are offered for the treatment of Alopecia. Since the
actual reason cannot be determined, the right solutions may be difficult. It is psychosomatic conditions and so a
hypnotic session will help in understanding the mental reasons behind the
station. Apart from psychological treatments, medicinal solutions are discussed
below.
No
high-quality, randomized controlled trials for AA treatment have been
completed, even though the Severity of Alopecia Guide that offers
recommendations for clinical research in AA has begun to improve. Hair loss may
occur spontaneously, though the re-growth period may be between months and
years. Corticosteroids, immunotherapy and light therapy are usually included in
medical treatments
Topical corticosteroids
The
main mechanism in using these topical corticosteroids is to damage the inflammation
in the scalp and improve the hair growth in the affected region. Results vary
for every individual, but about 57 per cent of patients show complete hair
regrowth after treatment.[44 ] Intralesional corticosteroids are somewhat
stronger and 63 per cent show complete hair regrowth in 1 test within 4 months.
Relapse rates are high
regardless of medication and range from 33 to 75% with corticosteroids in
Alopecia (Hafouda, 2019).
Side
effects that are experienced through this procedure are pain and increased risk
of cutaneous atrophy at
the injection site. Other major side effects are folliculitis, localized
eczema, skin thinning. Results show a good improvement of hair growth in young
people than in adults.
Immunotherapy
The
immunotherapeutic drugs used as a second-line treatment of AA are square acid
dibutylster and diphencyclopropenone. The mechanism postulated is an activation
of antigenic activity that distracts CD4 + T-cells from hair follicles. The
common adverse reactions are urticaria, dermatism, blistering and
depigmentation. Response rates vary between 9% and 87%, but one study found
20–30% of patients receives an adequate response that prevents the need for a
piece of hair. Some therapies which are not popular include topical minoxidil,
ultraviolet A therapy, laser excimer, and systemic immunomodulators.
Other
Treatments
There
are various other treatments that are in procedure and are in study such as, Contact
dermatitis inducers, Anthralin, Systemic corticosteroids, Interleukin-2,
Phenol, Antidepressants and Parathyroid hormone.
Conclusion
Alopecia
is a complex, variable-prognosis, multifactorial disorder. Although many
patients are spontaneously cured, other patients may be chronic. There are no
FDA-approved therapies, but the first line is corticosteroids. Potential new
clinical strategies are discussed here and will need further analysis future
treatments were suggested. Further studies into the infection cause may also
explain other treatment options. Low-level light therapy (LLLT) has primarily
been used for androgenic alopecia treatment and the results when tested on mice
show hair regrowth and increased hair follicles in the anagen phase on
histology in comparison to the sham control.
References
1. Pai GS. Hair and humor - 1 - “The only
problem”. Int J Trichol 2019;11:143
2. Vañó-Galván, S., Saceda-Corralo, D.,
Blume-Peytavi, U., Cucchía, J., Dlova, N. C., Gavazzoni Dias, M. F. R., …
Miteva, M. (2019). Frequency of the Types of Alopecia at Twenty-Two Specialist
Hair Clinics: A Multicenter Study. Skin Appendage Disorders, 1–7.
doi:10.1159/000496708
3. Sonthalia S, Sharma P, Agrawal M,
Kapoor J. Trichodynia – A condition worth treatment-directed evaluation rather
than “silencing”. Int J Trichol 2019;11:180-1
4. Hafouda Y, Yesudian PD. Unraveling the
locks of wigs: A historical analysis. Int J Trichol 2019;11:177-8
5. Thompson KG, Marchitto MC, Ly BC,
Chien AL. Evaluation of physiological, psychological, and lifestyle factors
associated with premature hair graying. Int J Trichol 2019;11:153-8