Trichology Today

 

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