hair disease

Hair loss can appear in many different ways, depending on what's causing it. It can come on suddenly or gradually and affect just your scalp or your whole body.

Common signs and symptoms of hair loss include:

• Gradual thinning on top of head [1]
• Alopecia areata is an autoimmune disease that causes patchy hair loss anywhere on your body, but it most commonly affects the hair on the skin that covers your head (scalp) [2]
• Sudden hair loss, which often begins as a round or oval, smooth balding patch that develops on the scalp or beard [3]
• Loss of small patches of hair on the scalp, eyebrows, eyelashes, nostril hairs, or hair on legs [4]
• Receding hairline (typical of male pattern baldness) and thinning hair all over the head (typical of female pattern hair loss) [5]

Other signs and symptoms may include:

• Excessive shedding of hair, but not complete baldness, after various illnesses and drug treatments, rapid weight loss, anemia, or stress [13]
• Inflammation or scarring is not usually present in hair loss [14]
• Hair loss can be a sign of underlying health conditions such as thyroid disease, Down syndrome, vitiligo, vitamin and mineral deficiencies, and nivolumab-induced alopecia areata [7]

It's essential to note that:

• The severity of hair loss can vary from a small area to the entire body [14]
• Hair loss in some people causes psychological distress [3]
• Early signs of alopecia may include a butterfly-shaped skin rash on the face, fatigue, hair loss, and pulmonary and kidney problems [12]

Please consult a healthcare professional for proper diagnosis and treatment if you're experiencing any of these symptoms.

Diagnostic Tests for Hair Diseases

Hair diseases, also known as alopecias, can be caused by various factors such as genetics, hormonal imbalances, infections, and autoimmune disorders. To diagnose the underlying cause of hair loss, several diagnostic tests are conducted.

• Physical Examination: A thorough physical examination is performed to assess the extent and pattern of hair loss. This includes examining the scalp for any signs of infection or inflammation.
• Blood Tests: Blood tests are used to check for hormonal imbalances, thyroid functioning, and nutritional deficiencies that may contribute to hair loss. These tests include:
  • Thyroid-stimulating hormone (TSH) test: Measures the level of TSH in the blood to determine if there is any irregular thyroid activity.
  • Vitamin B levels test: Checks for deficiency in vitamin B, which can cause hair loss.
• Scalp and Hair Examination: A visual inspection of the scalp and hair is performed using a handheld magnifying device. This helps identify any signs of infection or inflammation.
• Trichoscopy: A trichoscope is used to examine the hair follicles and scalp in detail. This test can help diagnose conditions such as alopecia areata, where the immune system attacks the hair follicles.
• Hair Pull Test: The hair pull test checks different parts of the scalp for active (current) hair loss. A small sample of hair is gently pulled to assess the rate of hair loss progression.
• Scalp Biopsy: In some cases, a scalp biopsy may be performed to examine the skin and hair follicles under a microscope. This can help diagnose conditions such as alopecia areata or other autoimmune disorders.

Additional Tests

Other tests that may be conducted to diagnose hair diseases include:

• Hair analysis: A sample of hair is taken and examined under a microscope to check for any abnormalities.
• Scalp sample: A small sample of skin from the scalp may be taken and examined under a microscope to check for any signs of infection or inflammation.

Early Diagnosis

Early diagnosis is crucial in treating hair diseases. By identifying the underlying cause of hair loss, healthcare professionals can develop an effective treatment plan to promote hair growth and prevent further hair loss.

References:

• [1] (Context 7) Blood tests can help identify hormonal imbalances, thyroid functioning, and nutritional deficiencies that might contribute to hair loss.
• [2] (Context 14) The pluck test (trichogram) is a semi-invasive test to determine the rate of hair loss progression by establishing how much of hair is in each of the three stages of the hair growth cycle: anagen, catagen, and telogen.
• [3] (Context 15) Blood testing identifies a component called thyroid-stimulating hormone, or TSH. High or low levels of TSH indicate irregular thyroid activity.

Medications for Hair Loss and Hair Diseases

Hair loss can be caused by various factors, including genetics, hormonal imbalances, autoimmune diseases, and more. Fortunately, there are several medications available to treat hair loss and promote hair growth.

• Minoxidil (Rogaine): This is one of the few FDA-approved drugs for treating hair loss, although not specifically for alopecia areata. It's a topical solution that can be applied directly to the scalp to stimulate hair growth.
• Corticosteroids: These anti-inflammatory medications are often used to treat autoimmune diseases like alopecia areata. They can help reduce inflammation and promote hair regrowth.
• Finasteride: This FDA-approved drug is primarily used to treat enlarged prostate, but it's also effective in treating hair loss in males by blocking the conversion of testosterone to dihydrotestosterone (DHT), a hormone that contributes to hair loss.
• Baricitinib: A once-a-day pill approved by the FDA to treat alopecia areata, an autoimmune disease that triggers sudden hair loss. It works by inhibiting the activity of Janus kinases (JAKs) and tyrosine kinases (TYKs), which play a role in inflammation.
• Ritlecitinib: Another FDA-approved treatment for alopecia areata, this medication targets the JAK pathway to reduce inflammation and promote hair growth.

Other Treatments

In addition to medications, other treatments like low-level light therapy, platelet-rich plasma (PRP) therapy, and microneedle patches loaded with baricitinib have shown promise in promoting hair growth. However, more research is needed to fully understand their effectiveness.

References:

• [1] Minoxidil solutions are one of the few drugs approved to help treat hair loss, though not specifically for alopecia areata (Source: #4)
• [2] Corticosteroids are often used to treat autoimmune diseases like alopecia areata (Source: #3)
• [3] Finasteride is an FDA-approved drug for treating enlarged prostate and hair loss in males (Source: #14)
• [4] Baricitinib, a once-a-day pill approved by the FDA to treat alopecia areata (Source: #10)
• [5] Ritlecitinib, another FDA-approved treatment for alopecia areata (Source: #11)

Differential Diagnosis of Hair Disease

Hair loss can be caused by a variety of factors, and it's essential to identify the underlying condition to provide effective treatment. The differential diagnosis of hair disease involves considering several possible causes of hair loss, which can be broadly categorized into focal or diffuse hair loss.

Focal Hair Loss

• Alopecia Areata: An autoimmune disease that attacks hair follicles, causing patchy hair loss [8].
• Tinea Capitis: A fungal infection of the scalp, characterized by erythema, scaling, and crusting locally on the scalp [2].
• Frontal Fibrosing Alopecia: A condition that affects the frontal region of the scalp, leading to scarring alopecia [13].

Diffuse Hair Loss

• Androgenetic Alopecia: A genetic condition that causes hair loss due to hormonal imbalances [3].
• Telogen Effluvium: A condition that accelerates androgenetic alopecia, caused by factors such as iron deficiency or papulosquamous diseases of the scalp [5].
• Anagen Effluvium: A condition that affects the growth phase of hair, leading to diffuse hair loss.

Other Causes

• Traction Alopecia: Hair loss due to constant pulling or tension on the hair follicles.
• Scarring Alopecias: Conditions such as frontal fibrosing alopecia and discoid lupus erythematosus that cause scarring and permanent hair loss.

Importance of Differential Diagnosis

Accurate differential diagnosis is crucial in addressing patients with hair loss. It helps to identify the underlying condition, which can then be treated accordingly. A systematic approach is needed to accurately diagnose and manage hair disease [12].

References:

[1] An overview of the basic principles of hair biology, potential causes of hair loss, and the assessment of patients who present with a complaint of hair loss.

[2] Tinea capitis: The diagnosis is suggested by erythema, scaling, and crusting locally on the scalp.

[3] Androgenetic alopecia can be diagnosed clinically and treated with minoxidil.

[4] Differential diagnosis of a diffuse alopecia with the female-pattern loss includes (1) androgenetic alopecia; (2) telogen effluvium; (3) ...

[5] Telogen effluvium: This condition may accelerate androgenetic alopecia, and causes, such as iron deficiency and papulosquamous diseases of the scalp.

[6] Alopecia (nonscarring) involves hair loss all over or in circular areas, a receding hair line, broken hairs, a smooth scalp, inflammation, and possibly loss of ...

[7] Some of the most well-known and common causes are: androgenetic alopecia, alopecia areata, telogen effluvium, anagen effluvium, traction ...

[8] Alopecia areata is an autoimmune disease that attacks your body's hair follicles, causing patchy hair loss.

[9] The most common cause of hair loss in women is female-pattern baldness, which is caused by hormonal changes during menopause.

[10] Hair loss can also be caused by a variety of other factors, including genetics, hormones, and certain medical conditions.

[11] A thorough examination and medical history are essential to determine the underlying cause of hair loss.

[12] Hair loss (alopecia) is a common problem and is often a major source of distress for patients. The differential diagnosis of alopecia includes both scarring and nonscarring alopecias.

[13] Associated scalp symptoms such as burning, itching, tenderness, erythema, and scaling are important to identify along with systemic symptoms that may point to an underlying disease process.