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HAIR THINNING - ALOPECIA: DIFFUSE

What is Hair Thinning ?

Diffuse alopecia is a form of hair loss that is seen in both men and women. It tends to affect the whole scalp, rather than specific areas of it. The hair loss is not associated with symptoms of itching or pain and can sometimes be corrected. It can occur at any age. The first signs are of increased hair loss which is followed after a while by recognizable thinning of the hair.

How does Hair Thinning occur ?

Hair has a cyclical growth pattern. Sometimes the hair is growing, sometimes falling and sometimes the hair root is resting. Normally, individual scalp hairs are all at different stages of their growth cycles. In this way a major loss of hair never occurs. Each hair grows for an average of 1000 days before falling out. On average, about 100 hairs are lost from the scalp daily. Due to the effects of infection, damage, inflammation or pregnancy, hair growth may become altered so that it is all at the same stage. Accordingly, large numbers of hairs are lost at the same time, resulting in diffuse alopecia. Certain drugs attack the growing cells of the hair root and can cause hair loss. This is particularly noticeable following the use of anti-cancer drugs, when considerable hair is lost from the scalp. This generally regrows once the drugs are stopped.

Why does Hair Thinning occur ?

There are many causes of diffuse hair loss including infection, inflammation, injury, pregnancy, lack of certain hormones, and drugs. Severe infections , such as pneumonia, may be followed by increased hair loss 6 16 weeks after the infection. Various diseases in which inflammation occurs in the skin or internal organs may be associated with diffuse hair loss. Injuries such as road traffic accidents (and even major surgery) may be followed by a period of increased hair loss and diffuse alopecia. Many women notice increased hair loss 3 to 6 months after pregnancy or starting the contraceptive pill. The major hormone lack or deficiency that causes diffuse hair loss is decreased thyroid function. Hair loss may in fact be the first sign of thyroid disease. Anti-cancer and anti-thyroid drugs can cause diffuse hair loss which may become very marked. The anticoagulant (blood-thinning) drugs can also cause diffuse hair loss. Iron deficiency, even in the absence of anaemia, can cause problems with hair growth and can cause diffuse alopecia.

Treatment Involved for Hair Thinning

This depends upon the cause. Tests will be performed by the doctor to make sure that the thyroid gland is working well and that the iron levels are normal. If abnormal, thyroid replacement tablets or iron supplements will be given. In most cases of diffuse alopecia, no treatment is needed as the condition is self-limiting. In some people, the hair loss diminishes and the hair regrows. However, it is unusual for it to return to its original density. In other people, the hair loss continues and the scalp hair remains generally thin. Fortunately, complete baldness is very rare.

During Treatment for Hair Thinning

If the alopecia is due to thyroid or iron deficiency and replacements are given, the rate of hair loss will become less. Over a period of 1 2 months new small hairs will appear. These will become most noticeable at the hair margins. If no cause is found, the increased hair loss usually subsides after a period of 6 18 months. This is followed by slow regrowth of hair. The hair density may never reach its original levels.

If Hair Thinning is Left Untreated

If the alopecia was due to a cause which was not treated, hair loss would become more marked and would persist. If no treatable cause is found, the hair loss usually stops and at least partial regrowth occurs.

Effects on Family of Hair Thinning

Diffuse hair loss can be very distressing, particularly in women. It often leads to loss of confidence and even depression. Considerable support and sympathy are needed from family and friends.