Other temporary patchy losses of hair
Ringworm can show small round or oval patches of alopecia and be very similar to AA to look at. Traumatic hair loss, breakage and scaling can be brought on by itching of the scalp and/or hairdressing mishaps, both painful and distressing. Trichotillomania is a condition, not widely known, because those suffering would not wish the loss of hair and the sparse regrowth to be seen. It is a habitual pulling of hairs from the scalp that can be very distressing for the person themselves and the family around them.
or Male Pattern baldness (MPB)
Progressive thinning, giving the appearance of loss of follicles, to temples and crown areas but does not extend to the back and sides of the scalp. If hair is being readily lost then the differences between diffuse loss/patchy loss and MPB must first be identified. Apparently, the absence of 5-alpha reductase keeps the man from developing MPB, and Men with higher levels of 5-alpha reductase and dihydrotestosterone are the men losing their hair.
Treatment: Finasteride can be taken orally available by prescription only. A 5% minoxidil solution can be applied to the scalp, twice daily and hair restoration surgery can be considered that is proving to be very worthwhile for the 40+ patient.
Androgenetic Dependant Alopecia (ADA)
or Female Pattern Loss
Progressive thinning with loss of density showing in a triangular shape behind a well defined hair line, forehead to crown. It must be emphasised that most ladies do not lose follicles in the same manner as men the effect is more diffuse loss than balding. Treatment can be sought through an Endocrinologist as ADA can be alleviated by oral anti-androgens and, if indicated, a 2% preparation of minoxidil could be applied. A diffuse loss in addition to ADA must be differentiated and tested accordingly.
Diffuse Loss of Hair
Increased shedding that is noticeable by seeing more hairs in the basin after shampooing and in the brush or comb. Hair can be shed in this way for many reasons and the most well known is after having a baby. It does not happen to all and it does not happen to the same person after each pregnancy. Hairs throughout the pregnancy are held in the anagen phase of the hair growth cycle and the hairs that would have been shed throughout, plus those due to be shed naturally, all fall together within the first few months after the baby has been born. The situation takes time to get back to normal and if there is more excess shedding after six to nine months then it is wise to see the General Practitioner and have both thyroid and ferritin levels checked.
The term used to describe large numbers of hairs going into the telogen phase and shedding two to four months later in a diffuse manner. TE is referred to as a reflective loss of hair and can be caused by thyroid disorder, low iron, diabetes, medications, and protein deficiency. This is not a definitive list as there are other causes, not least the effects of the sympathetic nervous system described generally as 'stress', to do with emotional upset.
Permanent Patchy Loss of Scalp Hair
Hair loss will happen in very small patches that grow very slowly, are hardly noticeable at their onset, but go through periods of time when they progress a little more, and in some cases stop altogether to leave small bald areas that grow no further than the size of a thumb nail. The causes are of unknown origin, although bacterial infection and auto-immune factors have been looked at during research into such cases. The follicles are replaced by scar tissue and different to all of the above conditions. In some cases hair can be transplanted and great success is achieved by scalp reduction for areas of scar tissue.