OM VERMA ASSISTANT PROFESSOR GRACIOUS COLLEGE OF NURSING ABHANPUR (C.G.)

1. ALOPECIA
By:
Mr. M.Sivananda Reddy

2. Definition:
• Alopecia is defined as the loss of hair from
areas where hair normally grows
According to Brunner
• Partial or complete baldness or loss of hair.
According to luck man’s

3. • Alopecia is the partial or complete loss of
hair—especially on the scalp—either in
patches (alopecia areata), on the entire head
(alopecia totalis), ...
According to Lewis
• sudden loss of hair especially of the scalp or
face in circumscribed patches with little or no
inflammation.
According to lippen cott

4. • Alopecia is defined as “ absence or loss of
hair”. It’s a chronic disorder secondary to the
disease of either the hair follicle, hair shaft or
the scalp

5. Forms of Alopecia:
There are different types of alopecia. the main
types of hair loss are:
• Alopecia Areata (AA)
• Alopecia Totalis (AT)
• Alopecia Universalis (AU)
• Alopecia Barbae
• Androgenetic Alopecia (AGA)
• Scarring Alopecias (Cicatricial Alopecias)

6. Alopecia Areata (AA):
• Alopecia areata is an autoimmune condition
which causes patchy hair loss. It can result in a
single bald patch or extensive patchy hair loss.

7. Alopecia Areata (AA)

8. Alopecia Totalis (AT)
• Alopecia totalis is a more advanced form of
alopecia areata which results in total loss of all hair
on the scalp.

9. Alopecia Totalis (AT)

10. Alopecia Universalis (AU)
• Alopecia universalis is the most advanced form
of alopecia areata which results in total loss of
all hair on the body, including eyelashes and
eyebrows.

11. Alopecia Universalis (AU)

12. • Alopecia Barbae
• Alopecia barbae is alopecia areata that is localised
to the beard area. It can be a single bald patch or
more extensive hair loss across the whole of the
beard area.

13. Alopecia Barbae

14. Androgenetic Alopecia (AGA)
• Also known as male pattern baldness or female pattern baldness.
• It is a thinning of the hair to an almost transparent state, in both men or
women.
• It is hereditary
• In both men and women, it's linked to having an excess of male hormones
(androgens) around the hair follicles, which can block hair growth.
• Women are more likely to develop androgenic alopecia after menopause,
when they have fewer female hormones.
• Most cases of hair loss are due to androgenic alopecia.

15. male pattern baldness

16. female pattern baldness

17. Scarring Alopecias (Cicatricial Alopecias):
• Scarring alopecias refers to a group of rare
disorders which cause permanent hair loss.
• Caused by any inflammatory processes which
causes permanent damage to hair follicles.(burns,
bacterial infections, autoimmune diseases )

18. Scarring Alopecias

19. • Physical trauma Long term traction of hair, x-ray
• overdose burn
• Infections Bacterial
• Dermatophytosis
• Viral
• Chemical injury Caustics
• Cutaneous diseases DLE, FLP,pseudopelade
• Destructive neoplasms &
• granulomas
• Psychogenic conditions Neurotic excoriating
tactile
• injury to skin

20. Causes of alopecia:
• Exposure to allergens, irritants, toxins, burns,
injuries, and infections.
• Certain medications (especially anabolic steroids
like testosterone)
• Chronic kidney failure
• Radiation and chemotherapy .
• Malnutrition

21. malnutriton
• While hair follicles are among the most
metabolically active in the body, and hair
growth may be impacted by calorie and
protein malnutrition as well as micronutrient
deficiency, the links are complex. ... Hair loss is
common, with close to 50% of men and
women affected by pattern hair loss by age
50

22. Radiation and chemotherapy
• Hair loss, also called alopecia, may be a side
effect of chemotherapy, targeted
therapy, radiation therapy, or bone
marrow/stem cell transplants. These
treatments can cause hair loss by harming the
cells that help hair grow.

23. •Diagnostic test

24. • History & Examination
• 1. Time period of hair loss(congenital, acquired)
• 2. Progression of hair loss
• 3. Any positive family history
• 4. H/o G.I dysfunction, thyroid gland dysfunction
• , psychological disorders
• 5. H/o any surgical intervention / chronic illness
• 6. All medications
• 7. In females, menstrual & obstetric history
• 8. Hair care routine/ hair products

25. • Medical History
• To determine the cause of hair loss, your dermatologist
asks a variety of questions about when hair loss began,
what the patterns of hair loss are, what kind of
hairstyles you usually wear, whether hair loss runs in
your family, and other details about your symptoms.
He or she may ask about any other medical conditions
you have.
• Details that may seem unrelated—such as what foods
you eat or whether you recently gave birth—may
provide a clue about the cause of the hair loss.

26. Diagnostic test
• Physical Exam
• A dermatologist examines your scalp to check for
inflammation, redness, sores, or scarring. The
doctor looks closely at your hair to determine
how much is being lost, the pattern of the hair
loss, and whether there is hair breakage.
• During a physical exam, your doctor may perform
simple tests to learn more about the health of
your hair. These may include the following.

27. • Trichometric Analysis
• In certain instances, dermatologists at NYU Langone use
trichometric analysis, a sophisticated computerized
measurement tool, to analyze characteristics of the scalp
and hair. Our doctors use a digital assessment system called
Folliscope® which consists of a small handheld device
containing a high definition, microscopic camera.
• Doctors use this camera to take pictures of the scalp and
hair, and the images are displayed on a computer monitor.
The Folliscope® can magnify these images by up to 100
times, giving doctors a detailed look at hair, hair follicles,
and the scalp.
• The Folliscope® also provides information about hair
coverage, including the total number of hairs on the scalp
and the diameter of each strand of hair. These details are
used to monitor the progression of new hair growth after
treatment begins.

28. • Fungal Culture
• A fungal culture is a laboratory test that can confirm
the presence of a fungus in hair or scalp cells. A
dermatologist may recommend this test to determine
whether a fungal infection called tinea capitis, or scalp
ringworm, is the cause of hair loss.
• A dermatologist may scrape or swab the scalp or take a
small sample of skin or hair for laboratory testing. It
can take several weeks of incubation in the laboratory
for a fungus culture to become positive.

29. punch” biopsy
• It’s called a “punch” biopsy because of the
technique used: Dermatologists use a device
the size and shape of a pencil to puncture the
scalp and remove a small tissue sample. This
sample is sent to a lab for testing, and the
incision is closed with a few stitches. Biopsies
are frequently used to distinguish between
the types of cicatricial, or scarring, alopecia.

30. • Blood Tests
• If doctors suspect the hair loss may be due to
an underlying medical condition, a vitamin or
mineral deficiency, or a hormonal imbalance,
they may recommend one or more blood
tests. For example, it may appear that a
woman whose hair is thinning all over the
scalp has hereditary hair loss, but it’s possible
that the cause is actually an iron deficiency.

31. • Iron Deficiency
• Too little iron in the bloodstream may contribute
to hair loss. Doctors use blood tests to check the
level of ferritin, a protein that indicates how
much iron is stored in the body. Ferritin levels are
often low in menstruating women; those with
anemia, a condition in which people lack healthy
red blood cells; and vegetarians or vegans.
• Adding foods rich in iron to your diet may help
hair to regrow. These include dark, leafy greens,
red meat, whole grains, and legumes. Iron
supplements, which are used to treat anemia,
may also help to stop hair loss.

32. • Daily Hair Counts
• Useful for quantitative assessment of the actual
number of
• hairs shed daily in patients with complaints of
excessive
• shedding.
• Collect for 14 consecutive days
• Average daily loss – 30-70 hairs /day.
• If >70 hairs – microscopic examination is done
to
• detect pathology.

33. Treatment
• Although hair loss rarely needs to be treated,
many people seek treatment for cosmetic
reasons.
• There is no cure for alopecia and no
universally proven therapy to induce hair re-
growth.

34. • Many cases of hair loss are temporary, for
example, due to chemotherapy, or they're a
natural part of ageing and don't need
treatment.
• If hair loss is caused by an infection or
another condition , treating the underlying
problem may help prevent further hair loss.

35. Finasteride:
• It acts by preventing the hormone testosterone being
converted to the hormone dihydrotestosterone (DHT).
• DHT causes the hair follicles to shrink, so blocking its
production allows the hair follicles to regain their
normal size.
• The balding process usually resumes within six to 12
months if treatment is stopped

37. • Minoxidil:
• Minoxidil is available as a lotion you rub on your
scalp every day
• It's not clear how minoxidil works, but evidence
suggests it can cause hair regrowth in some men.
• Minoxidil is currently the only medicine available
to treat female-pattern baldness.

39. Corticosteroid injections:
• Acts by suppressing the immune system.
• This is useful in alopecia Areata because the
condition is thought to be caused by the
immune system damaging the hair follicles.

40. Retin A / Tretinoin:
• Retin-A was originally used for the treatment of
acne and other skin problems.
• However studies have shown that Retin-A, when
used alone in the form of a gel, which is rubbed
onto the area of hair loss, or in combination with
topical Minoxidil can result in moderate to good
hair growth in individuals with Alopecia.

41. • Immunosuppressive drugs
• Ultraviolet light treatment
• Wigs
-Synthetic wigs- made of acrylic
-Real hair wigs
• Hair transplantation

42. • Surgical Treatment
• Hair transplantation
• Follicular unit transplant

43. • Hair transplantation is a surgical technique
that removes hair follicles from one part of
the body, called the 'donor site', to a bald or
balding part of the body known as the
'recipient site'. The technique is primarily used
to treat male pattern baldness.

44. • Follicular unit transplantation (FUT) is a hair
restoration technique, also known as the strip
procedure, where a patient's hair
is transplanted in naturally occurring groups
of 1 to 4 hairs, called follicular units.