What Is Alopecia?

Alopecia is a medical condition that causes hair loss in small patches. In most cases, the hair fall is unnoticeable. However, the patches might broaden and connect, thereby making it prominent and noticeable. It can be said that it is female patterned baldness.

It is an auto-immune disease, where the condition attacks the hair follicles, causing patterned hair loss. The loss of hair is most common on the scalp. However, in some cases, alopecia areata may also affect eyebrows, eyelashes, face and may even cause loss of body hair.

This medical condition when causes total hair loss, is called Alopecia Universalis. In most cases, the hair grows back naturally. However, the condition may recur from time to time. The extent of hair loss and the regrowth of hair depends on the patient and varies from people to people.

Women are more prone to pattern hair loss than men

Around one-third of women experience hair fall (alopecia) at some point in their lives. Nearly two-thirds of postmenopausal women suffer from hair thinning or bald spots. Women are more likely to experience hair fall than men and the impact is more stigmatized for women as well.

While men can freely walk around with a half-bald head, it is equally difficult for women to do the same, especially if it is hair loss front of head. Often, women are seen covering their baldness (even the ones caused by ageing) with wigs.

The primary type of hair loss (androgenetic alopecia or, pattern baldness) is the same for men and women. In women, the hair loss begins with gradual thinning around the hair partition, followed by increasing hair loss from the top of the head. Thankfully, women rarely go bald from alopecia, unlike men.

Female pattern baldness may arise from many causes, including medical conditions, side effects of medications, and physical or emotional stress. If unusual hair loss is noticed, we recommend contacting a dermatologist immediately to examine the cause and for appropriate treatment. 

One of the primary causes of alopecia is emotional stress. In such cases, you must see a therapist to deal with your emotional disturbances. Female hair loss can be frustrating and exhausting, especially when the hair loss is in front of the head. In recent years, however, there has been an increase in resources to cope with alopecia.

What is Androgenetic Alopecia?

Almost all women eventually develop female pattern baldness to some extent. In some women, it can start as early alongside the onset of puberty. The risk of female pattern baldness increases with age and it is higher amongst those who have genetically thin hair or a history of hair loss.

Androgenetic Alopecia
Androgenetic Alopecia

Androgenetic alopecia is a medical condition that involves the action of androgen hormones. The androgen hormone regulates sex drives and hair growth in both the sexes. Alopecia is often inherited and involves several different genes. It may also result from an underlying endocrine condition, like, overproduction of androgen or, an androgen-secreting tumor on the ovary, adrenal or pituitary gland.

Thus, it can be concluded that androgenetic alopecia is caused by the increase of the androgen hormone. In case an androgen-secreting tumor is involved, it is important to measure androgen levels in women with clear female pattern hair loss.

Androgenetic alopecia, the most common cause of hair loss in women, is usually diagnosed based on a thorough medical history and a detailed physical examination. Some patients also need laboratory follicle tests or punch biopsy. However, androgenetic alopecia is harmless and does not affect a woman’s normal menstrual cycle, fertility or endocrine system. 

Diagnosing Alopecia

Alopecia is diagnosed in three parts:

  1. The scalp is examined for evidence of scaling, erythema or inflammation. The follicular units are apparent in nonscarring kinds of alopecia but are absent in the scarring types.
  2. A thorough assessment of hair density and distribution.
  3. The hair shaft is examined for calibre, fragility, length and shape.

The ‘pull test’ is often the first unofficial examination of hair loss. A lock of hair is grasped between the thumb, index and the middle fingers and it is pulled gently but firmly. If six or fewer hairs are obtained, it indicates normal shedding. However, if more hairs are obtained, it indicates active hair shedding.

Hair Loss Treatment for Women

Medications are the most recommended treatment for hair loss in women. Typically, 2 per cent minoxidil is suggested for treating alopecia. Minoxidil affects the hair follicles in three ways. It increases the anagen, wakes up the follicles that are in the catagen and enlarges the actual follicles.

However, minoxidil therapy has its side effects too. It may lead to hypertrichosis (excessive hair growth.) The hair growth is often centred around the eyebrows, the malar region and on the lateral cheeks.

Exogenous Estrogen has also been used in the past to treat alopecia. Some women, who do not respond to minoxidil benefit may benefit from anti-androgens for the treatment of androgenic alopecia. It is especially effective for women with PCOS (polycystic ovarian syndrome.) The possible side effects of anti-androgens may be weight gain, loss of libido, and fatigue. Iron deficiency is found to be another important reason for hair fall in women. In such cases, iron supplements tend to help stop hair loss. 

Hair Transplantation: An Alopecia Solution 

Hair transplantation has been one of the most popular solutions for androgenetic alopecia ever since the 1950s. It involves removing a strip of scalp from the back of the head to fill in a bald patch. The use of mini grafts, rather than larger plugs, provides a more cosmetically pleasing outcome.

As an alternative to hair transplantation, wigs have played an immense role in the lives of men and women to cover up patterned bald spots. Women may also shampoo their hair frequently without fearing hair loss.

However, one unproven vegetable medicine has helped alopecia patients without fail. Many alopecia patients use onion juice to strengthen their hair follicles to reduce patterned baldness. The juice of the onion also helps in the growth of new hair thereby providing a denser volume to the hair.  

Women have often voiced against the undue pressure that society puts on women and their need to have socially acceptable hair. You can check out movies like Shweta Tripathi’s Gone Kesh, which brilliantly highlights the stigma associated with hair loss and alopecia in particular.

Also Read: A Guide To Hair Transplant