CLINICAL FORMS OF HAIR LOSS

There are several clinical forms of hair loss:

• Alopecia Areata (total, universal)
• Androgenic Alopecia in men and women
• Telogen Effluvium
• Diffuse Alopecia
• Cicatricial Alopecia

Alopecia Areata

Alopecia areata is a chronic dermatosis characterized by pathological hair loss caused by various pathological processes in the body, resulting in partial or complete hair loss in the scalp, beard, eyebrows, eyelashes, and other parts of the body.

Alopecia areata is a disease with a multifactorial pathogenesis of autoimmune origin. Its causes include:

• Stress
• Physical trauma
• Associated infections
• Gastrointestinal diseases
• Parasitic infestations
• Nervous system pathologies
• Thyroid gland pathologies
• Genetic predisposition
• Autoimmune stress
• Imbalance of microelements

Androgenic Alopecia in Men and Women

This condition affects 65% of men and 25% of women. It begins after puberty when hair transforms from terminal to vellus form, a process known as “miniaturization.” The cause is male sex hormones— androgens. The primary factor is the effect of free testosterone on androgen receptors near the hair follicle, inhibiting normal hair growth. The second factor is the imbalance of specific proteins involved in androgen metabolism. Environmental factors such as diet and the condition of the nervous system also play a role.

The main clinical sign common to both men and women is the replacement of terminal hair with thinner, less pigmented hair.

In men, this process begins with thinning hair in the crown-temporal region, disrupting the hairline, and gradually creating bald spots.

In women, the frontal hairline remains intact, but the crown area becomes vellus and diffusely thinned, particularly noticeable after menopause due to relative androgenemia.

Telogen Effluvium

Telogen is the phase of hair development when the hair bulb detaches from the dermal papilla. The hair gradually moves toward the skin surface and falls out, while new hair forms in the follicle.

Unfavorable conditions can disrupt this normal process, causing more hair than usual to enter the telogen phase. Triggers can include stress, high-fever infectious diseases, surgeries, pregnancy, childbirth, abortions, various medications, and physical overload. Hair loss begins approximately 3-6 months later, making it difficult for patients to identify the cause, often remaining unknown, and the hair loss itself becomes a source of stress, creating a vicious cycle.

Diffuse Alopecia

A person loses 50 to 100 hairs daily, a physiological process. However, external and internal factors can cause excessive hair loss (up to 1000 hairs per day), leading to diffuse alopecia. After addressing the cause of diffuse alopecia, hair loss stops, and hair growth resumes. Causes include:

• Endocrine disorders (hypo- and hyperthyroidism, pituitary function reduction, hypercortisolism, etc.)
• Large intake of medications (cytostatics, anticoagulants, D-penicillamine, thyreostatic drugs, retinoids, antimalarials, contraceptives, etc.)
• Emotional and physical stress (pregnancy, trauma, fever)
• Exogenous and metabolic hypoproteinemia, including blood loss, starvation, and strict diets
• Contact with chemicals
• Deficiency of iron, zinc, and other minerals
• Malignant diseases – radiation or chemotherapy

Cicatricial Alopecia

Scars result from various injuries (endogenous factors, trauma, burns, surgical interventions, etc.), replacing the skin defect with connective tissue. Scars, especially on the visible parts of the body such as the face and scalp, often cause functional and aesthetic defects. Scarring on the scalp often leads to bald patches, known as secondary cicatricial alopecia.