The so-called androgenetic alopecia (constitutional hair loss) is the most most common form of hair loss. The term is also used as an umbrella term for different Types hair loss used with different effects and characteristics. Often, this permanent decline in hair growth represents an enormous psychological burden for those affected. The effects range from partial thinning of the hair to complete baldness. In rare cases, there is a loss of hair on the face and body.

General signs of alopecia

  • Increased occurrence of brittle hair
  • Bald spots on the head
  • Severe hair loss
  • Falling tufts of hair during washing
  • Loss of tufts of hair in the morning

Similarly, a Changing the fingernails and toenails be an early warning signal. A generally poor condition of the nails, small furrows as well as narrow white lines on the nails sometimes also indicate alopecia.

Signs of advanced alopecia

  • Several bald areas on the head
  • Intensive thinning up to complete hair loss
  • Hair loss on other parts of the body such as arms, legs or eyelashes
  • Loss of beard hair and bald patches in the beard

As the disease progresses, it thus becomes more intense and in some cases spreads further over the body.


Androgenetic alopecia (constitutional hair loss)

It affects about 60 to 80 percent of all men and 20 to 30 percent of all women, whereby congenital hair loss in the female sex unlike men progressing. While the symptoms in men manifest themselves in the form of receding hairlinebald patches or a bald head, this is expressed in the form of hereditary disease here again by a change in hair density.

A reduction in growth caused by androgens, which is accelerated by smoking, is a natural process of aging. As often wrongly assumed, the causes are not based on a hormonal disorder. The male sex hormone dihydrotestosterone (DHT) however, plays a separate role. According to this, people with androgenetic alopecia show a considerable hypersensitivity to the steroid hormone DHT.

The reason for this is found in the genes and is therefore purely predisposition, although it is not necessarily passed on. Male androgenetic alopecia is not classified as an underlying disease, but could affect the self-image and the image of others.

Medicinal forms of therapy

Finasteride: This drug can stop the progression of androgenetic hair loss in those affected. The drug ensures that by taking it. less dihydrotestosterone arises. Thus, it affects the male hormone balance and slows the increase of the process.

MinoxidilMinoxidil, like finasteride, was originally developed for the treatment of Treatment of hypertension brought to the market. However, side effects in the form of massive hair growth occurred in the test persons. Through the development of a tincture for external application, this variant can now also be treated.

Antiandrogens: These are substances that are used to treat hereditary diseases in women. They achieve a Inhibition of dihydrotestosterone in the cells and stop the effect of the testosterone.

Alopecia areata (circular hair loss)

This variant is a Systemic disease (autoimmune disease), in which the body's immune system attacks the hair. Alopecia areata affects in the form of a round as well as pathological loss of hair on the head or legs. Bald spots on the beard are also not uncommon. Many of those affected report first signs already in the childhood or young adulthood.

In this disease, inflammation occurs at the roots of the hair, because the defense cells are suddenly directed for the body's own hair. As a result, they no longer grow to a normal extent and fall. Often this form occurs in Association with other autoimmune diseases such as white spot disease or any thyroid disorders.

Studies from the USA have shown that girls in particular are prone to developing alopecia areata. Women who use electric combs or chemical hair straighteners may also be at risk in Combination with abnormal hair follicles an scarring scalp get. The clinical picture has become more pronounced in some families, which speaks for a hereditary predisposition. Often the hair grows back in a period of six to twelve months - however, a recurrence of the disease is not excluded.

Medicinal forms of therapy

  • Dithranol: Dithranol is mainly known to provide relief from psoriasis. The substance irritates the skin, which in turn is supposed to promote hair growth. Negative side effects can occur in the form of skin irritation, redness or discoloration of the skin.
  • Glucocorticoids (cortisone): If the disease does not improve on its own after a few months, it may be necessary to administer a Treatment with cortisone creams or solutions. Cortisone is known to suppress inflammatory responses of the immune system. However, this methodology does not promise improvement in all patients and, moreover, due to the side effects, should only be done in cases of severe hair loss activity. Despite the anti-inflammatory effect of cortisone, the loss may recur after discontinuation.
  • Topical immunotherapy: In this case, the application of the medicinal substance Diphencyprone (diphenylcyclopropenone, DCP) caused deliberate allergic contact dermatitis. Recurrent treatments are used to maintain, to divert immune cells from attacking the hair roots. Again, there is a risk of recurrence. Side effects, such as the formation of eczema, can also not be excluded.
  • PUVA: By means of PUVA, this manifestation is treated by the application of a phototoxic substance (psoralen) is used to combat this. This is done in combination with irradiation of the bald area with UV-A light. Psoralen is applied as a cream and is supposed to stop the attack of the immune cells on the hair roots. Possible side effects can be found in adverse skin reactions caused by the UV-A irradiation.

Diffuse hair loss (telogen effluvium)

Diffuse hair loss is when the hair on the entire head becomes uniformly thinner or falls out. Predominantly women suffer from this variant, since the trigger is not infrequently from Hormone fluctuations is not possible. Taking certain medications for elevated blood lipid levels (lipid-lowering agents) or also agents from cancer treatment (cytostatics) as well as substances for hyperthyroidism (thyrostatic agents). favor the process additional.
Once the therapy is over, in most cases the failure reduces by itself or is stopped completely.

A nutrient deficiency can also be the trigger for a diffuse loss of hair. The deficit must then be remedied through the diet or by taking certain Supplementary preparations be regulated. In particular acute iron deficiency is often associated with this diagnosis. Here, the deficiency should be balanced by means of a balanced diet. Eating disorders, short crash diets as well as chronic intestinal diseases equally increase the risk. Infectious skin diseases such as skin fungi, psoriasis or herpes zoster occasionally contribute to an outbreak.

If radiation treatment is prescribed in the context of a cancer illness and the head area is exposed to the radiation field, there is also a risk here of suffering from increased manifestation to suffer. Usually, the body regenerates after some time and hair growth continues. However, if the treatment involved a high dose of radiation, the roots of the hair can sometimes be permanently damaged. The same is true for chemotherapy used to treat a cancer. It can, but does not necessarily have to lead to a diffuse hair loss come. With chemotherapy, however, there is a risk that body hair, eyebrows or eyelashes may also be affected and fall out. If the therapy is stopped, the loss is not infrequently restored.

General forms of therapy

The therapy is usually adapted to the respective cause. With the occurrence of diffuse hair loss, caused by taking certain medications, can already be a Change of medication Provide relief. Diseases such as anemia or the like, which, for example. Iron deficiency and also contribute to this, provide for combating with the help of iron preparations. In the event of a diet-induced reduction of the hair on the head should be immediately changed diet and adjusted accordingly.

After successful treatment by the described forms of therapy, symptoms may continue for another two to three months. The reason for this is in the so-called Telogen phase in which a part of the hair goes into a resting or failure phase and falls out during this time.

Other treatment alternatives

If the described approaches do not lead to a visible improvement in the long run, there is still the possibility of a Hair Transplant. A hair transplant for men with missing hair at the temples and baldness at the back of the head has proven to be particularly effective for hereditary conditions. This alternative is a permanent solution and is becoming increasingly popular. The technique allows hair follicles to be transplanted from one area of the head to a bald area. However, the procedure only allows the transplantation of one or two hairs at a time and is therefore very time-consuming.

Another and often used method consists in the Transplantation of larger skin areas. Small pieces of tissue are removed from the regions of the head that have more hair and are not sensitive to testosterone. These are then transplanted to the bald areas. The procedure is a plastic surgery and should therefore only be performed by an experienced dermatologist. On the other hand, hair transplantation is less suitable for women with hereditary hair loss, as the symptoms tend to manifest themselves in the form of increasing thinning. Complete baldness in women is therefore predominantly absent. In the case of circular hair loss, hair transplantation is also not suitable because the hair often grows back on its own after some time. In this case, medicine speaks of spontaneous healing.

As another surgical procedure, the Stretching the hairy scalp practiced over a larger area. However, this procedure is much more complicated and extensive.

In the event of a temporary complete breakdown, for example due to chemotherapy, those affected often resort to a Wig back. These serve as a practical aid so that there is no need to undergo further treatment. Wigs should be ordered from a wigmaker before undergoing chemotherapy, as it takes time to make them. For women, the cost of a wig is usually covered by health insurance.

FAQ - Questions and answers

When is alopecia generally referred to?

We speak of alopecia when hair growth stops and the hair gradually falls out or becomes thinner.

What are the signs of alopecia?

There are many signs of alopecia occurring. They range from permanently brittle hair, bald patches on the head to severe hair loss.

What forms of therapy are available?

Alopecia can be treated with various medications. The most common drugs are dithranol or cortisone creams or solutions. Depending on the findings, a change in diet is also recommended.

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