Alopecia Areata is an autoimmune disease which causes partial or complete hair loss on scalp, face and sometimes on other areas of the body. Its causes are unconfirmed and may occur spontaneously. Alopecia Areata is first identified through a physical examination, and is recognized by its typical hair loss pattern – round or oval bald patches on the scalp, and sometimes eyebrows.

Androgenic Alopecia is a common cause for hair loss for both men and women. Also known as male pattern baldness and female pattern baldness, this form of hair loss presents itself differently in both men and women.

For males, the first sign of the start would be the receding of hairline at the two corners above the forehead – Showing a characteristic “M” shaped hairline.

For women, the hairline does not recede but hair starts to thin out over the entire head.

The causes of Alopecia Areata are complex and vary for each individual. Identified determinants of the disease to date include genetic factors, psychological factors, autoimmune processes, and infectious factors.

There are several types of Alopecia Areata, with each type ranging from mild to more severe cases. The four main forms would be:

1. Alopecia Areata (Patchy)
   The form where one or more coin-sized( Usually round or oval) bald patches appear on the scalp or other places of the body. This type can lead to either alopecia totalis or alopecia universalis.
2. Alopecia Totalis
   An advanced form of Alopecia Areata, where patches expand or increase in number.
3. Alopecia Universalis
   Most advanced form of Alopecia Areata which results in total loss of all hair on the body – including eyelashes and brows.
4. Androgenetic Alopecia
   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 and women. It is the most common type of progressive hair loss.

There is currently no specific cure to arrest Alopecia Areata, but there are treatments that are effective to counter the effects of the disease.

The kind of treatment varies depending on the type of Alopecia Areata, age and extent of hair loss,

From oral and topical medication, to devices, there are a number of therapies and treatment that help to stimulate hair re-growth for Alopecia Areata patients such as corticosteroid injections, topical minoxidil and phototherapy.

Due to the subjective nature of this disease, it is advisable to approach a certified trichologist to get a proper diagnosis and treatment advice.

5 usual causes of hair loss can be attributed to the following factors:

• Genetics
  • Genes may play a part in hair loss as an inherited risk found in the androgen receptor gene affects the risk of hair loss. The activity of androgen receptor (AR) is positively correlated to the risk of androgenetic alopecia. Higher activity of AR may lead to it being more susceptible to DHT, and hence higher risk of Androgenetic Alopecia.
• Stress
  • Cortisol is a marker for stress. During stressful periods, the elevated cortisol levels in the body may damage hair follicles which will constrict blood vessels, hence reducing blood circulation that will affect the flow of oxygen to the papilla or hair roots.
• Micro-inflammation
  • Micro-inflammation is often present in the hair follicles of patients suffering from Androgenetic Alopecia. Micro-inflammation can be caused by a variety of factors such as scratching, cosmetic products or heat from the hairdryer. The condition results in fibrosis and thickening of the dermal sheath of the follicle, which blocks communication of hair follicle with surrounding tissue in signals and nutrition, further leading to miniaturisation of follicle. The presence of micro-inflammation prevents hair recovery in those who even have reduced level of androgen.
• Hormonal
  • Imbalanced estrogen and the production of DHT slows hair growth.Estrogen can prolong hair Anagen phase and delay Telogen phase. Women have thick hair during pregnancy due to elevated level of estrogen, but thin hair after menopause when estrogen level drops. However, too high level of estrogen can exert opposite effect. Women with higher level of estrogen have higher risk of hair loss than those with normal level.DHT is the most important androgen that promotes human sexual organs development and maintains secondary sexual characters. DHT binds to androgen receptor to activate the downstream genes, which may lead to apoptosis of dermal papilla cells, and inhibition of proliferation and differentiation of follicular stem cells, eventually causing hair loss.
• Minerals and toxic elements
  • Low minerals may lead to hair loss from nutritional gaps, and toxic elements that may enter into the human body through food, water and air can have adverse effects on many organs including hair.The accumulation of toxic element is not perceivable, and it can only be detected by equipments like ICP-MS. Body health and hair growth cannot live without essential elements, all of which must be maintained at a balanced level.

The first step is to get a scalp scan to identify causes leading to hair loss. This would also allow for detection of early signs of hair loss, which might not necessarily be apparent to the naked eye. Early detection is critical because arresting progression of hair loss is more effective and easier than stimulating hair re-growth.  A scalp scan also allows for a more in-depth assessment of the scalp condition which would shed light into the causes of hair loss.

The following are also steps to cultivate a healthy scalp condition for hair loss prevention

• Usage of appropriate products depending on the condition of one’s hair and scalp
• Good hair wash practices such as thoroughly massaging the scalp with firm fingers in circular motion to remove residue from styling products, avoiding hot water which might lead to over stimulation and irritation, and avoiding the use of harsh chemicals
• Prescription of appropriate treatments by a certified trichologist
• Prescription of oral or topical medication by a doctor

Male pattern baldness is related to genes and male sex hormones. The typical pattern of male baldness begins at the hairline. The hairline gradually moves backward (recedes) and forms an "M" shape. Eventually the hair becomes finer, shorter, and thinner, and creates a U-shaped (or horseshoe) pattern of hair around the sides of the head.

Genetic (hereditary) influence is generally the primary cause.

In addition, excessive use of styling products coupled with poor hygiene practice such as infrequent shampooing to remove residue may aggravate the situation,

A stressful lifestyle with poor sleeping patterns and nutritional diet will also contribute towards hair loss at this age.

Female pattern baldness involves a typical pattern of hair loss in women, due to hormones, aging, and genes.

Hair thinning is different from that of male pattern baldness. In female pattern baldness:

• Hair thins mainly on the top and crown of the scalp. It usually starts with a widening through the center hair part.
• The front hairline remains
• The hair loss rarely progresses to total or near total baldness, as it may in men

In most cases of initial hair thinning, you will likely start noticing significantly more hair on your pillow and shower strainers. . Another sign would be receding of the frontal hair line and your hair would also feel less dense when you run your hands through. Click here to find out the 6 signs of hair loss.

The first step to reversing hair loss, and growing healthier hair, would be an accurate diagnosis of the current scalp and hair condition. Then after, the appropriate treatment or products can be recommended.

A trichologist is a medical expert specialising in hair loss and scalp related problems, such as thinning, baldness, breakage and itchy or flaking scalp. Their forte lies in medical and cosmetic practices to diagnose and treat hair thinning, or scalp and hair conditions.

A trichologist will discuss different aspects of one’s lifestyle such as diet and stress levels, medical history and conduct a scalp scan - for a comprehensive diagnosis of the causes of hair loss or scalp condition. This is followed by a prescription of targeted treatments and products to treat the condition.

At Svenson, our trichologist would conduct a comprehensive hair diagnostics which is a procedure that analyses hair on a cellular level. Three weeks after sending a suitable hair sample for laboratory testing in Italy, results determine the right therapies for different conditions.