HAIR DISORDERS

ALOPECIA AREATA

This non-scarring condition appears as sharply defined non-inflamed bald patches, usually on the scalp. During the active stage of hair loss pathognomonic 'exclamation-mark' hairs are seen (broken off hairs of 3-4 mm long which taper off towards the scalp. An uncommon diffuse pattern on the scalp is recognised. The condition may affect the eyebrows, eyelashes and beard. The hair usually regrows spontaneously in small bald patches, but the outlook is less good with larger patches and when the alopecia appears early in life or is associated with atopy. Alopecia totalis describes complete loss of scalp hair and alopecia universalis complete loss of all hair.

Aetiology

Aetiology is unknown but there is an association with autoimmune disorders, atopy and Down syndrome.

 

The scalp hair should be inspected and its lustre, calibre, structure, kinks, breaks and frayed ends and density assessed. A search for nits and lice is essential when faced with an itchy scalp and adenopathy of the posterior cervical chain. When assessing alopecia it is helpful to distinguish whether the hair loss is due to an abnormality of the hair shaft (as in some inherited diseases of scalp hair) or of the scalp and, in the latter, whether there is scarring or not.

Management

Wigs may be the only answer in some women with extensive involvement.

 

ANDROGENETIC ALOPECIA

Male - pattern baldness is physiological in men over 20 years old though rarely it may be extensive and develop at an alarming pace in the late teens. It also occurs in females, but most obviously after the menopause. The well-known distribution (bitemporal recession and then crown involvement) is described as "male-pattern" but this type of hair loss in females is often diffuse.

Aetiology

Androgenetic alopecia is often familial though the precise mode of inheritance is not clear. As the name implies the hair loss is androgen-dependent though those afflicted usually have normal levels of circulating androgens. When this type of alopecia in associated with other signs of virilisation in the female, especially if there is menstrual irregularity or cessation, full endocrinological assessment is required to exclude an androgen-secreting tumour of the adrenal of ovary.

Management

Scalp surgery, hair transplants and wigs are welcomed by some.

 

 

TREATMENT AT DR. SOHAN LAL CLINIC

The integrated POLYCLINIC facility offers patients to select their treatment either from the Department of Homeopathy or from the Department of Medicine.

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