The diagnosis of hair loss should always be performed by a qualified dermatologist. Key elements in the diagnosis of androgenetic alopecia are the post-puberty history of occurrence, the gradual thinning in specific areas, and the family history regarding hair loss and alopecia. At Advanced Hair Clinics, hair loss is diagnosed or confirmed with a trichogram, using a special microcamera and software.
The special diagnostic photographic imaging and digital analysis tool “Follysis” that is used in our clinic, is one of the most comprehensive and accurate tools for the diagnosis of hair loss and the monitoring of response to treatment, allowing accurate measurements of hair density and hair strand diameter in each area.
Certain cases of hair loss, such as alopecia areata or cicatricial alopecia, may require special blood tests (hormonological tests, iron, vitamins, minerals, etc.) or a skin biopsy (punch biopsy) for the purpose of differential diagnosis.
The life cycle of hair comprises of: the anagen phase (in which hair growth takes place), the catagen phase (in which the hair stops growing and becomes detached from its root), the telogen phase (shedding). Hair loss occurs when the duration of the anagen phase becomes shorter and the hairs quickly pass into the telogen phase (telogen hair loss or telogen effluvium). In this case, the hair loss is diffuse, i.e. not located in a particular area, but spread over the entire scalp, causing reduction of the hair density and thinning of the hair strands. This form of hair loss can occur after giving birth, due to chronic infections or after administration of certain medications.
Other cases of hair loss are due to diseases of the scalp, such as fungal infections, folliculitis and other inflammations. Hair thinning can also be caused by malfunction of the thyroid gland (hypothyroidism, hyperthyroidism) and in hyperparathyroidism and other chronic diseases. Hair loss also occurs after chemotherapy, radiation therapy and certain medications, and in a number of chronic diseases. In these situations, hair loss subsides after identifying and eliminating the cause. Especially in women, major hormonal changes such as pregnancy, lactation, menstrual disorders, polycystic ovarian syndrome, menopause, etc., can lead to severe hair loss which is reversible in most cases.
Especially in women, major hormonal changes such as pregnancy, lactation, menstrual disorders, polycystic ovarian syndrome, menopause, etc., can lead to severe hair loss which is reversible in most cases. Localised hair loss of a usually permanent nature may occur in cases of traumatic alopecia, caused by injuries or burns to the scalp, face or body.
Complete loss of hair at specific locations can be seen in alopecia areata (spot baldness) and in scars (cicatricial alopecia), such as scalp injuries or burns. Hair loss and creation of cicatricial patches is also seen in follicular lichen planus and lupus erythematosus. Characteristic feature of these pathological forms of hair loss is that they can affect any area of the scalp, even the constant hair growth zone, and evolve in an erratic and unforeseeable manner.
These conditions may be localised, small-scaled and relatively stable, but in rare cases can take a global form; in some cases of alopecia areata, complete hair loss may occur not only on the area of the scalp, but also on face, on eyelashes or even on the entire body. The cases of pathological hair loss are much rarer than androgenetic alopecia and constitute less than 10% of all cases of alopecia.
Important causes of hair loss in today’s era is the quite stressful way of life as well as intense emotions, stress, exposure to a dusted and polluted environment, excessive exposure to solar UV radiation, frequent contact with sea or chlorinated water.
Malnutrition can aggravate hair loss, as a lack of protein, vitamins and minerals such as iron or zinc intensify the problem. A proper diet that includes protein and iron can reverse hair loss.
Traction hair loss caused by the excessive pulling of the hair due to various hairdressing and styling processes (e.g. ponytails, extensions, etc) can take place.