OM VERMA ASSISTANT PROFESSOR RELIANCE INSTITUTE OF NURSING DHAMTARI

1. ALOPECIA

2. PRESENTED BY –
OM VERMA
ASSISTANT PROFESSOR
RELIANCE INSTITUTE OF NURSING

3. Definition:
• Alopecia is defined as the loss of hair from
areas where hair normally grows
According to Brunner
• Partial or complete baldness or loss of hair.
According to luck man’s

4. • Alopecia is the partial or complete loss of
hair—especially on the scalp—either in
patches (alopecia areata), on the entire head
(alopecia totalis), ...
According to Lewis
• sudden loss of hair especially of the scalp or
face in circumscribed patches with little or no
inflammation.
According to lippen cott

5. • Alopecia is defined as “ absence or
loss of hair”. It’s a chronic disorder
secondary to the disease of either
the hair follicle, hair shaft or the
scalp

6. Forms of Alopecia:
There are different types of alopecia. the main types
of hair loss are:
• Alopecia Areata (AA)
• Alopecia Totalis (AT)
• Alopecia Universalis (AU)
• Alopecia Barbae
• Androgenetic Alopecia (AGA)
• Scarring Alopecias (Cicatricial Alopecias)

7. Alopecia Areata (AA):
• Alopecia areata is an autoimmune condition which
causes patchy hair loss. It can result in a single
bald patch or extensive patchy hair loss.

8. Alopecia Areata (AA)

9. Alopecia Totalis (AT)
• Alopecia totalis is a more advanced form of alopecia
areata which results in total loss of all hair on the
scalp.

10. Alopecia Totalis (AT)

11. Alopecia Universalis (AU)
• Alopecia universalis is the most advanced form
of alopecia areata which results in total loss of
all hair on the body, including eyelashes and
eyebrows.

12. Alopecia Universalis (AU)

13. • Alopecia Barbae
• Alopecia barbae is alopecia areata that is localised
to the beard area. It can be a single bald patch or
more extensive hair loss across the whole of the
beard area.

14. Alopecia Barbae

15. Androgenetic Alopecia (AGA)
• 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 or
women.
• It is hereditary
• In both men and women, it's linked to having an excess of male hormones
(androgens) around the hair follicles, which can block hair growth.
• Women are more likely to develop androgenic alopecia after menopause,
when they have fewer female hormones.
• Most cases of hair loss are due to androgenic alopecia.

16. male pattern baldness

17. female pattern baldness

18. Scarring Alopecias (Cicatricial Alopecias):
• Scarring alopecias refers to a group of rare
disorders which cause permanent hair loss.
• Caused by any inflammatory processes which
causes permanent damage to hair follicles.(burns,
bacterial infections, autoimmune diseases )

19. Scarring Alopecias

20. • Types
• Several types of alopecia areata exist. Each type is
characterized by the extent of hair loss and other symptoms
you may be experiencing. Each type may also have a slightly
different treatment and prognosis.
• Alopecia areata (patchy)
• The main characteristic of this type of alopecia areata is one or
more coin-sized patches of hair loss on the skin or body. If this
condition expands, it may become alopecia totalis or alopecia
universalis.
• Alopecia totalis
• Alopecia totalis occurs when you have hair loss across the
entire scalp.
•

21. • Alopecia universalis
• In addition to losing hair on the scalp, people with
this type of alopecia areata also lose all hair on the
face — eyebrows and eyelashes. It’s also possible
to lose other body hair, including chest, back, and
pubic hair.
• Diffuse alopecia areata
• Diffuse alopecia areata may look a lot like female-
or male-pattern hair loss. It results in sudden and
unexpected thinning of hair all over the scalp, not
in just one area or patch.
• Ophiasis alopecia
• Hair loss that follows a band along the sides and
lower back of the scalp is called ophiasis alopecia.

22. • Physical trauma Long term traction of hair, x-ray
• overdose burn
• Infections Bacterial
• Dermatophytosis
• Viral
• Chemical injury Caustics
• Cutaneous diseases DLE, FLP,pseudopelade
• Destructive neoplasms &
• granulomas
• Psychogenic conditions Neurotic excoriating
tactile
• injury to skin

23. Causes of alopecia:
• Exposure to allergens, irritants, toxins, burns,
injuries, and infections.
• Certain medications (especially anabolic steroids
like testosterone)
• Chronic kidney failure
• Radiation and chemotherapy .
• Malnutrition

26. MALNUTRITON
• While hair follicles are among the most
metabolically active in the body, and hair
growth may be impacted by calorie and
protein malnutrition as well as micronutrient
deficiency, the links are complex. ... Hair loss is
common, with close to 50% of men and
women affected by pattern hair loss by age
50

27. RADIATION AND CHEMOTHERAPY
• Hair loss, also called alopecia, may be a side
effect of chemotherapy, targeted
therapy, radiation therapy, or bone
marrow/stem cell transplants. These
treatments can cause hair loss by harming the
cells that help hair grow.

28. CLINICAL MANIFESTATION
• The main symptom of alopecia areata is hair loss. Hair
usually falls out in small patches on the scalp. These patches
are often several centimeters or less.
• Hair loss might also occur on other parts of the face, like the
eyebrows, eyelashes, and beard, as well as other parts of the
body. Some people lose hair in a few places. Others lose it in
a lot of spots.
• You may first notice clumps of hair on your pillow or in the
shower. If the spots are on the back of your head, someone
may bring it to your attention. However, other health
conditions can also cause hair to fall out in a similar pattern.
Hair loss alone isn’t used to diagnose alopecia areata.

29. Con….
• Signs and symptoms of hair loss may include:
• Gradual thinning on top of head. This is the
most common type of hair loss, affecting
people as they age. ...
• Circular or patchy bald spots. ...
• Sudden loosening of hair. ...
• Full-body hair loss. ...
• Patches of scaling that spread over the scalp.

30. •DIAGNOSTIC TEST

31. • History & Examination
• 1. Time period of hair loss(congenital, acquired)
• 2. Progression of hair loss
• 3. Any positive family history
• 4. H/o G.I dysfunction, thyroid gland dysfunction
• , psychological disorders
• 5. H/o any surgical intervention / chronic illness
• 6. All medications
• 7. In females, menstrual & obstetric history
• 8. Hair care routine/ hair products

32. MEDICAL HISTORY
• To determine the cause of hair loss, your
dermatologist asks a variety of questions about
when hair loss began, what the patterns of hair
loss are, what kind of hairstyles you usually wear,
whether hair loss runs in your family, and other
details about your symptoms. He or she may ask
about any other medical conditions you have.
• Details that may seem unrelated—such as what
foods you eat or whether you recently gave
birth—may provide a clue about the cause of the
hair loss.

33. PHYSICAL EXAM
• A dermatologist examines your scalp to check for
inflammation, redness, sores, or scarring. The
doctor looks closely at your hair to determine
how much is being lost, the pattern of the hair
loss, and whether there is hair breakage.
• During a physical exam, your doctor may perform
simple tests to learn more about the health of
your hair. These may include the following.

34. • TRICHOMETRIC ANALYSIS
• In certain instances, dermatologists at NYU Langone use
trichometric analysis, a sophisticated computerized measurement
tool, to analyze characteristics of the scalp and hair. Our doctors use
a digital assessment system called Folliscope® which consists of a
small handheld device containing a high definition, microscopic
camera.
• Doctors use this camera to take pictures of the scalp and hair, and
the images are displayed on a computer monitor. The
Folliscope® can magnify these images by up to 100 times, giving
doctors a detailed look at hair, hair follicles, and the scalp.
• The Folliscope® also provides information about hair coverage,
including the total number of hairs on the scalp and the diameter of
each strand of hair. These details are used to monitor the
progression of new hair growth after treatment begins.

35. FUNGAL CULTURE
• A fungal culture is a laboratory test that can
confirm the presence of a fungus in hair or scalp
cells. A dermatologist may recommend this test
to determine whether a fungal infection called
tinea capitis, or scalp ringworm, is the cause of
hair loss.
• A dermatologist may scrape or swab the scalp or
take a small sample of skin or hair for laboratory
testing. It can take several weeks of incubation in
the laboratory for a fungus culture to become
positive.

36. PUNCH” BIOPSY
• It’s called a “punch” biopsy because of the
technique used: Dermatologists use a device
the size and shape of a pencil to puncture the
scalp and remove a small tissue sample. This
sample is sent to a lab for testing, and the
incision is closed with a few stitches. Biopsies
are frequently used to distinguish between
the types of cicatricial, or scarring, alopecia.

37. BLOOD TESTS
• If doctors suspect the hair loss may be due to
an underlying medical condition, a vitamin or
mineral deficiency, or a hormonal imbalance,
they may recommend one or more blood
tests. For example, it may appear that a
woman whose hair is thinning all over the
scalp has hereditary hair loss, but it’s possible
that the cause is actually an iron deficiency.

38. • IRON DEFICIENCY
• Too little iron in the bloodstream may contribute
to hair loss. Doctors use blood tests to check the
level of ferritin, a protein that indicates how
much iron is stored in the body. Ferritin levels are
often low in menstruating women; those with
anemia, a condition in which people lack healthy
red blood cells; and vegetarians or vegans.
• Adding foods rich in iron to your diet may help
hair to regrow. These include dark, leafy greens,
red meat, whole grains, and legumes. Iron
supplements, which are used to treat anemia,
may also help to stop hair loss.

39. • Daily Hair Counts
• Useful for quantitative assessment of the actual
number of
• hairs shed daily in patients with complaints of
excessive
• shedding.
• Collect for 14 consecutive days
• Average daily loss – 30-70 hairs /day.
• If >70 hairs – microscopic examination is done
to
• detect pathology.

40. TREATMENT
• Although hair loss rarely needs to be treated,
many people seek treatment for cosmetic
reasons.
• There is no cure for alopecia and no
universally proven therapy to induce hair re-
growth.

41. • Many cases of hair loss are temporary, for
example, due to chemotherapy, or they're a
natural part of ageing and don't need treatment.
• If hair loss is caused by an infection or another
condition , treating the underlying
problem may help prevent further hair loss.

42. Finasteride:
• It acts by preventing the hormone testosterone being
converted to the hormone dihydrotestosterone (DHT).
• DHT causes the hair follicles to shrink, so blocking its
production allows the hair follicles to regain their normal
size.
• The balding process usually resumes within six to 12
months if treatment is stopped

44. • Minoxidil:
• Minoxidil is available as a lotion you rub on your
scalp every day
• It's not clear how minoxidil works, but evidence
suggests it can cause hair regrowth in some men.
• Minoxidil is currently the only medicine available
to treat female-pattern baldness.

46. Corticosteroid injections:
• Acts by suppressing the immune system.
• This is useful in alopecia Areata because the
condition is thought to be caused by the immune
system damaging the hair follicles.

47. Retin A / Tretinoin:
• Retin-A was originally used for the treatment of
acne and other skin problems.
• However studies have shown that Retin-A, when
used alone in the form of a gel, which is rubbed
onto the area of hair loss, or in combination with
topical Minoxidil can result in moderate to good
hair growth in individuals with Alopecia.

48. • Medical treatments
• Topical agents
• You can rub medications into your scalp to help stimulate hair growth. A
number of medications are available, both over-the-counter (OTC) and
by prescription:
• Minoxidil (Rogaine) is available OTC and applied twice daily to the scalp,
eyebrows, and beard. It’s relatively safe, but it can take a year to see
results. There is only evidence that it’s useful for people with limited
alopecia areata.
• Anthralin (Dritho-Scalp) is a drug that irritates the skin in order to spur
hair regrowth.
• Corticosteroid creams such as clobetasol (Impoyz), foams, lotions, and
ointments are thought to work by decreasing inflammation in the hair
follicle.
• Topical immunotherapy is a technique in which a chemical like
diphencyprone is applied to the skin to spark an allergic rash. The rash,
which resembles poison oak, may induce new hair growth within six
months, but you’ll have to continue the treatment to maintain the
regrowth.

49. • Immunosuppressive drugs
• Ultraviolet light treatment
• Wigs
-Synthetic wigs- made of acrylic
-Real hair wigs
• Hair transplantation

50. • SURGICAL TREATMENT
• Hair transplantation
• Follicular unit transplant

51. • Hair transplantation is a surgical technique
that removes hair follicles from one part of
the body, called the 'donor site', to a bald or
balding part of the body known as the
'recipient site'. The technique is primarily used
to treat male pattern baldness.

52. • Follicular unit transplantation (FUT) is a hair
restoration technique, also known as the strip
procedure, where a patient's hair
is transplanted in naturally occurring groups
of 1 to 4 hairs, called follicular units.