Hair loss is an emotive topic for many people because often it’s bound up with our sense of identity and self-esteem. It can affect people of all ages and genders, and there is a lot of confusion about the causes and treatments of the condition, which is known by the medical term alopecia.
Here’s a look at the different types of hair loss and how it can be treated.
Androgenetic Alopecia
Androgenetic alopecia is more commonly known as male pattern baldness, although it can affect women as well (although it’s generally referred to as female pattern hair loss rather than baldness because in women the condition rarely results in complete baldness). It is the most frequent type of hair loss in both genders.
In men, the hair loss typically begins above the temples, and the hairline gradually recedes over the course of months or years. Hair also begins to thin at the crown, and the hairs on the rest of the head become finer and sparser. Eventually, the hair follicles die completely and no new hair will grow, leading to complete baldness.
In women, the hair typically becomes thinner on the top of the head, leading to a wide middle parting, but it does not recede from the hairline or fall out completely. Fewer women than men suffer from this type of hair loss, and it typically starts after the menopause.
In men, the condition can start as early as the teenage years, although the risk increases with age. It’s estimated that about half of all men over the age of 50 have some degree of male pattern baldness. In men, the cause is thought to be hormonal, and in particular an androgen called dihydrotestosterone (DHT).
An abundance of DHT can overstimulate the hair follicles, causing shorter growth cycles with thinner and shorter strands of hair. Eventually, the hair may stop growing altogether. The condition is thought to be genetic, so men who have close male relatives with pattern baldness are more likely to be affected by it themselves.
The condition may also be related to certain medical conditions, including heart disease, diabetes, obesity, and prostate cancer.
How is Pattern Baldness Treated?
Some people choose to accept male pattern baldness as a natural consequence of getting older, and are not unduly bothered by it. However, younger men in particular can find hair loss a distressing problem, and it may affect their self-confidence and ability to form romantic partnerships.
Finasteride and minoxidil are the main treatments for male pattern baldness. Minoxidil can additionally be used to treat female pattern hair loss, but not finasteride. They work by blocking the production of DHT and about 80% of users respond positively to the treatment.
However, it’s important to start the treatment as early as possible, because once the hair follicles have died it will be ineffective. The medication is taken orally and it’s important to follow the dosage instructions carefully. It should also be noted that the treatment only works for as long as it is taken, and it may have side effects.
Finasteride is known commercially as Propecia in the UK, and it’s a prescription-only drug. It’s not available on the NHS, but you can order privately from an online men’s healthcare service.
Alopecia Areata
Alopecia areata is a severe type of hair loss that is caused by an autoimmune disorder. The immune system mistakenly identifies the hair follicles as a foreign body and attacks them. Until recently, there has been no cure for this distressing condition, which can cause the hair to fall out in patches, or cause a complete loss of hair from the entire body.
However, BBC News reports that the National Institute for Clinical Excellence (NICE) have recommended that a new treatment called Ritlecitinib be used by the NHS. It is thought that alopecia areata affects about 400,000 people in the UK. Patients often suffer from acute anxiety and social isolation as a result of their condition.
The new drug can be given to patients over the age of 12, and could be used to treat 14,000 people with the severest cases of alopecia areata. Patients can lose their eyelashes, eyebrows, and nasal hair, which leaves them vulnerable to infections. The loss of hair on the body also makes it more difficult to regulate body temperature.
Helen Knight, the director of medicines evaluation at Nice, said: “Our committee heard how severe alopecia areata can have a significant impact on people’s health and quality of life. I’m delighted that we are now able to recommend this innovative treatment, the first time a medicine for severe alopecia areata has been recommended by Nice for use in the NHS.
“It is especially pleasing that we have been able to recommend Ritlecitinib just 16 weeks after it was granted a licence by the Medicines and Healthcare Products Regulatory Agency (MHRA), demonstrating Nice’s commitment to getting the best care to patients fast.”
Sue Schilling, the chief executive of Alopecia UK, said: “I thank our volunteers who took part in this process and thank the committee for their work on reaching this decision. This is a monumental day for the alopecia areata community.”
“For far too long, patients with alopecia areata have gone without a licensed treatment option available via NHS pathways. If new treatments are only available privately, it becomes a case of the ‘haves and the have-nots’. This latest Nice recommendation will go some way to address this.”
An NHS spokesperson said: “People suffering with severe alopecia areata can experience hair loss that affects their health and quality of life, and this latest innovative treatment for patients – the first NHS treatment for the condition – could greatly benefit thousands of people.”
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Other Causes of Hair Loss
Some degree of hair loss is a normal part of the shedding and growth cycle, but this can be driven into a temporary pause by external factors such as stress, illness, medical treatment, or a nutrient deficiency. In most cases, the hair growth will return once the stressor has been dealt with.
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