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Hair loss What we need to know

Hair loss (alopecia) can involve the hairy part of the scalp or the entire body. Hair loss has a periodic or permanent character. It can be hereditary, hormonal, associated with various pathologies or caused by age reasons. Hair loss happens to everyone, but it is more common in men.

The most common cause of baldness is age-related hair loss. Depending on the cause of hair loss, it may develop gradually or over a short period of time.


Symptoms may include:

Gradual thinning of hair in the scalp area. This is the most common form of hair loss with age. Hair loss in men often starts from the forehead area. Hair loss in the direction of the frontal line is common in elderly women - frontal fibrotic alopecia.

Patchy or circular balding areas. Such areas are noted in the areas of the scalp, beard or eyebrows. Itching, pain and other symptoms are sometimes observed on bald areas.

sudden hair loss In response to physical or emotional shock. This type of hair loss involves mass loss of hair when combing or simply touching it, although it is usually temporary.

Hair loss all over the body. Some conditions, medications such as chemotherapy can cause hair loss. After the treatment, the hair usually grows back.

Spotted formations on the scalp - Ringworms, which are the result of a fungal disease. It is accompanied by hair breakage, as well as skin redness, swelling, and periodic rashes.





Diagnosis of hair loss includes physical examination of the patient, collection of anamnestic data and laboratory (sometimes instrumental) studies.

Diffuse hair thinning (general thinning of hair over the entire scalp) may be a symptom of various conditions, such as:

  • Female pattern hair loss: – which is caused by genetic factor or hormonal imbalance
  • Telogen - hair loss accompanied by stress or trauma.
  • Autoimmune alopecia - an autoimmune process in which the immune system "fights" hair follicles
  • Hair loss associated with chemotherapy


Since there are many factors that cause hair loss, a variety of diagnostic methods are used to determine the cause. For example, the Ludwig scale is used to determine the extent of female hair loss. However, it is impossible to determine the type of hair loss with this scale. Laboratory diagnostics is mainly used for this, which includes conducting the following studies:

  • Thyroid hormones
  • sex hormones
  • Iron and ferritin
  • General blood test
  • Vitamin D
  • B group vitamins
  • determination of blood sugar
  • Determination of EDS and C-reactive protein




Thyroid hormones

Disorders of thyroid hormones - hypothyroidism and hyperthyroidism - can cause hair loss, the cause of which is not completely certain. TSH, FT3 and FT4 must be determined to evaluate gland function.


sex hormones

Sex hormones play an important role in the growth process of both women and men. Excess testosterone produced in a woman's body is metabolized into dihydrotestosterone (DHT), which binds to the androgen receptors of hair follicles, causing them to shrink in size, disrupting the process of hair formation.

To diagnose the involvement of sex hormones in the process of hair loss, it is necessary to determine the level of sex hormones:

· Testosterone

· Estradiol


· Prolactin

· FSH – follicle stimulating hormone

· LH - malutheinizing hormone

Hair loss and hormonal disorders may be a concomitant process of a pathology such as polycystic ovary syndrome.


Iron and ferritin

Hair loss is a less common symptom of anemia or iron deficiency, however, these conditions are accompanied by changes in hair texture.

Studies have shown that people with female pattern hair loss have significantly lower serum ferritin (an iron-containing protein) level. In case of iron deficiency, it is also possible to develop hair loss.


General blood test

General blood analysis is necessary to assess the probability of inflammatory or coagulation processes and disorders in the body. During autoimmune processes, characteristic changes of the inflammatory process may be observed in the blood.


Vitamin D

Vitamin D deficiency is known to exacerbate or worsen autoimmune hair loss. Vitamin D deficiency is also believed to be the cause of female pattern hair loss progression.


B group vitamins

From this group of vitamins, several are directly related to the development of hair loss, such as:

· Folate (vitamin B9) –

· Biotin (vitamin B7)

Cyanocobalamin (vitamin B12)


Determination of glucose in the blood

Type 2 diabetes may be associated with hair loss in some cases.



EDS and C-reactive protein

Erythrocyte sedimentation rate and C-reactive protein are indicators of systemic inflammation. Some forms of alopecia are associated with inflammation around the hair follicle, causing stunted hair growth, shedding, and baldness.


In some cases, it is necessary to use methods such as scalp biopsy for diagnostics. The material taken will be studied microscopically.

The structure of the hair shaft is studied by light microscopy. to detect possible damage.



Some forms of hair loss can be effectively treated. In some forms of alopecia areata, hair can regrow without treatment. In most cases, etiopathogenic therapy is necessary, the purpose and duration of which is determined by the attending physician.


In case of permanent hair loss, hair transplantation or reconstructive surgery is required.

Laser therapy method of treatment is used in cases of hereditary hair loss. It improves hair frequency. There is insufficient information on long-term effects.



When to see a doctor?

In case of reduction in hair volume, thinning, baldness and other types of hair loss, it is necessary to consult a specialist, who will establish a diagnostics based on anamnestic, clinical and laboratory data and select an appropriate course of treatment.



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