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HAIR LOSS: THE CAUSES

Hair loss (= alopecia) affects both men and women.

It very often causes psychological and social suffering.

Some will be fatalistic, others interventionist: the best philosophy is to make the right diagnosis, know how to wait sometimes and then propose a reasonable, realistic and coherent treatment plan.

HAIR LOSS: IN DETAIL

There are several forms of hair loss, each with its own mechanisms that are sometimes complex and not always fully understood.
It is necessary to determine whether these falls are:

  • Localized or diffuse
  • Congenital (from birth) or acquired later
  • Hereditary or not
  • Acute or chronic
  • Scarred (regrowth is impossible) or non-scarred (temporary phenomenon with possible regrowth).


The main cause of hair loss is androgenetic alopecia .
Schematically, all forms of alopecia can be grouped into two categories: cicatricial or non-cicatricial.





NON-SCARRING ALOPECIA

  • Androgenetic alopecia
  • Telogen effluvium: Hair loss is temporary and without miniaturization. It can be seasonal (spring, fall), or following childbirth, trauma, surgery, diet, or even linked to a thyroid problem or taking medication or an iron deficiency... we then observe a rapid synchronization of hair in the telogen phase.
  • Alopecia areata or alopecia areata: this is a chronic autoimmune disease with a risk of recurrence. Alopecia areata presents as bald patches. It can affect all or part of the hair, but it can also affect the entire hair system (universal alopecia areata). Treatments are limited, but hair often grows back on its own in the more or less long term. This favorable outcome is common for most cases of alopecia areata.
  • Trichotillomania: Alopecia is linked to the compulsive pulling out of one's own body hair and/or hair. It affects both adults and children, and most often requires psychological help.

SCARRING ALOPECIA

  • Traction alopecia: Alopecia results from excessive traction (bun, African braids, hair pulled back too far). The hair becomes weakened, breaks, and falls out. This repeated pulling leads to progressive scarring (fibrosis).
  • Brocq's pseudopelade: This is an inflammatory process of the scalp caused by a disorder of the immune system. The scalp appears more whitish and smooth without visible follicles.
  • All other causes of scalp scarring: accident, surgery, burn, radiotherapy, infection (lichen planus), inflammatory, systemic disease (lupus)...
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