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 Hair loss, alopecia, needs immediate attention from a dermatologist. Have you noticed clumps of hair in your shower drain, brush, or on the bathroom floor? If so, you are not alone, many women suffer from alopecia, or hair loss. This problem is not only physically disturbing but can also cause significant emotional distress. In our society, hair loss, although not desirable, is more socially acceptable for men than for women. Women spend a significant amount of time and money in salons and on hair products as part of their overall general appearance. Therefore, thinning or loss of hair can and often does, affect social interactions and self esteem. There are many types of alopecia. If you are noticing hair loss, it is important that you see your physician. There are a number of organic problems that may manifest themselves as hair loss. These include anemia (low blood count) or autoimmune conditions such as thyroid disease. Unfortunately, there are 2 types of alopecia that are specific for women with tightly coiled or curly hair, seen in women of color; central centrifugal cicatricial (or scarring) alopecia (ccca) and traction alopecia. CCCA, previously known as hot comb alopecia or follicular degeneration syndrome, may progress quickly and relentlessly. Therefore, it is important to get to your dermatologist as soon as you notice the hair loss. This type of alopecia usually begins at the crown of the scalp (central) and progresses in a circular fashion outwardly. There is inflammation of the scalp and many patients initially describe a sensation of pins and needles, along with itching and tenderness. This condition can affect women of all ages, oftentimes beginning in women in their twenties. The cause is still unknown, but is likely multifactorial with both genetic and environmental factors being involved. Styling techniques such as hot comb use, relaxers, tight rollers or curlers, braids with extensions or weaves, blow drying or “oiling the scalp” may all contribute. Treatment of CCCA is difficult, particularly because the exact cause is unknown. Your dermatologist may initially recommend you avoid certain styling practices for a period of time. These include pressing the hair, relaxers, using rollers, or extensions. Topical steroids or cortisone injections are among the initial recommendations. These are used to reduce scalp inflammation which may lead to scarring. Oral or topical antibiotics are also used. Once the inflammation is decreased, over-the-counter Minoxidil (Rogaine) may be recommended to stimulate the remaining hair follicles. For patients with severe scarring, re-growth is not possible and hair transplantation may be the next step. Whatever the treatment, the best chance of reversing the condition is seeking a dermatologist early in the process. Traction alopecia is also commonly found in women of color. This hair loss results from continuous pulling of the hair, often seen with certain hair styles such cornrows or braids, ponytails, or rollers. Thermal or chemical straightening may also contribute, as can excessive weight due to extensions or locks. Signs of this condition include soreness of the scalp, headaches, or difficulty moving the forehead/temples. Hair loss is most commonly seen along the frontal hair line and above the ears and is most often found in younger women. If this pulling continues after hair loss is noted, scarring may result leading to permanent hair loss. Obviously, treatment for this condition would start with discontinuation of the trauma inducing hair styles. Oral or topical antibiotics may be prescribed by your dermatologist in order to decrease inflammation. Again, if significant scarring is present, hair transplantation may be necessary. Remember, with both of these conditions, early intervention is necessary to prevent severe, permanent hair loss. |
