Alopecia - what is it? Note to permanent makeup masters

Hair is the most important attribute of external attractiveness, so they play a crucial role in a person's life. The canons of beauty gradually changed over time, but it was the condition of the hair that was one of their constant components.
Scalp skin disease, increased or complete hair loss cause serious psychological and neurotic disorders and, as a result, adversely affect the quality of life for both men and women.
The causes of hair loss can be both external (stress, infections, scalp injuries) and internal (hormonal, autoimmune, infectious, genetic).
Unfortunately, reversible forms of hair loss account for a negligible percentage. In 96 cases out of 100, people with insufficient hair volume suffer from normal or androgenic alopecia.
The emergence of such a direction as trichopigmentation, its development in the industry of permanent makeup and aesthetic dermopigmentation leads to the fact that work in this area requires certain ideas and knowledge about the types of alopecia, the causes of its occurrence and all kinds of treatment methods.

This topic is relevant and requires constant broad consideration. So, let's consider in more detail the existing types of alopecia: androgenetic, diffuse, alopecia and cicatricial.

Alopecia areata (androgenetic or androgenetic alopecia)

Alopecia areata is the most common physiological phenomenon in genetically predisposed subjects. It may be noticeable in healthy men by age 17 and in healthy women by age 25-30.
Androgenetic alopecia is often incorrectly referred to as male pattern baldness, which leads to an unreasonably rare diagnosis in women, especially when evaluating the early manifestations of alopecia, since the pattern of hair loss in women is different than in men.
In men, the process of baldness begins with changes in the fronto-temporal hairline, it recedes from the sides and the forehead becomes higher, the bald patches gradually deepen, and hair thinning appears, and then baldness in the parietal region. Characteristically, with normal baldness, hair is completely preserved in the lateral and back parts of the head in the form of a horseshoe.
In women, the frontal hairline usually does not change, there is diffuse hair thinning in the fronto-parietal region. Characterized by the expansion of the central parting.
The cause of androgenetic alopecia is the destructive effect of male sex hormones on the hair follicle. Of course, this cause of baldness in men only affects those who have the genetic prerequisites for such destruction.

The discovery of the role of androgens in the pathogenesis of normal baldness has led to a judgment about the increased sexuality of balding men, but this lacks a scientific basis. Also, there was no connection between hair loss and their thick growth on the trunk and limbs.
Balding men who are genetically predisposed to this have normal levels of androgens. In women, the situation is different: the degree of baldness partly depends on the level of androgens, hair loss in such patients is combined with seborrhea, acne hirsutism, with a maximum change after menopause.
Interestingly, each hair follicle has a genetic program that determines its response to androgens, and the effect of these androgens on hair follicles is not the same in different parts of the body. This condition, left untreated, steadily progresses.

Diffuse alopecia (symptomatic)

If we are not dealing with genetically determined common baldness or alopecia areata, if the hair falls out all over the head, then we have diffuse alopecia.

Diffuse alopecia is the very case when the mirror of our health shows some deviations from the norm. It arises under the influence of various external factors, when the asynchrony of hair cycles characteristic of a person is disturbed and excessive (up to 1000 per day) hair loss occurs. Diffuse alopecia is reversible, and when the cause of the disease is eliminated, hair loss stops and their growth resumes. This baldness can be caused by endocrine disorders, a reaction to medication, emotional or physical stress, including fasting and dieting, occupational or casual exposure to chemicals, mineral deficiencies, malignant neoplasms, etc.

The prognosis for the treatment of diffuse (symptomatic) alopecia is favorable when the cause of hair loss is established. However, with the constant development of the disease, even the most thorough history taking may not be productive. It is believed that diffuse alopecia is equally common in both sexes.

Alopecia areata (alopecia areata, alopecia areata)

This disease is characterized by the appearance of a round or oval bald spot with clear boundaries and apparently unchanged skin.

Limited forms of the disease can progress to complete hair loss on the scalp (alopecia totalis) and hair loss on the entire body (alopecia universalis).
Patients with alopecia areata (KO) make up about 2% of dermatological patients. This disease affects both sexes equally with the rise of the disease from 20 to 50 years.
The etiology of FGM has not yet been established, nor has a universal drug been found. The unpredictability of the course allows us to consider KO as a heterogeneous clinical syndrome, in the development of which the following factors play an important role: emotional stress, infection, physical trauma, and genetic factors. Therapy for this type of baldness should be comprehensive and as individual as possible.

Persistent hair loss: scarring alopecia

All skin lesions leading to cicatricial changes also cause the death of hair follicles. The causes of cicatricial alopecia are diverse: skin damage from physical and chemical irritants, infectious skin diseases, neoplasms, developmental defects and genodermatoses.

In most cases, cicatricial atrophy is the end result of the evolution of various dermatoses localized on the scalp, primarily atrophic forms of lichen planus, decalcifying folliculitis, etc. Moreover, a number of dermatoses at their debut on the scalp differ clinically little, it is sometimes quite difficult to determine which specific dermatosis led to focal atrophic alopecia.
All these listed reasons lead to the formation of two types of scarring on the head: cicatricial alopecia with a dense, rough scar and atrophic cicatricial alopecia with a shiny, smooth, pitted scalp without holes for hair follicles.
Thus, talking about alopecia and its treatment in general is like talking about the treatment of headache, the same for patients with migraine, high blood pressure and trauma to the skull.
Another necessary link in the treatment is the fight against depression, which develops as a result of hair loss, and as an undesirable side effect when taking certain drugs.
Despite the fact that baldness is equally common in both sexes, the majority of patients complaining of increased hair loss are women. This is due to the traditionally less male attention to their appearance, as well as the fact that a short haircut makes hair loss less noticeable. For women, this is socially unacceptable, and just the imaginary prospect of baldness often causes depression in women.
In the arsenal of modern trichology there are many means and methods for the treatment of baldness. These are topical products that stimulate hair growth, a large number of general treatment products, various physiotherapeutic methods of treatment, surgical correction with the help of transplantation.
The variety of various causes of various forms of baldness allows us to conclude that it is not always possible to eliminate the cause of the disease that contributes to hair loss.
Until now, a universal safe remedy has not been found that would permanently get rid of the existing problem, and the choice of treatment sometimes requires a careful comparison of the real benefits and possible harms of therapy, since baldness is only a cosmetic defect.

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