Hair Loss



There are many types of hair loss. It is very important to have a correct diagnosis as treatments can be very different. Most importantly, we want to differentiate hair loss that are due to a scarring or a non-scarring process.

When it is a non-scarring process, then the chance of hairs returning is higher. However, in the case of patchy Alopecia Areata (autoimmue type) and androgenetic alopecia (hormone related), the earlier the treatment, the better the outcome.

A scarring process produces inflammation and fibrosis, which will result in the loss of hair follicles. Once there is loss of hair follicles, there are no treatments that can bring back hair. The aim of treatment is to prevent further inflammation and hair loss. Therefore, it is important that you seek treatment early.

Symptoms and signs of inflammation which may suggest scarring type of hair loss.

Redness around the hair follicles

Darker pigmentation around hair follicles

Itchy and burning

Lonely hairs

Loss of outer eyebrow hairs and axilla hairs

Common causes of hair loss

Alopecia Areata

Alopecia Areata of back of scalp

Alopecia Areata is a common autoimmune condition that causes sudden onset of patchy hair loss in the hair bearing areas of the face and the scalp in children and young adults. However, occasionally more diffuse hair loss is seen and can become generalized to all over the body. The treatments for localized lesions are usually potent topical or injectible steroids. There is a new treatment under research development that maybe helpful for more severe form of this condition.

There is often a personal history of eczema, asthma and seasonal allergy. Family history of alopecia areata or other autoimmune conditions such as thyroid, and early onset diabetes can also present.

Click here for a video on steroid injections for alopecia areata.

Androgenetic Alopecia (loss of hair follicles over time)

Androgenetic alopecia can occur in males or females. In males, the areas of involvement are often temples, vertex of scalp and later frontal part of the scalp. In females, it is often frontal and vertex of scalp. Genetic factors plays a large role in this condition. Hormonal imbalance maybe the cause of androgenetic alopecia is females. Treatments in males are generally Rogaine solution or foam (minoxidil) daily or propecia (finasteride) 1mg tablet daily. For female patients, Rogaine or hormonal treatments maybe indicated. In addition, androgenetic alopecia can be improved with PRP (platelet activated plasma) injections. Click here for more information on PRP. Once the hair loss is established, it is very difficult to bring back hairs. Therefore, early treatment is indicated. When hair loss becomes stable, hair transplantation can be considered. We can refer you to a hair transplant surgeon if necessary,

Telogen Effluvium

Telogen effluvium is a common type of hair loss that produces hair shredding. It can be due to many different reasons including pregnancy, physical stress and medication, season change, dieting, weight loss, reduce body iron stores or low thyroid hormone. When the underlying condition has resolved, the hairs will take a few months to return. Occasional longstanding telogen effluvium can be an early presentation of androgenetic alopecia. Rogaine can be used for a period of 6 months to reduce hair shredding.

Tinea Capitis

Please see Fungal Infection


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