July 2019
Hair loss is a common problem that can be caused by aging, hormonal changes, high-stress levels, or immune system reactions. Not all hair loss is permanent, and treatments may range from cosmetic solutions to transplantation to medications. Dermatologist Mary Margaret Noland, MD, discusses the types of hair loss, their symptoms and treatments.
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There are two main types of alopecia: scarring alopecia and non-scarring alopecia. Most of these, if they’re non-scarring, are either hormonally triggered, stress-induced, or medication-induced. Scarring alopecia often is inflammatory, or your immune system is triggering the alopecia.
Most patients experience increased shedding of hairs. Some people will notice a widened part. Patients that have acute hair loss can have redness, itching, or pain in the scalp, and sometimes tenderness.
Hair regrowth depends on the type of alopecia you have. Non-scarring alopecia does grow back. It does take time, hair grows very slowly. It's like watching grass grow in your yard. If you look out your window every day, you don't see anything. But if you look in a month, you'll see thick, lush grass. The same thing applies to hair growth. It's very slow, and you're not going to see it on a day to day basis.
In non-scarring alopecia, you can get full regrowth back to your normal baseline.
With scarring alopecia, scar replaces those hairs. Starting treatment early to prevent further loss is the best option because once those scars overtake a hair follicle, the hair cannot grow back.
Treatment options can span from watchful waiting for your immune system or your level of stress to improve to systemic oral treatments that suppress your immune system. It depends on classifying the type of hair loss that you have. You may start with things like Rogaine or anti-inflammatory shampoos or topical steroids and work your way up to more aggressive oral treatments if need be.
