Thinning and Alopecia

Hair loss

The hair loss, up to a hundred a day for thicker hair , it should be considered a physiological process of hair replacement , and in this case there are no grounds for a balding. Growth, fall and hair regrowth represent the various phases of a cycle which is repeated approximately 20 times during the life of a human being. In some people, usually in women, the duration of each cycle may also last 6 years. As long as the hair loss is within the range of this growth cycle is not worrisome but quite natural; but when the new hair will give rise to a regrowth cycle getting shorter, and the ratio of hair in the growth phase and in involution phase, next to fall, will lean in favor of the latter, it means that is an abnormal loss of hair. So you have to check whether it is a temporary phenomenon, related to contingent factors (emotional, dietary, environmental), or if the hair loss has most important and long-lasting causes.
Hair analysis, except in cases of exclusive medical expertise (eg. Hormonal dysfunction), allows us to understand whether certain abnormalities of the skin, such as dandruff or seborrhea, are compromising the health of the hair encouraging the fall. In most cases, localized hair treatments, act on the causes of the hair loss, leading it within physiological limits.

Thinning and Alopecia

The thinning of hair is a physiological condition related to aging in both men and women. The receding hairline is the dominant form of hair loss in man, which is manifested by the gradual fronto-temporal regression and thinning up to the summit. However in women, the frontal hairline is preserved and hair loss affects evenly across the all surface of the scalp.
The thinning of the hair is the physiological hair loss, also called Androgenic Alopecia, caused by the end of the hair growth cycle within a number of hair follicles. Some scientific studies have shown that man’s receding hairline and thinning hair in women are correlated with the increase of the enzyme 5-alpha-reductase activity, which converts testosterone into dihydrotestosterone (DHT), which causes the miniaturization of hair within the follicles. Due to the activity of this hormone androgen, hair become thinner and their life cycle is shortened. As a result, men tend to be balding and women have thinning hair. The thinning of hair and receding hairline progression occurs differently in people. This situation is worrying when it occurs in advance or when it progresses with an abnormal rapidity.
There are the scales of measurement of baldness useful to classify and assess the extent of hair loss. The Ludwig Scale, divided into 3 levels, is used to measure the balding and thinning hair in women; the Hamilton-Norwood Scale, divided into 5 levels, is used to measure the balding and thinning hair in men.

Androgenetic Alopecia

Androgenetic alopecia may be a temporary or an early and definitive hair loss. It is considered a real pathology of a normal aging process that affects approximately 50% of men and perhaps as many women over 40 years of age, although in recent years the female alopecia, in particular, has increased at an alarming rate even among young girls under 30 years of age.
Androgenetic alopecia is the most common form of baldness (hereditary hair loss) and is manifested by a progressive thinning of the hair with a tendency to become bald.
It is clinically different between men and women, but probably the basic cellular mechanisms are the same. In addition to a demonstrated genetic predisposition, different eating disorders (anemia, anorexia), too restrictive diets and nutritional deficiencies (protein, vitamins or minerals), hormonal imbalances (abnormal levels of testosterone; thyroid, pituitary or adrenal glands dysfunctions), physical and psychological stress (stress alopecia, trauma, shock or depression), environmental pollution, excessive exposure to the sun, the postpartum period, various diseases, the use of drugs (eg antidepressants ), chemotherapy, are all factors that may interfere with the physiological hair cycle. Then the hair weaken and, in more severe cases, they fall because the anagen phase (the growth phase) progressively decreases in favor of the catagen phase (the involution phase) and of telogen phase (the resting phase).
In the most common form, however, androgenetic alopecia is due to the action of androgenetic hormones. In man it is generally not related to excess androgens but rather to the excessive sensitivity of the follicles to the action of this hormone. In women over this excessive sensitivity, contribute additional causes such as hyperandrogenism, menstrual disorders, ovarian diseases, obesity etc.

Kinds of Alopecia

One of the basic criteria for distinguishing different types of alopecia is the temporary or not of hair loss. According to this criterion the alopecia is divided into:


The effective remedies against hair loss and alopecia can only be set if the hair follicles are not already atrophied, that in case of temporary alopecia and scarring alopecia. In these cases, various remedies and local hair treatments are used because allow to:

  • Slow down the excessive hair fall bringing it back to a normal level
  • Promote, where the hair follicles are still active, hair regrowth trough nutritional and stimulating treatments and using good hygiene practices

In the case of scarring alopecia, with atrophied follicles that can no longer be “awakened ” there are no remedies that stimulate the re-growth , but it can only act with self- surgical hair transplantation.
In all other cases, to treat alopecia may intervene basically with:

  • Hair treatments – They are based on the use of hygienic products, ampoules and lotions against hair fall, aimed to contain and remove the specific causes of alopecia that help to accelerate the “death” of the hair follicles
  • Specific Laser Therapy – It is especially effective when used in conjunction with hair treatments, because it allows to stimulate follicular activity
  • High-frequency rays Treatments – They are based on the use of ultraviolet high frequency able to penetrate inside the follicles, sanitize the scalp, cleaning it from impurities, and by stimulating the activity of the hair follicles, with a revitalizing effect on the skin

RSS International Journal of Trichology

  • A painless, slow-growing ulcer on the scalp October 16, 2019
    Fernando Garcia-Souto, Isabel Maria Coronel-Perez, Francisco Sosa-Moreno, Yessica Sanchez-Santos, Jerónimo Escudero-OrdoñezInternational Journal of Trichology 2019 11(5):223-225
    Fernando Garcia-Souto
  • Central centrifugal cicatricial alopecia following a patchy pattern: A new form of clinical presentation and a challenging diagnosis for the dermatologist October 16, 2019
    Alba Gomez-Zubiaur, David Saceda-Corralo, María Dolores Velez-Velázquez, Ana Rodriguez-Villa Lario, Lidia Trasobares-MaruganInternational Journal of Trichology 2019 11(5):216-218 Central centrifugal cicatricial alopecia (CCCA) is included among the primary lymphocytic cicatricial alopecias. The current nomenclature of CCCA suggested by the North American Hair Research Society refers to the traditional clinical presentation pattern of this type of alopecia, […]
    Alba Gomez-Zubiaur
  • Alopecia areata treated with oral azathioprine: A case series October 16, 2019
    Vikrant Saoji, Sandeep Kulkarni, Bhushan MadkeInternational Journal of Trichology 2019 11(5):219-222 Alopecia areata is commonly encountered non scarring alopecia with clinical presentations ranging from localised bald patches to extensive involvement. Clinical course is variable ranging from self limiting disease to chronic relapsing and recalcitrant disease. Topical and oral corticosteroids; nonetheless being front line agents for […]
    Vikrant Saoji
  • Apremilast in refractory alopecia areata October 16, 2019
    Andrea Estébanez, Nuria Estébanez, Jose M Martín, Encarna MontesinosInternational Journal of Trichology 2019 11(5):213-215 Alopecia areata (AA) is a common disease characterized by nonscarring hair loss. There are no satisfactory therapies for extensive cases. Systemic immune suppressants are usually used despite their nonspecific actions and often associated side effects. Apremilast is an oral, small-molecule, inhibitor […]
    Andrea Estébanez
  • Hair and scalp disorders in children below 2 years: An unremarked sphere October 16, 2019
    Balvinder Kaur Brar, Sukhmani Kaur Brar, Rajvir Kaur, Naveen SethiInternational Journal of Trichology 2019 11(5):207-212 Context: Hairs contribute significantly to our appearance and are mirror to many systemic diseases. Hair and scalp disorders in children are associated with profound psychological effects arising from concerns of chronicity, severity, and contagiousness, in addition to cosmetic outline. Studies […]
    Balvinder Kaur Brar
  • Evaluation of the efficacy and safety of 308-nm monochromatic excimer lamp in the treatment of resistant alopecia areata October 16, 2019
    Nabeel K Al HamzawiInternational Journal of Trichology 2019 11(5):199-206 Context: Treatment of resistant alopecia areata (AA) can be very challenging and include many options with variable efficacy and safety profiles. The 308-nm excimer lamp has been claimed to offer an effective alternative without significant risks, though there exists a lack of guidelines in this setting. […]
    Nabeel K Al Hamzawi
  • Trichoscopic findings in normal hair and scalp in children under 17 years October 16, 2019
    Jeta Y Buch, Sebastian CritonInternational Journal of Trichology 2019 11(5):189-198 Objective: The aim of the study is to establish normal values of measurable parameters, set the standard, and provide a framework for future reference. Materials and Methods: A total of 750 children of Malayalam speaking ethnicity with no hair or scalp diseases in anamnesis and […]
    Jeta Y Buch
  • What's new in the pathophysiology of alopecia areata? the possible contribution of skin and gut microbiome in the pathogenesis of alopecia – Big opportunities, big challenges, and novel perspectives October 16, 2019
    Kamila Migacz-Gruszka, Wojciech Branicki, Aleksander Obtulowicz, Magdalena Pirowska, Krystian Gruszka, Anna Wojas-PelcInternational Journal of Trichology 2019 11(5):185-188 The term “microbiome” defines the collective genome of all commensal, symbiotic, and pathogenic microbes living in the human body. The composition of microbiota in the gut and skin is influenced by many factors such as the stage of […]
    Kamila Migacz-Gruszka