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

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  • Graham-little-piccardi-lassueur syndrome: Report of a chinese case with hair casts May 5, 2020
    Xiangqian Li, Xi Chen, Jianzhong Zhang, Cheng ZhouInternational Journal of Trichology 2020 12(2):97-98
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  • Woolly hair nevus with trichotillomania in a 9-year-old boy: A rare case association May 5, 2020
    Shivani Saini, Ramesh Kumar, Devendra YadavInternational Journal of Trichology 2020 12(2):86-88 Woolly hair nevus is a rare entity characterized by structural anomaly, which presents as curly hair in a circumscribed area of scalp, in a nonNegroid individual. These are abnormal hairs which are short, thin, and sparse. The term “woolly hair” refers to tightly coiled […]
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  • Congenital triangular alopecia - A case report May 5, 2020
    Dhruv Ramanbhai Patel, Jinal Jainendrabhai Tandel, Pragya Ashok NairInternational Journal of Trichology 2020 12(2):89-92 Congenital triangular alopecia also known as temporal triangular alopecia or Brauer nevus may be present at birth or acquired during the first decade of life. It can present as triangular, oval, or lancet-shaped patch of alopecia. It may be misdiagnosed as […]
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  • Anterior ectopic cilia with myopia and lichen nitidus: A rare case report with dermoscopic findings May 5, 2020
    Alpana Mohta, Aditi Agrawal, Pritee Sharma, Ramesh Kumar Kushwaha, Rajeev Saxena, Rekha Mohta, Suresh Kumar JainInternational Journal of Trichology 2020 12(2):79-81 Ectopic cilia, or lash follicles situated over abnormal sites, are an extremely rare entity. Here, we report the case of a 6-year-old-boy who presented with ectopic cilia over the left upper eyelid along with […]
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  • Trichilemmal carcinoma of scalp masquerading as squamous cell carcinoma: A report of a rare case with histogenesis and literature review May 5, 2020
    Kavitha Kannan, Kiran C Mahesh, Niraimathi Manickam, Anita RamdasInternational Journal of Trichology 2020 12(2):82-85 Trichilemmal carcinoma is a rare malignant adnexal neoplasm of follicular type usually seen over the sun-exposed areas of elderly people. We present a report of a 60-year-old male with ulceroproliferative lesion over the occipital region of the scalp for 2 months, […]
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  • A study of association of premature graying of hair and osteopenia in North Indian population May 5, 2020
    Soumya Agarwal, Anshul Choudhary, Arushi Kumar, Aliza Zaidi, Swosti Mohanty, Shivani YadavInternational Journal of Trichology 2020 12(2):75-78 Context: Hair graying is one of the signs of human aging and is caused by a progressive loss of pigmentation from growing hair shafts. Studies have shown a correlation of early hair graying with osteopenia, indicating that premature […]
    Soumya Agarwal
  • Trichoscopy as a diagnostic tool for tinea capitis: A prospective, observational study May 5, 2020
    Pradeep Kumar, Deepika Pandhi, Sambit Nath Bhattacharya, Shukla DasInternational Journal of Trichology 2020 12(2):68-74 Background: Tinea capitis is the most common pediatric dermatophyte infection. Trichoscopy aids in the rapid diagnosis and allows prompt treatment, preventing horizontal transmission. Objectives: The objective of this study is to document the trichoscopic features of tinea capitis and evaluate its […]
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