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

  • Pili trianguli et canaliculi: A case report with 10-year follow-up October 7, 2022
    Suparuj Lueangarun, Therdpong Tempark, Ratchathorn PanchaprateepInternational Journal of Trichology 2022 14(5):188-189
    Suparuj Lueangarun
  • Alopecia areata complicated by plica neuropathica: A rare case report October 7, 2022
    Shail Agarwal, Atul Vijay, Manoj Kumar Sharma, Akshay Kumar JainInternational Journal of Trichology 2022 14(5):183-185 Plica neuropathica is a rare scalp condition, which is manifested as a compact mass of scalp hair. Previously, it has been found to be associated with a variety of dermatological disorders. We report a case of 15-year-old female presenting with […]
    Shail Agarwal
  • Family history of autoimmunity and endocrine disorders in patients with alopecia areata. A Greek study October 7, 2022
    Eleni KlimiInternational Journal of Trichology 2022 14(5):186-187
    Eleni Klimi
  • Erosive pustular dermatosis of the scalp: Report of three cases October 7, 2022
    Sowmya S Aithal, Kanathur Shilpa, TN RevathiInternational Journal of Trichology 2022 14(5):178-180 Erosive pustular dermatosis of the scalp is a chronic cutaneous condition presenting with areas of erosions and pustules, healing with scarring and alopecia. We report three such cases presenting with pus-filled lesions of the scalp with nonspecific pathological changes. This condition is often […]
    Sowmya S Aithal
  • Resistant alopecia areata treated with tofacitinib October 7, 2022
    Govind SahayInternational Journal of Trichology 2022 14(5):181-182 Several reports more so from western countries present recovery for alopecia areata (AA) with tofacitinib. In this report, we present the case of a young adult male diagnosed with resistant AA with failed treatment to oral as well topical steroids, minoxidil, and oral troxasalen. He was treated with […]
    Govind Sahay
  • Vitamin D levels in alopecia areata and other alopecias: A retrospective case–control study at a single institution October 7, 2022
    Patrick Thanh Tran, Alessandra Chen, Lynn Yi, Carolyn GohInternational Journal of Trichology 2022 14(5):175-177 Recent research has associated alopecia areata (AA), an autoimmune disorder, with deficiency of Vitamin D, which regulates immune processes. This retrospective study compared Vitamin D levels in AA patients to those of other alopecia diagnoses and nonalopecia controls. When compared to […]
    Patrick Thanh Tran
  • Scanning electron microscopy of the inner and outer aspects of tiger tail hairs October 7, 2022
    Hiram Larangeira de Almeida, Joice Brião Göebel Pinto, Antônia Larangeira de Almeida, Luis Antonio Suita de Castro, Caroline Pires RuasInternational Journal of Trichology 2022 14(5):172-174 Background: Tiger tail hairs, Morse hairs or pili annulati is a nonsyndromic hair shaft disorder, characterized by alternating light and dark bands along the hair shaft. Methods: The outer surface […]
    Hiram Larangeira de Almeida
  • A clinico-trichoscopic analysis of hair density and diameter variability in relation to severity grading of female pattern hair loss October 7, 2022
    Vishu Michelle, Kanathur Shilpa, Budamakuntala LeelavathyInternational Journal of Trichology 2022 14(5):162-171 Context: Hair loss is a common complaint among Indian women. For female pattern hair loss (FPHL), diagnosis is primarily clinical. In the early stages, it can be confused with other conditions. Histopathology is the diagnostic method of choice but requires multiple biopsies and can […]
    Vishu Michelle