Stress, genetics and iron deficiency among the causes. New therapies aimed at the most severe cases can counteract severe alopecia, but attention should be paid to side effects
That of hair loss it is a problem that afflicts many people, mostly men, but there is no shortage of cases among women. Sometimes it is a transitory phenomenon, other times it is not. Hair loss, in medical terms
alopecia
it can also be an indicator of other conditions which, with a targeted intervention, can be resolved to the benefit of the foliage as well.
What are the most common types of alopecia?
«Androgenetic alopecia is the most common form. It mainly affects males although not exclusively. L’man typically features a recession of the hairline at the temples and a hair loss at the top, while the donna tends to have a diffuse thinning over the entire upper part of the scalp – explains the professor Antonio Costanzo, Head of the Dermatology Operative Unit of the Humanitas Clinical Institute of Rozzano (Milan) -. Androgenetic alopecia, as the name suggests, has a genetic basis that determines a hypersensitivity of the hair follicle to androgens. In practice, in these people, especially in the central area of the scalp, at the level of the hair follicles, there is a high amount of androgen receptors, which are able to stop the cell cycle of the hair and induce its miniaturization. Cycle after cycle, the hair thins to become like a baby’s fluff. It usually occurs in women after menopause. Another common form of alopecia is represented by the telogen effluvium. It is a very fast fall, which manifests itself above all in women. Although hair loss can sometimes be progressive in most cases it resolves within three months of starting with total regrowth. Among the various forms of alopecia, this is probably the one most linked to stressful episodesbut hormonal imbalances may also be involved, such as those that can occur during pregnancy o to menopauseor thyroid dysfunction. It can also be associated with vitamin or iron deficiencies, both of which can worsen hair loss. The cause is not well known, the mechanism is that of the sudden inhibition of the division of the cells of the hair follicle: from that moment on, following the hair cycle, there is a profuse fall that never leaves the scalp completely uncovered. This feature helps to differentiate it from the diagnostic point of view from other forms of alopecia ».
What is alopecia areata?
“It’s a autoimmune disease with a genetic component. The presence of genetic alterations leads to one overproduction of inflammatory cytokines by immune system cells that release them around the hair follicle, blocking its function. Start with small areas where the hair falls out, areas that then begin to spread out. Often the fall can also affect the eyebrows and body hair. Today we know that during the illness proteins (enzymes) are activated that signal inflammation within the cell, called Janus kinase (Jak)».
What are the possible anti-hair loss remedies?
“The interventions are different depending on the cause. The main therapies that can be proposed to combat androgenetic alopecia are represented by minoxidil e finasteride. Minoxidil is a drug that increases the blood supply to the hair follicle, but its action is not yet well known. It is generally applied topically, however a tablet formulation has recently been approved in the US. It has like side effect of lowering blood pressurehowever, which may be beneficial in some patients. It can be used by both men and women and also in the telogen effluvium.
The finasteride, born as a drug for prostate cancer and benign prostatic hypertrophy, blocks the transformation of testosterone into dihydroxytestosterone, which is the active form. The consequence is ainhibition of the function of testosterone receptors. It must be taken by mouth and can also be used in women, but not during the childbearing age because in case of pregnancy it can cause the feminization of the fetus if male.
The European Medicines Agency recently approved some new medicines for alopecia areata, which precisely target the target. It is about the Jak inhibitors, already used today for other autoimmune diseases such as rheumatoid arthritis and atopic dermatitis. These drugs have been approved for patients over the age of 18 with severe disease who have not benefited from corticosteroid treatment. In Italy they have not yet been approved, however some centers have the possibility of using them for compassionate use
For the telogen effluvium we must try to understand the cause. If they identify cvitamin or iron arenzeit is necessary to replenish these nutrients, while if there is ato thyroid dysfunction a targeted therapy is needed. In some cases, essential amino acid supplements, in particular cystine, or minoxidil may be useful. In the case of alopecia areata, sometimes the hair grows back spontaneously. If this does not happen, it is possible to intervene with cortisone to be applied or injected on the affected areas. Sometimes therapies with stinging substances are used that aim to “free” the hair follicle from the aggression of the immune system ».
What are the most feared side effects?
Many men are reluctant to take finasteride for fear of ecollateral effects on sexuality, such as reduced desire and difficulty getting an erection. ‘The frequency of these side effects is not common. The dosage used for androgenetic alopecia is in fact 1 mg per day, able to block on average 10 percent of androgen receptors. Precisely for this reason in most cases its intake does not alter sexual function. However, should these disturbances occur in more sensitive patients, it is possible to interrupt the therapy, thus eliminating these drawbacks. Available data on this drug indicates that it can help stop hair loss
October 25, 2022 (change October 25, 2022 | 12:58)
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