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Local Hair Loss

LOCAL HAIR LOSS 
Alopecia areata, which is characterized with coin sized hairless lesions whose cause is not known, is the most commonly seen form of this condition. It is thought that it is caused of the dysfunction in the follicular cycle. It is probably caused by the anagen phase, which normally continues for 2 to 6 years, to be short and the hair to get into catagen phase instantly. It may seen in beard, eyebrows, eyelashes, and it may even effect nails even it is very rare. 
It is named as alopecia totalis if the entire scalp is affected as a result of an accompanying disease or as alopecia universalis if all the body hair (eyebrows, eyelashes, beard, chest and back hair) is lost. 
The patients know that it is mainly related with stress. 
It is thought that some endocrine diseases and eye diseases aggravate this condition.
It may occur as a result of some bacterial, viral or fungal infections;
Some skin cancer types; 
Exposure to radiation;
Burns; 
Chemical drugs; 
Systemic lupus;
Lichen planus; 
Sarcoidosis. 
Alopecia may develop as a result of pulling hair or exposure of the scalp to a direct trauma.
 Long term exposure to pressure (especially in those confined to bed and children) may result in alopecia. 
Using curling iron and blow dryer may also cause alopecia.  
 
DIAGNOSIS: 
It is easy to diagnose, but it may require biopsy in some cases. 
It may be confused with some fungi holding the scalp. 
It is mostly confused with traction alopecia caused by pulling hair. 
And it is beneficial to know the fact that it may be confused with AIDS even though it is rare. 
 
TREATMENT: 
The most frequently used method for its treatment is local corticosteroid injection. The results that will be obtained from the treatment are inversely proportional to younger age. While the disease can be more easily and quickly treated when it is seen in older ages, its treatment is harder when it is seen in children. The treatment chance is lower when eyebrows and eyelashes are affected besides the scalp. The probability of the treatment of alopecia universalis that affect all the body hair to be successful is much lower than all the other types. Besides the option of injecting steroids directly into the lesion, injecting them inside the muscle is also another option. 
It is necessary to attract attention to the success of minoxidil types that are used as topical in recent years. 
The most successful surgical method is hair transplant in suitable patients. But the patient should be selected carefully.
Again in some patients (especially for those alopecia patients that the condition repeats itself on the same region every year), tattoo may be recommended. 
The likelihood of the disease to repeat itself even years after the treatment that was effective is much higher than normal individuals to face the problem of alopecia. That’s why it is necessary to keep an eye on those patients and decrease the risk by regular check-ups. 

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