Alopecia is the medical term for hair loss. The most common form of alopecia is androgenetic alopecia, or pattern baldness. This hereditary hair loss affects both men and women and is progressive. Alopecia areata is also fairly common. It is an autoimmune disorder that causes patchy hair loss on the scalp, face and sometimes other areas of the body. Traction alopecia is caused by hair styles that pull excessively on the hair shafts and damage hair follicles.
A more rare form of hair loss is called cicatricial alopecia, or scarring alopecia. This actually refers to many different types of hair loss, but all of them see the hair follicles destroyed and replaced with scar tissue. Symptoms vary.
Sometimes this hair loss progresses rapidly accompanied by painful sensations, burning and severe itching, but other times there are no noticeable symptoms and the hair loss is gradual. The skin at the site of the hair loss might show symptoms that are easily recognized as illness, or it might not. It is possible to experience redness, scaling, increased or decreased pigmentation, or raised blisters with fluids or pus, however these kinds of symptoms are not always present.
The American Hair Loss Association does say that cicatricial alopecia, which is a patchy hair loss like alopecia areata, has more “ragged” patches rather than the circular patches of alopecia areata. In order to confirm that a person has scarring alopecia, and what type of scarring alopecia, if it is suspected, one or more biopsy is performed. The destroyed hair follicles are deep under the skin and this has to be determined by a pathologist or dermatologist by biopsy.
Treatment depends on the type of cicatricial alopecia and the stage of the disease. Scarring alopecia almost always reaches what is called a burnt-out stage where a biopsy reveals no more hair follicles, just a few longitudinal scars deep in the skin where the hair follicles once were.
“Scarring alopecia can involve a lot of damage and permanent hair loss. For this reason treatment of scarring alopecia should be quite aggressive,” says the American Hair Loss Association.
Another type of alopecia is called anagen effluvium. This patchy hair loss caused by chemicals such as chemotherapy is generally expected to be temporary, with hair growing back about six months after treatment, but that is not always the case. Breast cancer patients and others taking the drug Taxotere have found that, like those with scarring alopecia, their hair follicles have been damaged and they are facing permanent alopecia, a lifetime of baldness.
“Treatments exist for types of alopecia that are hereditary and those related to autoimmune diseases, and new treatments are being developed all the time. Unfortunately, for people affected by Taxotere, these treatments are unlikely to work because the hair follicle is damaged or altered, with the stem cells necessary for hair growth terminated or replaced by non-functional cells,” said Beau Darley III of Beasley Allen, a law firm in Montgomery, Alabama, representing some of the thousands of people who have chosen to sue Taxotere manufacturer Sanofi SA for not warning them of the risk.
The American Hair Loss Association