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alopecia

Is My Hair Loss a Symptom of a Serious Disease?

Alopecia universalis is not a life-threatening disease. It does not cause any physical pain, and people with the condition are generally healthy otherwise. But for most people, a disease that unpredictably affects their appearance the way alopecia universalis does is a serious matter.

The effects of alopecia universalis are primarily socially and emotionally disturbing. In alopecia universalis, however, loss of eyelashes and eyebrows and hair in the nose and ears can make the person more vulnerable to dust, germs, and foreign particles entering the eyes, nose, and ears.

Alopecia universalis often occurs in people whose family members have other autoimmune diseases, such as diabetes, rheumatoid arthritis, thyroid disease, systemic lupus erythematosus, pernicious anemia, or Addison’s disease. People who have alopecia areata do not usually have other autoimmune diseases, but they do have a higher occurrence of thyroid disease, atopic eczema, nasal allergies, and asthma.

Polycystic Ovary Syndrome

How common is PCOS?

It is currently believed that approximately 5 to 10% of women have Polycystic Ovary Syndrome (PCOS). It is the most common hormonal disorder in women of reproductive years and the leading cause in women for infertility. Since many women can have PCOS without exhibiting any symptoms, the actual number of women affected could be as much as 10% more of the population.

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What are the symptoms of PCOS?

Photo of a polycystic ovary courtesy of http://www.ovarian-cysts-pcos.com

Photo of a polycystic ovary courtesy of http://www.ovarian-cysts-pcos.com

Some of the most common symptoms include:

  • Amenorrhea (no menstrual period), infrequent menses, and/or oligomenorrhea (irregular bleeding) Menstrual cycles can often be scant, irregular and infrequent or may also exhibit in the form of spotting throughout the month.
  • Oligo or anovulation (infrequent or absent ovulation) Women with PCOS generally produce an egg but they don’t fully mature. Instead, these immature egg sacs can create ovarian cysts.
  • Hyperandrogenism Women who have PCOS generally also have an increase in serum levels of male hormones such as testosterone, androstenedione, and dehydroepiandrosterone sulfate (DHEAS).
  • Infertility
  • Cystic ovaries Classic PCOS ovaries have a “string of pearls” or “pearl necklace” appearance with many cysts.
  • Enlarged ovaries Polycystic ovaries are usually 1.5 to 3 times larger than normal.
  • Chronic pelvic pain
  • Obesity or weight gain Most commonly referred to as an “apple figure”. PCOS women will generally gain weight primarily in the abdomen and waistline.
  • Insulin resistance, hyperinsulinemia, and diabetes Insulin resistance is a condition where the body’s use of insulin is inefficient.
  • Hirsutism (excess hair) Excess hair growth such as on the face, chest, abdomen, thumbs, or toes.
  • Alopecia (female-pattern baldness or thinning hair) The thinning most commonly occurs on the top of the head.
  • Acne/Oily Skin/Seborrhea
  • Acrochordons (skin tags)

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What causes PCOS?

The exact cause of PCOS is unknown. However, there are studies that may lead us to believe that there may be a genetic link. Just as one may have a genetic predisposition to diabetes, one might also have a disposition to PCOS.

Photo trichogram findings in women with AGA

Phototrichogram findings in women with androgenetic alopecia.
Department of Dermatology, Sisli Etfal Research and Training Hospital, Istanbul, Turkey.

Background/purpose: Androgenetic alopecia (AGA) in women is characterized by diffuse thinning in the frontal and parietal areas of the scalp; preservation of the frontal hairline is norm. Hair over the occipital scalp is preserved. The purpose of this work was to investigate the findings of phototrichogram (PTG) of the affected and the spared areas in women with AGA and to compare them with those of healthy subjects.

Methods: Twenty-two controls and 60 untreated women with AGA (32 with Ludwig I, 28 with Ludwig II) were included in this study. Hair density, percentages of thin hair, and non-growing hair were estimated both on the midscalp and on the occiput by using PTG with digital camera attached to a dermoscope.

Results: In the control group, hair density was higher on the midscalp than the occiput. In AGA groups, hair density was lower on the midscalp than the occiput and percentages of thin hair and non-growing hair were higher on the midscalp than the occiput. These findings were more prominent in Ludwig II group. In the occiput there were findings mimicking the changes seen on the midscalp. These were less striking than those seen on the midscalp yet the difference between the control and Ludwig II group was statistically significant.

Conclusion: We concluded that the hair is not equally distributed on the scalp, the occiput may be affected in females with AGA and further studies are necessary to support these findings.

PMID: 17026665 [PubMed – in process]

Ludwig Scale of Hair Loss for Women

courtesy of www.dermalogix.net

courtesy of www.dermalogix.net

Photo image of middle aged woman with AGA

Photo image of middle aged woman with female pattern baldness.  Courtesy of www.trichologists.org.uk

Photo image of middle aged woman with female pattern baldness. Courtesy of www.trichologists.org.uk

HHLH Forum Member has head tattoed on Miami Ink

One of our beautiful forum members, JoyceStock recently had her head tattooed on Miami Ink. It’s a lovely butterfly! Thank you, Joyce, for being such an inspiration!

melanie

Can I Pass Alopecia on to My Children?

It is possible, but not likely, for alopecia universalis to be inherited. Most children with alopecia universalis do not have a parent with the disease, and the vast majority of parents with alopecia universalis do not pass it along to their children.

Alopecia universalis is not like some genetic diseases in which a child has a 50-50 chance of developing the disease if one parent has it. Scientists believe that there may be a number of genes that predispose certain people to the disease. It is highly unlikely that a child would inherit all of the genes needed to predispose him or her to the disease.

Even with the right (or wrong) combination of genes, alopecia universalis is not a certainty. In identical twins, who share all of the same genes, the concordance rate is only 55 percent. In other words, if one twin has the disease, there is only a 55 percent chance that the other twin will have it as well. This shows that other factors besides genetics are required to trigger the disease.

Who Is Most Likely To Get Alopecia Areata?

Alopecia areata affects an estimated four million Americans of both sexes and of all ages and ethnic backgrounds. It often begins in childhood.

If you have a close family member with the disease, your risk of developing it is slightly increased. If your family member lost his or her first patch of hair before age 30, the risk to other family members is greater. Overall, one in five people with the disease have a family member who has it as well.

What Causes Alopecia Universalis?

In alopecia universalis, immune system cells called white blood cells attack the rapidly growing cells in the hair follicles that make the hair. The affected hair follicles become small and drastically slow down hair production. Fortunately, the stem cells that continually supply the follicle with new cells do not seem to be targeted. So the follicle always has the potential to regrow hair.

Scientists do not know exactly why the hair follicles undergo these changes, but they suspect that a combination of genes may predispose some people to the disease. In those who are genetically predisposed, some type of trigger–perhaps a virus or something in the person’s environment–brings on the attack against the hair follicles.

There are, however, studies that have been done that show a genetic link for those people who are diagnosed as having Alopecia Universalis. According to MedicineNet.com, the “disorder is inherited as an autosomal recessive trait. It is caused by a mutation in a gene dubbed HR in chromosome band 8p21.2 that is the human homolog of the mouse “hairless” gene — the human version of the gene in the mouse that is responsible for hairless mice.” Huh?? Basically they are saying that a good majority of those who develop alopecia universalis have a hereditary gene that could be the possible cause of their hair loss. This is great news since pinpointing a gene may provide scientists a more targeted approach to treating hair growth disorders such as alopecia.

More information concerning studies such as this can be found at:

What Is Alopecia?

Alopecia is considered to be an autoimmune disease, in which the immune system, which is designed to protect the body from foreign invaders such as viruses and bacteria, mistakenly attacks the hair follicles, the tiny cup-shaped structures from which hairs grow. This can lead to hair loss on the scalp and elsewhere.

In most cases, hair falls out in small, round patches about the size of a quarter. In many cases, the disease does not extend beyond a few bare patches. In some people, hair loss is more extensive. Although uncommon, the disease can progress to cause total loss of hair on the head (referred to as alopecia areata totalis) or complete loss of hair on the head, face, and body (alopecia areata universalis).

Alopecia can occur at any age and is not life threatening, however the psychological impact on the person experiencing alopecia can be incredible. Such an impact can affect the person’s social life and may lead to a higher risk of major depression and/or anxiety disorders.

Images of Further Stages of Alopecia

Further stages of alopecia areata

Further stages of alopecia areata

Alopecia with diffuse thinning courtesy of www.meddean.luc.edu

Alopecia with diffuse thinning courtesy of www.meddean.luc.edu

Alopecia Universalis courtesy of www.dermatology.org

Alopecia Universalis courtesy of www.dermatology.org

How can I cope with the effects of AGA?


Living with hair loss can be hard, especially in a culture that views hair as a sign of youth and good health. Even so, most people with alopecia areata are well-adjusted, contented people living full lives.

The key to coping is valuing yourself for who you are, not for how much hair you have or don’t have. Many people learning to cope with alopecia areata find it helpful to talk with other people who are dealing with the same problems. More than four million people nationwide have this disease at some point in their lives, so you are not alone. We have a number of women who live with alopecias of all kinds a daily basis in our Online Community who can help through message boards and support groups.

Another way to cope with the disease is to minimize its effects on your appearance. A wig or hairpiece can look natural and stylish. For small patches of hair loss, a hair-colored powder, cream, or crayon applied to the scalp can make hair loss less obvious by eliminating the contrast between the hair and the scalp. Skillfully applied eyebrow pencil can mask missing eyebrows.

For women, attractive scarves can hide patchy hair loss; jewelry and clothing can distract attention from patchy hair; and proper makeup can camouflage the effects of lost facial hair. If you would like to learn more about camouflaging the cosmetic aspects of androgenetic alopecia, ask your doctor or members of your local support group to recommend a cosmetologist who specializes in working with people whose appearance is affected by medical conditions.

Photo Image of Alopecia Barbae

Image photo of alopecia barbae (barbie)

Image photo of alopecia barbae (barbie)

Alopecia Areata Image Photo

Image photo of what a typical onset of alopecia areata looks like.

Image photo of what a typical onset of alopecia areata looks like.

How will androgenetic alopecia affect my life?

The comforting news is that androgenetic alopecia is not a painful disease and does not make people feel sick physically. It is not contagious, and people who have the disease are generally healthy otherwise. It does not reduce life expectancy and it should not interfere with the ability to achieve such life goals as going to school, working, marrying, raising a family, playing sports, and exercising.

The emotional aspects of living with hair loss, however, can be challenging. Many people cope by learning as much as they can about the disease; speaking with others who are facing the same problem; and, if necessary, seeking counseling to help build a positive self-image. HerHairLossHelp.com offers a wonderful Online Community of women who suffer from alopecia and other hair loss afflictions that can help women who suffer from hair loss cope with their everyday activities. Having a community of women, who are all going through various stages of hair loss, offers other women an empathetic person to turn to when dealing with emotional difficulties because of their hair loss. Visit the HerHairLossHelp.com Forum to learn more!