Understanding Alopecia: Causes, risks, and effective solutions

Alopecia is a common disease and refers to hair loss in women or men. 

Normal hair breakage leaves strands shorter and broken but not entirely absent, hair loss due to alopecia results in complete bald spots on the head or body, explains Dr Matete Mathobela, Dermatologist at Mediclinic Cape Gate.

Hair loss or alopecia is classified into two broader groups: scarring alopecia (central centrifugal cicatricial alopecia, alopecia decalvans, dissecting cellulitis, frontal fibrosing alopecia and late traction alopecia amongst others) and non-scarring alopecia (early traction alopecia, alopecia areata, male and female pattern alopecia and telogen effluvium).

What causes alopecia, and is it contagious?

Alopecia can be triggered by various factors, including genetics, intense amounts of stress, your diet, autoimmune disorders such as thyroid disease, and even hormonal changes from taking birth control pills or post-delivery hormonal changes can be a trigger. Some forms of alopecia, like alopecia areata, which occur when the body's immune system attacks hair follicles, can be triggered by infections from bacteria or viruses. While conditions causing alopecia may be contagious, the hair loss itself is not.

Another form of alopecia that has become more common is traction alopecia, which happens when hair is frequently pulled too tightly through frequently wearing tight hairstyles, such as tight ponytails. All these factors combined result in broken hairs, thinner strands and more cuticle damage. It is usually seen along the hairline but can be central and can lead to permanent damage if not addressed. Preventing further damage involves loosening hairstyles and allowing the hair and scalp to recover before trying new hairstyles that require the use of harsh chemicals or lots of manipulation.

Central centrifugal cicatricial alopecia, one of the most common causes of hair loss, is unfortunately on the rise. It’s more common in females and has a genetic link. Mothers who have the condition can pass it on to their daughters. It is a scarring form of alopecia that starts in the centres of the scalp and expands slowly with time. Early symptoms include hair breakage, severe itching, pimples on the scalp and bald spots. Some people experience no symptoms at all except for noticing their hair is thinning.

Untreated, this condition can lead to permanent hair loss, and therefore, early diagnosis and treatment are important. Trigger factors include the usage of heat on the hair.

According to Dr Mathobela, lifestyle choices like a healthy diet, reducing stress, and avoiding harsh chemical hair treatments can help manage the risk. Early detection and intervention may not prevent hair loss completely but can reduce its severity.

Emotional impact of alopecia

Our hair plays a huge part in how we view ourselves and in forming our identity, and having alopecia often impacts how we view ourselves. Those who suffer from it often withdraw from socialising because they fear being questioned about their hair loss. And with no community to provide support during this time, battling the negative thoughts all alone can lead to a depressive state.

There is hope for those with this condition: emotional support, either from family and friends or a therapist, can make coping with the psychological and emotional challenges of hair loss more bearable.

Effective treatments and hair transplants

”While no permanent cure for alopecia exists, managing the condition is possible. For early stage traction alopecia, medications such as minoxidil can help slow down or stop hair loss and even encourage regrowth,” Dr Mathobela explains. “In cases of severe or long-term hair loss, hair transplants are sometimes recommended to restore a natural appearance. This procedure involves taking healthy hair follicles from another part of the scalp and transplanting them into thinning or bald areas. Wearing wigs or hair plugs has also been prescribed for those with irreversible alopecia; they help with regaining a sense of normalcy and rebuilding self-esteem and pulling one out of social withdrawal.”

If you’re experiencing hair loss, don’t hesitate to consult with a healthcare professional to explore treatment options and emotional support resources that can help you manage the condition effectively.

Contact your nearest Mediclinic to get an appointment with a dermatologist if you suffer from traction alopecia.