Bald spots and sparse barbs: Alopecia explained



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Illustration of four men lined up, each with less hair than last

Illustration of Alicia Tatone

Here's how to handle these curious missing hair spots.

Many of us have uneven beards and curious bald spots, but these are just genes involved. What about guys who have bald spots more concentrated, right in the middle of ################################################################################ 39, a beard or a mane? It could be alopecia.

The underlying science is complicated, especially since a kind of alopecia differs so much from the other, and from one person to another. Although you need to consult your doctor to discuss any of your symptoms, you can still learn some basics before this appointment. To better understand the main types of alopecia that affect the beard and hair, we called on Lindsey Bordone, certified dermatologist for the board of directors, Columbia University Medical Center and NY-Presbyterian.

There are different types of alopecia

There are many types of alopecia, ranging from hair loss due to too tight traction on the hair (traction alopecia), as well as to hair loss to the whole body (universal alopecia) or to the totality of the hair of the head).

You may not have understood it, but your hair loss at the standard rate is actually alopecia. This is the most common type: hair loss in men and women is known androgenetic alopecia. Bordone points out that, in men, this is manifested by a thinning of the hair density on the scalp and / or a recession in the front of the scalp.

The second most discussed type of alopecia is alopecia areata. It affects the hair follicles and leads to bald spots. It is more common in people with an autoimmune disease, such as lupus, vitiligo, thyroid disease, type 1 diabetes and colitis. For example, I myself have vitiligo and some of the white patches on my head and beard have become bald. It is also believed that alopecia areata can be caused by stress. (There is another phenomenon of hair loss called telogen effluvium it's stress-induced.)

A common form of alopecia areata is barbecued alopecia, in which the beard undergoes hair loss patches. Do not confuse barbaceous alopecia with trichotillomania, which is the condition in which a stressed man chooses his beard and hurts the follicles. "Although this hair can grow back after being pulled, chronic wounds can cause a permanent decrease in density," Bordone explains.

Who has alopecia?

Bordone says that genes play an important role in the choice of androgenetic alopecia. "Mothers and fathers contribute to genetics and can determine if their adult child will have a given hair density." She adds that obesity and an unhealthy lifestyle worsen hair loss, as these behaviors age biologically.

Many autoimmune diseases that lead to alopecia areata are also inherited through genetics, but not all. If you develop alopecia, it may be that one of your lineage presents the same problem, even if it jumped your mother or father before you express yourself in it.

Can we prevent or treat alopecia?

Androgenetic alopecia can be slowed down, yes, by prescription drugs, topical solutions and healthy, active lifestyles. (We have more tips on how to prevent hair loss.)

Alopecia areata is harder to predict and therefore prevent. You can talk with your dermatologist about different methods to fortify and resuscitate the follicles before they become sterile. (Even seemingly lost hair can sometimes be retrieved because the follicle has remained intact for some time.Various procedures can revive the weak follicle and stimulate hair growth.) Topical solutions that strengthen the follicles, such as minoxidil (aka Rogaine, which is also effective against androgenetic alopecia), steroid creams, etc. Consult your registered dermatologist to discuss the best approach and track progress safely.

In both cases, when the treatment is effective, "the density of some miniaturized hairs can increase," Bordone explains. "[When it works]this may give the impression that the hair has grown back. "

What about side effects?

One of the usual treatments for androgenetic alopecia, Propecia (or finasteride), is sometimes associated with a decreased libido in humans, Bordone explains. "It's uncommon and should go away once the treatment is stopped, and any remaining Propecia is metabolized and eliminated by the patient's system." Watch the process carefully and talk to your doctor immediately if you notice anything suspicious.

Many treatment options for alopecia areata (on the head or beard) pose a high risk because they include chemicals or steroids. Again, your doctor is your best friend through this process.

OK, what about hair transplants?

"Hair transplants could help an area of ​​androgenetic alopecia but would not help improve hair density in cases of inflammatory hair loss (alopecia areata)," Bordone explains.

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