Tempo fa, qdo avevo Discovery Health ho guardato un documentario dove si parlava dell'alopecia androgenetica femminile negli Stati Uniti. Oggi, navigando su internet ho trovato questo articolo che mostra come in quel paese sia numerosa la quantità di donne che subiscono di questa patologia.
In the United States it is estimated that 21 million women are affected by FPHL. The incidence in women has been reported to be as low as eight percent and as high as 87 percent. It does appear to be as common in women as in men. The hair loss in women becomes particularly notable in menopause.
Female pattern hair loss (FPHL) differs from male pattern hair loss (MPHL) in the following ways. It is more likely to be noticed later than in men, in the late twenties through early forties. It is likely to be seen at times of hormonal change, i.e., use of birth control pills, after childbirth, around the time of menopause, and after menopause. Recession at the temples is less likely than in men and women tend to maintain the position of their hairlines. Like in men, the entire top of the scalp is the area of risk. In women there is generally a diffuse thinning throughout the area as opposed to thinning in the crown of men. Ludwig has classified hair loss in women into three classes. The vast majority of women affected fall into the Ludwig I class.
Androgens are responsible for hair loss in women by the same mechanisms they cause hair loss in men. Women do produce small amounts of androgens by way of the ovaries and adrenal glands. Also prehormones are produced by the ovaries that are converted to androgens outside of the ovaries or adrenal glands. Women rarely experience total loss of hair in an area if the loss is due to FPHL. If they do they should be evaluated for an underlying pathological (disease) condition. In women, the process of miniaturization of the hair follicle is more random with some hair being unaffected. Normal thick hairs are mixed with finer, smaller diameter hairs. The end result is a visual decrease in density of hair rather than total loss of hair. The hair growth cycle is affected as in men. The growth phase (anagen) is shortened resulting in shorter hairs and the resting phase (telogen) is increased resulting in fewer hairs.
If the cause of hair loss is suspected to be abnormally elevated or decreased amounts of hormones the patient should undergo laboratory tests to measure hormone levels.
OTHER CAUSES OF HAIR LOSS
ALOPECIA AREATA
Alopecia areata (AA) is a recurrent disease, which can cause hairloss in any hair-bearing area. The most common type of AA presents as round or oval patches of hair loss most noticeably on the scalp or in the eyebrows. The hair usually grows back within 6 months to one year. Most patients will suffer episodes of hair loss in the same area in the future. Those who develop round or oval areas of hair loss can progress to loss of all scalp hair (alopecia totalis). The cause of AA is unknown but commonly thought to be an autoimmune disorder (the body does not recognize the hair follicles and attacks them). Stress and anxiety are frequently blamed by patients as the cause of their hair loss. The most common treatment is with steroids (cortisone is one form) either topically or by injection. The outcome of treatment is good when the AA process is present less than one year and poor, especially in adults, if the disease has been present for longer periods of time. Minoxidil (Rogaine®) can help to regrow hair. Surgical treatment of this disorder is not recommended. If you have questions concerning Alopecia areata, please contact an ISHRS physician.
TRACTION ALOPECIA
Traction alopecia is caused by chronic traction (pulling) on the hair follicle and is seen most commonly in African-American females associated with tight braiding or cornrow hair styles. It is generally present along the hairline. Men who attach hairpieces to their existing hair can experience this type of permanent hairloss if the hairpiece is attached in the same location over a long period of time. Trichotillomania is a traction alopecia related to a compulsive disorder caused when patients pull on and pluck hairs, often creating bizarre patterns of hairloss. In long term case of trichotillomania, permanent hairloss can occur.
SCARRING ALOPECIAS
The diseases which cause permanent hairloss do so when scar tissue replaces destroyed normal tissue. They include:
Lupus Erythematosus- occurs more frequently in females than in males and is more common in adults than in children.
Scleroderma- hair loss tends to be slowly progressive
Infectious Agents- Bacterial folliculitis, fungal infections, herpes zoster.
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