ALOPECIA (EXCESSIVE HAIR LOSS)
Each hair strand grows on the scalp for several years, after which it falls out and is replaced by a new hair strand that grows from the same hair follicle. In a healthy person about 100 hair strands fall out every day. Excessive hair loss occurs when the hair falls out significantly more than is expected, or if it does not grow back properly. Excessive hair loss or ‘alopecia’ may have several causes including:
- congenital diseases
- short-term effect of a hair damage factor (eg. some medications, stress, fever diseases, general anesthesia)
- long-lasting effect of hair-damaging factors associated with chronic diseases of internal organs or diseases of the endocrine system
- long-term deficiencies resulting from an incorrect diet or malabsorption
- skin diseases with excessive hair loss
- hair and scalp diseases
The determination of the cause of excessive hair loss usually consists of:
- a medical examination (information about hair loss and previous illnesses)
- blood laboratory tests (after receiving above information)
- trichogram (microscopic examination of hair roots)
- trichoscopy (computer hair and scalp examination)
- histopathological examination (involves taking a section of the scalp with a dimention 2 × 2 mm under local anesthesia and examining it under the microscope after the application of an appropriate stain).
It should be emphasized that no single examination is sufficient to obtain a full picture of the condition of the hair. This is especially true for the trichogram and trichoscopy, which evaluate different parts of the hair and complement each other.
A trichogram is a diagnostic method that involves the removal of about 100 hairs from the skin of the scalp, where the roots are then examined for particular conditions under a microscope. This method gives information about the activity (dynamics) of the disease and speed as well as the type of hair loss, and also allows for exclusion of some causes of excessive hair loss. Trichogram is performed not only for diagnostic purposes but also to assess whether there has been any improvement since the previous examination. It is suggested that the interval between subsequent tests should not be shorter than a few months, because frequent examinations usually do not provide additional clinical information. This test should be performed no earlier than 3 days after the last hair wash. In order to make it easier for patients with frequent hair washing to be properly prepared, we offer the possibility to perform tests on Saturdays. In case of testing on Saturday, the hair should not be washed after Wednesday evening.
Trichograms in our office are performed by Dr. Adriana Rakowska, Dr. Olga Warszawik-Hendzel, Dr. Marta Kurzeja and Dr. Anna Waśkiel.
Trichoscopy is a non-invasive examination. It involves a computer examination of the hair and the surface of the scalp. It also provides information about the condition of the hair follicles and hair stems. The study is particularly useful in the diagnosis of certain hair diseases (eg. androgenic alopecia of women, unusual alopecia areata, or congenital diseases). This examination also allows for monitoring of treatment effects and/or the progression of a disease. Trichoscopy can also be used to determine the diagnosis of some causes of abnormal hair growth in children (eg. Netherton syndrome or monilethrix). Trichoscopy is painless so it is well tolerated by most children. The examination does not require any special hair preparation.
Trichoscopy in our office is performed by Dr. Adriana Rakowska, Dr. Olga Warszawik-Hendzel, Dr. Marta Kurzeja and Dr. Anna Waśkiel.