00:11Alopecia is the medical term for hair loss and this encompasses any type of hair loss whether
00:15it be temporary or more permanent. There's more than 20 types of alopecia and they can broadly
00:22be divided into those that cause scarring and those that are non-scarring. The most common
00:27type which affects men is male pattern hair loss and the female equivalents tends to be
00:32female pattern hair loss which develops much more slowly. There are other types of hair
00:37loss which are not hormonal genetic dependent and these include those that are autoimmune
00:42such as alopecia areata which is another very common cause of hair loss. There can also be
00:47alterations in the hair cycle and telogen effluvium or chronic telogen effluvium causes excess hair
00:53shedding which can cause thinning and a reduction in the volume of the hair.
01:00The presentation of alopecia is very much dependent on the cause. So the commonest cause of hair
01:05loss in men is male pattern hair loss and that tends to present in men in their 20s or 30s.
01:10Usually they notice the recession of the hair over the temples. They may also notice thinning
01:16over the crown of the scalp. In women the commonest cause is female pattern hair loss and often
01:21women notice thinning of the hair at the top of the scalp compared to the hair at the back
01:25of the scalp. Both these conditions, that is male pattern hair loss and female pattern
01:29and hair loss have a strong genetic component. However, male pattern hair loss tends to be
01:33more strongly influenced by hormonal factors. Other causes of hair loss include autoimmune type
01:39of hair loss and the commonest of this is alopecia areata. In alopecia areata patients often notice
01:45or incidentally told they have a single discrete patch of hair loss which is often a patch of
01:51bald scalp. In terms of scarring hair loss patients often get symptoms as compared to patients with
01:57non-scarring types of hair loss. This can include a stinging sensation, a sensation of burning
02:03or discomfort and patients may also experience tenderness and touch on the scalp. Looking at
02:09the scalp there may be changes such as redness around the hair follicle or indeed larger areas
02:14of redness and often over time, if left untreated, these can progress to a scarring patch of hair
02:20loss where a scar is seen on the scalp.
02:25So the treatment for alopecia is very dependent upon the underlying cause and the diagnosis.
02:31Male pattern hair loss, minoxidil is often a good treatment and tablet options include finasteride.
02:38Women have a few more options for female pattern hair loss. Again, minoxidil can be used with
02:42good effect. Additionally, hormonal therapies such as oral contraceptive pill or hormone replacement
02:48therapies can be useful. However, it's important to be aware that some are hair friendly and
02:53some may encourage hair loss. Patients with alopecia areata, it's important to treat the underlying
02:58autoimmune cause. This may be with steroid tablets, steroid creams or non-steroid based creams.
03:05Alternatives include light therapy, immunotherapy and tablet treatments that suppress the overall immune system.
03:12There are some newer therapies that are in trial which look very promising.
03:16Treatment of telogen effluvium is looking at the underlying cause, identifying it and then
03:22addressing it and there are a huge number of lifestyle factors that one would consider.
03:26In terms of scarring hair loss, the aim of treatment is to reduce the inflammation to prevent the scarring
03:32from occurring. Therefore, early treatment is important. A variety of creams, lotions and foams
03:38may be used on the surface of the scalp but often tablets that suppress the immune system are needed.
03:43As with all treatments and especially so in hair loss, it's important to balance the risk and the benefit.
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