Traumatic Alopecia

Traumatic alopecia refers to hair loss caused by physical or mechanical damage to the hair follicles. There are various types of traumatic alopecia, each with its unique set of causes, symptoms, and treatment options. Traumatic alopecia is a type of hair loss that occurs as a result of physical trauma to the scalp or hair. There are several factors that can contribute to traumatic alopecia, and understanding these causes can help individuals take steps to prevent hair loss or seek appropriate treatment when it occurs. In this article, we will discuss the main definitions and types of traumatic alopecia.

  1. Traction Alopecia: Traction alopecia is a form of hair loss caused by repeated pulling or tension on the hair. This can occur due to tight hairstyles, such as braids, weaves, and cornrows, or from wearing hair extensions for extended periods. Traction alopecia often results in hair loss around the hairline, temples, and nape of the neck.
  2. Chemical Alopecia: Chemical alopecia occurs when harsh chemicals, such as relaxers, hair dyes, and bleach, damage the hair shaft and hair follicles. This type of traumatic alopecia can result in patchy hair loss, breakage, and thinning of the hair.
  3. Thermal Alopecia: Thermal alopecia is a type of hair loss caused by heat styling tools, such as flat irons, curling irons, and hot combs. Prolonged and excessive use of these tools can damage the hair shaft and hair follicles, resulting in hair loss.
  4. Mechanical Alopecia: Mechanical alopecia occurs when the hair is subjected to repeated friction, such as from wearing tight hats, helmets, or headbands. This type of traumatic alopecia can result in hair loss around the areas where the hair is repeatedly rubbed or pulled.
  5. Trichotillomania: Trichotillomania is a psychiatric disorder characterized by the urge to pull out one’s hair, including eyelashes and eyebrows. This condition can result in patchy hair loss, breakage, and thinning of the hair.
  6. Alopecia Areata: Alopecia areata is an autoimmune disorder in which the immune system attacks the hair follicles, resulting in hair loss. Traumatic alopecia can exacerbate the symptoms of alopecia areata, causing hair loss to occur more rapidly and in larger areas.
  7. Pressure Alopecia: Pressure alopecia is a type of hair loss caused by prolonged and continuous pressure on the scalp. This can occur due to wearing tight hairstyles or headgear, such as headbands, wigs, or helmets. Pressure alopecia can result in hair loss around the areas where the pressure is applied.
  8. Radiodermatitis Alopecia: Radiodermatitis alopecia occurs when radiation therapy is used to treat cancer in the head and neck area. Radiation therapy can damage the hair follicles, resulting in hair loss. This type of traumatic alopecia is usually temporary, and the hair will usually regrow after the radiation therapy is completed.

Causes

Causes of traumatic alopecia, along with details on each cause.

  1. Traction Alopecia: Traction alopecia is a type of hair loss that occurs when hair is pulled too tightly, either due to tight hairstyles or hair accessories. This can cause damage to the hair follicles and lead to hair loss over time.
  2. Chemical Damage: Chemical treatments, such as perms, relaxers, and hair dyes, can cause damage to the hair and scalp, leading to hair loss. This can occur when these products are applied too frequently or when they are used incorrectly.
  3. Heat Damage: Heat styling tools, such as flat irons and curling irons, can also cause damage to the hair and scalp, leading to hair loss. This can occur when these tools are used too frequently or at high temperatures.
  4. Trichotillomania: Trichotillomania is a disorder characterized by the compulsive urge to pull out one’s own hair. This can lead to hair loss over time.
  5. Physical Trauma: Physical trauma, such as head injuries or scalp burns, can damage hair follicles and lead to hair loss.
  6. Surgery: Certain surgical procedures, such as scalp reduction or hair transplantation, can cause trauma to the scalp and hair follicles, leading to hair loss.
  7. Radiation Therapy: Radiation therapy for cancer treatment can damage hair follicles and lead to hair loss.
  8. Nutritional Deficiencies: Nutritional deficiencies, such as deficiencies in iron or vitamin D, can lead to hair loss.
  9. Hormonal Imbalances: Hormonal imbalances, such as those that occur during pregnancy or menopause, can lead to hair loss.
  10. Medications: Certain medications, such as chemotherapy drugs, can cause hair loss as a side effect.
  11. Stress: Chronic stress can disrupt the hair growth cycle and lead to hair loss over time.
  12. Autoimmune Disorders: Autoimmune disorders, such as alopecia areata, can cause hair loss by attacking the hair follicles.
  13. Infections: Certain infections, such as scalp ringworm or folliculitis, can damage hair follicles and lead to hair loss.
  14. Genetic Predisposition: Some individuals may have a genetic predisposition to hair loss, which can be exacerbated by traumatic events.
  15. Aging: As individuals age, hair follicles may become less active, leading to hair loss.
  16. Environmental Factors: Exposure to environmental factors, such as pollution or harsh weather conditions, can damage hair follicles and lead to hair loss.
  17. Scalp Conditions: Scalp conditions, such as seborrheic dermatitis or psoriasis, can damage hair follicles and lead to hair loss.
  18. Allergic Reactions: Allergic reactions to certain hair products or other substances can lead to hair loss.
  19. Poor Hair Care: Poor hair care, such as infrequent washing or brushing, can lead to hair loss.
  20. Cancer: Certain types of cancer, such as lymphoma or leukemia, can cause hair loss as a symptom of the disease or as a side effect of treatment.

Symptoms

Main symptoms of traumatic alopecia, along with a detailed explanation of each:

  1. Hair breakage: Traumatic alopecia often results in hair breakage, particularly at the site of the injury. Hair may appear shorter or uneven due to the breakage.
  2. Thinning hair: Traumatic alopecia can also cause hair to become thin or sparse in certain areas. This may be due to repeated trauma to the hair follicles, which can cause them to shrink or become damaged.
  3. Patchy hair loss: In some cases, traumatic alopecia can cause patchy hair loss. This can occur when the hair follicles are damaged or destroyed, leading to the formation of small bald spots on the scalp.
  4. Scarring: Severe cases of traumatic alopecia can lead to scarring on the scalp. This can be particularly concerning if the scars are permanent and affect the appearance of the hair.
  5. Itching and irritation: Traumatic alopecia can cause itching and irritation on the scalp. This is often due to inflammation caused by repeated trauma or injury to the scalp.
  6. Redness and inflammation: Inflammation is a common symptom of traumatic alopecia. It can cause the scalp to become red, swollen, and tender to the touch.
  7. Burning sensation: Some people with traumatic alopecia report feeling a burning sensation on their scalp. This may be due to the irritation and inflammation caused by the condition.
  8. Tenderness: Traumatic alopecia can make the scalp tender to the touch. This can be particularly uncomfortable if the affected area is brushed or touched frequently.
  9. Tightness: Tight hairstyles or head coverings can cause the scalp to feel tight and uncomfortable. This can contribute to the development of traumatic alopecia.
  10. Headaches: In some cases, traumatic alopecia can cause headaches. This may be due to the tension and strain caused by tight hairstyles or head coverings.
  11. Dandruff: Traumatic alopecia can also cause dandruff, which is characterized by flaky, itchy, and irritated skin on the scalp.
  12. Sores: Repeated trauma or injury to the scalp can cause sores to form. These may be painful and can lead to scarring if left untreated.
  13. Pimples: Traumatic alopecia can cause pimples to form on the scalp. This is often due to inflammation and irritation caused by repeated trauma to the hair follicles.
  14. Cysts: In some cases, traumatic alopecia can cause cysts to form on the scalp. These are typically small, fluid-filled sacs that can be painful if they become infected.
  15. Ingrown hairs: Traumatic alopecia can cause hairs to grow back into the skin, leading to ingrown hairs. These can be painful and may cause further damage to the hair follicles.
  16. Brittle hair: Traumatic alopecia can cause hair to become brittle and dry. This can make it more prone to breakage and further damage.
  17. Split ends: Traumatic alopecia can cause split ends to form on the hair. This is often due to repeated trauma or injury to the hair shaft.
  18. Changes in hair texture: Traumatic alopecia can cause changes in the texture of the hair. This may include an increase in curliness or coarseness, as well as a decrease in shine and softness.

Diagnosis

Diagnosis and tests for traumatic alopecia and provide a detailed explanation for each one.

  1. Physical exam: A physical exam of the scalp is the first step in diagnosing traumatic alopecia. The healthcare provider will look for signs of hair loss, such as thinning or bald patches, and examine the scalp for any signs of inflammation, scarring, or infection.
  2. Medical history: The healthcare provider will ask about the patient’s medical history, including any previous injuries, surgeries, or illnesses that may have contributed to the hair loss.
  3. Hair pull test: A hair pull test involves gently pulling on a small section of hair to see how many hairs come out. A positive result, where more than 10% of hairs come out, may indicate a hair loss condition.
  4. Trichoscopy: Trichoscopy is a non-invasive diagnostic test that uses a handheld microscope to examine the hair and scalp. This can help identify the pattern of hair loss and any underlying scalp conditions.
  5. Scalp biopsy: A scalp biopsy involves removing a small piece of scalp tissue for examination under a microscope. This can help identify the underlying cause of hair loss, such as scarring or inflammation.
  6. Blood tests: Blood tests can help identify any underlying medical conditions that may be contributing to hair loss, such as thyroid disorders or nutritional deficiencies.
  7. Hormone tests: Hormone tests can help identify any hormonal imbalances that may be contributing to hair loss, such as androgenetic alopecia or polycystic ovary syndrome (PCOS).
  8. Patch tests: Patch tests can help identify any allergies or sensitivities to hair care products that may be contributing to hair loss.
  9. Trichogram: A trichogram involves plucking 50-100 hairs from the scalp and examining them under a microscope. This can help identify the stage of the hair growth cycle and any abnormalities in hair growth.
  10. Phototrichogram: A phototrichogram is a non-invasive diagnostic test that uses a digital camera to take pictures of the hair and scalp. This can help identify the pattern of hair loss and monitor changes over time.
  11. Scalp cultures: Scalp cultures can help identify any bacterial or fungal infections that may be contributing to hair loss.
  12. Hair analysis: Hair analysis involves examining the hair for mineral imbalances, such as excess levels of copper or iron, which may contribute to hair loss.
  13. Hair shaft analysis: Hair shaft analysis involves examining the hair shaft under a microscope to identify any structural abnormalities or signs of damage.
  14. Skin allergy tests: Skin allergy tests can help identify any allergies or sensitivities to environmental allergens that may be contributing to hair loss.
  15. Scalp ultrasound: Scalp ultrasound is a non-invasive diagnostic test that uses sound waves to examine the scalp and hair follicles. This can help identify any structural abnormalities or inflammation.
  16. MRI or CT scan: MRI or CT scans can help identify any structural abnormalities or injuries to the scalp or underlying tissues.
  17. Video microscopy: Video microscopy involves using a digital camera to take close-up images of the scalp and hair follicles. This can help identify any abnormalities in hair growth or signs of damage.
  18. Digital dermoscopy: Digital dermoscopy is a non-invasive diagnostic test that uses a handheld microscope to examine the scalp and hair follicles. This can help identify any signs of inflammation, scarring, or infection.

Treatment

The most common drugs used to treat traumatic alopecia.

  1. Minoxidil: Minoxidil is a topical medication that is applied to the scalp to promote hair growth. It works by widening the blood vessels in the scalp, which allows more oxygen, blood, and nutrients to reach the hair follicles. Minoxidil is available over-the-counter in 2% and 5% formulations.
  2. Finasteride: Finasteride is an oral medication that is used to treat male pattern baldness. It works by blocking the conversion of testosterone to dihydrotestosterone (DHT), which is a hormone that is responsible for hair loss. Finasteride is only available with a prescription.
  3. Spironolactone: Spironolactone is an oral medication that is used to treat hair loss in women. It works by blocking androgens, which are hormones that can cause hair loss. Spironolactone is only available with a prescription.
  4. Corticosteroids: Corticosteroids are a type of medication that is used to reduce inflammation in the body. They can be applied topically to the scalp or injected into the scalp to treat traumatic alopecia. Corticosteroids are available with a prescription.
  5. Triamcinolone: Triamcinolone is a corticosteroid medication that is often used to treat scalp conditions such as psoriasis or eczema. It can also be used to treat traumatic alopecia by reducing inflammation in the scalp. Triamcinolone is available with a prescription.
  6. Betamethasone: Betamethasone is a corticosteroid medication that is used to treat a variety of conditions, including traumatic alopecia. It works by reducing inflammation in the scalp. Betamethasone is available with a prescription.
  7. Fluocinonide: Fluocinonide is a corticosteroid medication that is used to treat skin conditions such as psoriasis and eczema. It can also be used to treat traumatic alopecia by reducing inflammation in the scalp. Fluocinonide is available with a prescription.
  8. Clobetasol: Clobetasol is a corticosteroid medication that is used to treat a variety of skin conditions, including psoriasis and eczema. It can also be used to treat traumatic alopecia by reducing inflammation in the scalp. Clobetasol is available with a prescription.
  9. Tacrolimus: Tacrolimus is a topical medication that is used to treat eczema. It works by suppressing the immune system in the affected area, which can help to reduce inflammation and promote hair growth. Tacrolimus is available with a prescription.
  10. Anthralin: Anthralin is a topical medication that is used to treat psoriasis. It works by slowing down the growth of skin cells, which can help to reduce inflammation and promote hair growth. Anthralin is available with a prescription.
  11. Ketoconazole: Ketoconazole is an antifungal medication that is used to treat a variety of skin conditions, including dandruff and seborrheic dermatitis. It can also be used to treat traumatic alopecia by reducing inflammation in the scalp. Ketoconazole is available over-the-counter and with a prescription.

Natural Treatment

  1. Platelet-rich plasma (PRP) therapy: PRP therapy involves injecting a patient’s own platelet-rich plasma into the scalp to promote hair growth. Platelets contain growth factors that can stimulate hair follicles.
  2. Hair transplant surgery: Hair transplant surgery involves transplanting hair from one area of the scalp to another. It is typically used to treat male pattern baldness, but it can also be used to treat traumatic alopecia.
  3. Scalp micro pigmentation: Scalp micro pigmentation involves tattooing the scalp with tiny dots to create the illusion of hair growth. It can be used to treat both male and female pattern baldness, as well as traumatic alopecia.
  4. Low-level laser therapy: Low-level laser therapy involves exposing the scalp to low-level laser light to stimulate hair growth. It is typically used in combination with other treatments.
  5. Hair fibers: Hair fibers are small, keratin fibers that can be sprinkled onto the scalp to create the illusion of thicker hair. They are available in a range of colors and can be used by both men and women.
  6. Hair extensions: Hair extensions can be used to add length and volume to hair that has been damaged by traumatic alopecia. They can be applied using a variety of methods, including clips, tape, and sewn-in weaves.
  7. Wig: A wig is a hairpiece that can be worn to cover hair loss caused by traumatic alopecia. Wigs are available in a variety of styles, colors, and materials.
  8. Hair growth supplements: Hair growth supplements are oral supplements that contain vitamins, minerals, and other nutrients that can support hair growth. They are often used in combination with other treatments.
  9. Aloe vera: Aloe vera is a plant that has been used for centuries to treat a variety of skin conditions, including hair loss. Aloe vera gel can be applied topically to the scalp to promote hair growth.
  10. Essential oils: Essential oils, such as lavender, rosemary, and peppermint, can be used topically to promote hair growth. They are often used in combination with carrier oils, such as coconut oil or jojoba oil.
  11. Onion juice: Onion juice is a natural remedy for hair loss that has been used for centuries. It can be applied topically to the scalp to stimulate hair growth.
  12. Green tea: Green tea contains antioxidants that can help to promote hair growth. It can be applied topically to the scalp or consumed orally as a supplement
References