Hair Loss
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Androgenetic Alopecia

Classification by Norwood Scale:
Type II The frontotemporal region has small recessions (hairline) that tend to be symmetrical. Start a slight hair loss and the density decreases on the front. When a treatment is initiated in this state, the results are generally excellent.
Type III While hair loss is usually minimal, this is the first degree considered as baldness. In type 3V (Vertex) the loss is also evident in the crown area and will expand over time. The treatments in this state also have excellent results.
Type IV Clearly it is a more advanced degree of baldness. We can see that the recession in the frontal and frontotemporal is more pronounced than in grade III. The density of hair is greatly reduced in the same way that happens in the crown area. Even in this state the treatments can be successful.
Type V The hair start to strip away around the area that separates the crown and frontotemporal zone. Now it seems generalized baldness but in reality is deeply located in both zones. Baldness is well advanced and treatments -non surgical- help only in few cases.
Type VI & Type VII In type VI there is no bridge or strip that separated the two areas. Baldness begins to spread in a lateral and posterior areas.

The type VII is the most advanced degree of baldness. The hair is only available in the area of the neck and on the sides (above the ears). In these grades, there is no treatment, drug or lotion that can help.

Alopecia Types:

The fox may lose his hair but not his tricks. In fact, he loses it twice a year.

The word "alopecia" descends from the Greek word "Alopex" which means "Fox". The Royal Spanish Academy defines Alopecia as "pathological fall or hair loss". Maybe it's a short definition but is more than successful.

Alopecia is the prematurely fall or absence of hair in one or more parts of the body. Its causes are many, and the types of alopecia are classified as follows:

Non-Scarring Alopecia:

Is one of the most common and can be improved or cured by treatments. Sometime can be reversed spontaneously without any treatment too. In this type of alopecia the hair follicle has a pathological behavior but it's still alive unless the alopecia extends over a very long period of time (common baldness or androgenetic alopecia). We can classify Non-Scarring Alopecia as:

  • Androgenetic Alopecia: it's also known as androgenic alopecia, premature, or common baldness. It affects many men and rarely women too.

    If you suffers from androgenetic alopecia, like most men, I recommend having a look to the left on the Norwood Scale to check what type/grade of alopecia you have. This will be very useful to know if a treatment can give you results. If your level is very advanced (5, 6 or 7) you will have to consider surgery or simply accept that you are/will be bald. There are no treatments that have proven to be effective in those advanced degrees.

    Androgens are the hormones responsible for hair loss and that is why many of the current treatments inhibit the production of them. If baldness continues to advance and the hair follicles die, the process becomes irreversible and no treatment will restore this situation. Only follicles can be repaired by transplanting them from other areas to the crown and the hairline. Ideally, of course, is to fight the fall while the follicles are alive. Women are more fortunate than men as androgenetic alopecia appears only in the front of the scalp (hairline), leaving hair more sparse, but on rare occasions it can be completely depopulated areas as well.

  • Alopecia Areata: the cause is unknown but the symptoms are clear: Rounded patches completely depopulated of hair. Alopecia Totalis (AT) is when the hair is completely out from the scalp. In cases of Alopecia Universalis (AU) hair is miss around the body. There are still no fully effective treatments for this type of alopecia. Therapies that are used with medium results include: ultraviolet light, topical corticosteroids, steroid injections, and irritants agents to excite follicles stimulating hair growth.

  • Traumatic Alopecia: may be caused by the use of hair dryers, combs, metal or any other element capable of generating lesions on the scalp. It can also be generated when the patient -in a manic state- take his hair out of himself. This pathology is known as Trichotillomania.

  • Diffuse Alopecia (Chronic Telogen Efluvio): The term "telogen effluvium" was coined by Kligman in 1961. This is the acute loss of hair after chronic systemic diseases, emotional stress, febrile illness or childbirth. In the latter, telogen effluvium can last up to six months before fully recovering.

  • Alopecia caused by drugs: vitamin A in large doses, cytostatics, thyroid, anticoagulated, mercury and valproic acid can produce alopecia. When the drug is stopped hair loss disappears.

  • Alopecia by systemic diseases: with endocrine origin, infectious, Lupus erythematosus or nutritional deficit.

  • Alopecia by hereditary syndromes: in the case of congenital atriquia the person does not have hair. We also found it in temporal triangular alopecia, in the syndrome of anagen hair loss, hypoplasia of hair and cartilage, in Menkes syndrome, in anhidrotic ectodermal dysplasia and in tricorrinofalangic syndrome.

Scarring Alopecia:

Unfortunately this type of alopecia usually provoke an irreversible damage, malformation or complete rupture of the follicular structure. There is no treatment or drug that helps when the hair follicles in inert. If there are no damaged areas, they can be used to implant hair.
The scarring alopecia are classified as follows:

  • Infectious Alopecia: fungal (Kerion, candidiasis, favus), bacterial (syphilis, leprosy, acne necrotic) viral (herpes, varicella); protozoa (Leishmaniasis).

  • Alopecia by physicochemical agents: caustic agents, mechanical trauma, burns and X-ray rediodermitis. Keep in mind that the follicles are sensitive to radiation.

  • Tumoral Alopecia: dermal tumors and metastases. Mast cells, basal cells, carcinoma or squamous, lymphoma, and adnexal tumors.

  • Dermatosis Alopecia: Graham-Little syndrome, dermatomyositis, sarcoidosis, follicular mucinosis.

  • Hereditary sickness Alopecia:porokeratosis of Mibelli, epidermal nevus, Darier's disease, ichthyosis, and aplasia cutis.

  • decalvans clinical syndromes Alopecia: erosive pustular dermatosis, folliculitis decalvans, parvimaculata alopecia and Pseudopelade.
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