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Alopecia, also known as hair loss or baldness, is a condition that affects about 2 in 3 men and 1 in 5 women. There are a few different types of alopecia: common baldness, drug-caused alopecia, and immune-disorder alopecia. Common baldness is the most common type of alopecia. In common baldness, hair is not actually lost; instead it becomes fine and colorless. One cause of common baldness is a chemical called DHT that causes hair to become thin and fine. DHT is made in the body when testosterone is broken down.
There are a couple of choices for treating common baldness. A topical solution of minoxidil (Rogaine®) is used to increase blood flow to the affected area, which should therefore improve hair growth. However, minoxidil has not been shown to work very well. The main side effects of minoxidil may include skin irritation and more than normal hair growth. Another treatment choice is finasteride (Proscar®) and it is taken by mouth. Finasteride works by blocking a step in the breakdown of testosterone to DHT. This lowers DHT levels in the body. The main side effects of finasteride may include impotence or decreased sexual desire, breast enlargement, and allergic reaction. It usually takes several weeks or months before either minoxidil or finasteride will help hair growth.
Hair loss or thinning can also be caused by certain drugs. This is
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usually caused by certain cancer drugs, also called chemotherapy. Some of these drugs have little to no effect on hair loss, while others can cause total hair loss. When hair loss is caused by cancer drugs, it will usually reverse when patients have finished taking that drug.
There are three different types of immune-disorder alopecia: alopecia areatis, alopecia totalis, and alopecia universalis (AA, AT, AU). Immune-disorder alopecias are much less common and affect a very small amount of people. It can affect all ages and races, and appears to equally affect both men and women. These types are possibly inherited and probably caused by a problem with the immune system. In these conditions, patches of hair may be lost from any part of the body. The difference among these conditions is in the degree of hair loss. The least hair loss is seen in AA; total hair loss is seen in AU.
Different treatment options for immune-disorder alopecias include topical steroids (clobetasol propionate, fluocinolone acetonide), prednisone, minoxidil solution, finasteride, anthralin, psoralen plus UV-A, and topical immunotherapy (SADBE, DPCP). Prednisone is a steroid and is thought to work because it decreases the power of the body's immune system. However, the high doses and long-term use of prednisone needed can cause serious side effects, including: diabetes, osteoporosis, hypertension, acne, and weight gain. These side
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effects can cause patients to stop taking prednisone.
There is not a perfect choice for all patients. You must work with your physician to find the best treatment for you. If you or a loved one is suffering from hair loss, please talk to your physician about possible treatments. You are not alone with this condition. Many organizations exist to provide support and advice for those with alopecia. For more information about alopecia, please visit the following websites:
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