Other Causes of Hair Loss

Hair loss is not a single condition. It can develop for many different reasons — genetics, the immune system, infections, physical trauma, medications and various systemic diseases. The first step in correct treatment is identifying the cause of the hair loss accurately.

Trichotillomania is a type of hair loss that arises from a person pulling out their hair involuntarily or repetitively. It is characterised by irregularly bordered broken hairs and strands of differing lengths. Clinical examination and trichoscopy play an important role in diagnosis. Where necessary, a multidisciplinary approach together with psychiatry may be needed.

Traction alopecia develops from constant pulling on the hair follicles due to prolonged tight styling — braids, tight buns, hair extensions and similar causes. It can be reversible when noticed early; however, permanent hair loss can develop in long-standing cases.

Anagen effluvium is a rapid hair loss that develops when follicles in the growth (anagen) phase are damaged. It is seen most often with chemotherapy drugs, though some toxic substances and certain rare conditions can produce a similar picture. Once the underlying cause is removed, the hair begins to grow again in most patients.

Dissecting cellulitis is a chronic inflammatory condition of the scalp that runs a course of painful swellings, inflamed nodules, discharge and, over time, scarring. It is seen most often in young men. Starting appropriate treatment early is important for preventing permanent hair loss.

Discoid lupus erythematosus is a chronic skin condition related to the immune system. When it affects the scalp, it can cause redness, crusting, colour change and, over time, permanent hair loss due to scarring. Early diagnosis and treatment are very important in preventing progression.

Besides these, there are many other conditions that can cause hair loss. Some of them are congenital hair disorders, tinea capitis (fungal infection of the scalp), central centrifugal cicatricial alopecia (CCCA), temporal triangular alopecia, pressure-induced alopecia, alopecia due to psoriasis, loose (short) anagen syndrome, hair loss due to systemic lupus erythematosus, and sclerosing conditions such as morphea and scleroderma.

In hair loss, correct treatment begins with the correct diagnosis. Different conditions with a similar appearance can require entirely different treatments. It is therefore very important to make an individual assessment using diagnostic methods such as detailed clinical evaluation, trichoscopy, hair analysis and, where needed, scalp biopsy.