Traction Alopecia

Traction Alopecia

Traction alopecia is caused by the gradual loss of hair which is primarily the result of pulling by force.

Chronic pulling or traction can result in the recession of the hairline

This is mechanical in cause primarily due to wearing hair in very tight pony tails and braids. Hair extensions, braids or even sleeping in rollers can result in permanent loss in other areas.

It can take months and many years to become apparent that there is a problem.

This is irreversible.

Printed from 'Hair Loss Handbook' with permission of the IAT and David Salinger

We are here to help with professionalism and confidentiality

Alopecia Totalis and Universalis

Alopecia Totalis and Universalis

Alopecia totalis and universalis are both more extreme versions of areata.

Totalis is the total loss of hair on the head including the brows and eye lashes.

Universalis is the total loss of all hair throughout the whole body.

The nails are affected by both and become brittle and often distorted. Neither leave scarring and the follicles remain alive but empty in both conditions.

The follicles lie dormant and may regrow hair at any time or not at all.

Printed from 'Hair Loss Handbook' with permission of the IAT and David Salinger

We are here to help with professionalism and confidentiality

Psoriasis

Psoriasis

Psoriasis generally consists of patches of silvery white scale on inflamed red skin and can affect skin on any part of the body. Skin can bleed easily when the scales are removed or disturbed.

The three main features of psoriasis are the shape, colour and the scales. Firstly, a small oval patch appears that remains circular until its size increases to about 5 cm in diameter if this patch continues to enlarge the shape becomes irregular. The inflamed area is usually uniformed colour which can vary from deep red to brown or even purple.

Dry thin scales are always present but the extent of the scaling may vary. The scales remain together in layers on the skins surface and are not easily removed. The scales can be so dense that sometimes the redness of the skin is only apparent when the scales are removed. Removal of the scales can easily make the skin bleed and patches can occur in the crease behind the ears or even in the ears.

Psoriasis can fluctuate on a daily basis. It can be really bad one day and the next a lot better. Hair loss can occur where the erythema is bad and sometimes a patch of baldness can occur similar to patches of baldness associated with discoid lupus erythematous.  It is not normally itchy.

There is a type called guttate psoriasis which has pin head sized flat papules which appear like drops of water on the skin. Streptococcal infection is a major precipitating factor in this type.

Fingernails can also have a pitting or pinprick holes and can appear to have a brown tint or be separated.

Printed from 'Hair Loss Handbook' with permission of the IAT and David Salinger

Seborrheic Dermatitis

Seborrheic Dermatitis

Seborrheic dermatitis is generally areas of erythema covered by inflamed yellow oily scales. It is often found around the front hairline and forehead but can also affect any part of the scalp, neck, face, back and other areas of the body. It is normally an itchy condition.

The yeast, Malassezia Globosa, is abundant on the skin with this problem and may play a causative role by acting on the sebum to produce free fatty acids. It is the free fatty acids that irritates the skin which then leads to the inflammatory process and the scaling.

It can affect females at almost any age but generally found in men aged 16 to 40 and is known as cradle cap in babies.

Hormonal factors can play a part as the sex hormones and thyroxine influence the sebum production. Although active at birth the production of sebum subsides soon after adolescence when the increase in androgen production increases the size of the sebaceous glands which, in turn, increases sebum production.

Females and males of 13 to16 produce about the same amount of sebum. However, after age 16, sebum is much greater in males due to the influence of the increase in androgens from the testes.

In females it is the combined production of androgens from the adrenal cortex and ovaries that influences sebum. In females, excessive oiliness could indicate a hormonal imbalance or the influence of certain oral contraceptives on the skin.

Printed from 'Hair Loss Handbook' with permission of the IAT and David Salinger