Hair has many functions. The physiological role of hair is to protect the neck and scalp from mechanical damage, UV radiation, cold, and heat, while eyelashes prevent foreign bodies from entering the eye. Besides the mechanical function, the hair also has a sensory one - it acts as a sensory touch receptor.
However, the esthetic role of hair has long since overpowered the biological one. Hair is one of the most important aspects of creating a picture of ourselves and our body, a physical attribute for expressing individuality. Therefore, it comes as no surprise that loss of hair can have a significant impact on the individual’s psyche, quality of life, and social life.
The causes of hair loss differ from disorders inside a hair, through hair growth disorder, to physiological hair loss due to aging which is called androgenetic alopecia. However, there is also scarring alopecia (follicle destruction) that can cause irreversible hair loss and scar tissue formation. In scarring alopecia, it is especially important to get an early diagnosis and start with the treatment.
Hair can also fall out after giving birth or experiencing a traumatic or stressful event. Hair loss can also be a consequence of taking certain medications, most commonly the ones for lowering high blood pressure and cholesterol. Increased hair loss can happen due to a thyroid disorder, low levels of iron and vitamin D, and in case of hormonal disorders, such as polycystic ovary syndrome.
Anamnesis, clinical examination, and trichoscopy (dermatoscopy of the scalp) are important in the diagnosis of the disease.
Anamnesis is used to determine when the hair loss started, the extent to which the scalp is affected (limited/entire scalp), hair loss dynamics (permanent/periodical), the severity of hair loss, seasonal variations, and potential factors that could cause increased hair loss (medications, past infections, stress, hormonal diseases, other diseases…). It is also being established whether hair loss is accompanied by hair thinning and subjective sensations, such as itchiness, pain, hyper-sensitivity during brushing…
A clinical examination provides insight into the activity of the disease and the level of hair thinning.
Trichoscopy has become quite valuable in diagnosis in the past few years - a method that can be used to diagnose irregularities in the hair structure, and inflammatory changes of the scalp. Nowadays, it has become an indispensable tool in diagnosing scalp diseases, but also in following the treatment. Trichoscopy has significantly shortened the time for setting a diagnosis, but has also increased the accuracy (if the examination is performed by a specially educated dermatologist) and has increased the performance of scalp treatments.
That is why a dermatologist’s examination should be detailed and include anamnesis, clinical examination, and trichoscopy. It is often necessary to perform a scalp biopsy (taking a 3mm skin sample for a pathohistological analysis). Besides the dermatologist, a pathologist skilled in the pathohistological analysis of scalp diseases plays a significant role in the diagnosis of scalp diseases.
Treatment of hair loss depends on the diagnosis, which is in most cases androgenetic alopecia, physiological hair loss that can be slowed down and delayed by continuous treatments and local preparations that need to be applied at home almost daily. Also, systemic food supplements can be used, such as omega acids, vitamin A, biotin, folic acid, vitamin D, turmeric…
Mesotherapy and plasma rich in platelets (PRGF) are esthetic treatments that can stimulate hair growth, prevent hair loss, and improve the quality of hair, but also be ancillary treatments for scarring scalp diseases.
In mesotherapy, a cocktail of different ingredients is injected into the area around the hair follicle, 1-4 mm from the skin surface. The most important ingredients are biotin, vitamins, coenzymes, and different amino acids that play a significant role in the structure of the hair.
With the common action of these ingredients, hair loss can be stopped, and hair growth can be stimulated for it to be thicker and of better quality.