All posts by miriam

Lichen planopilaris is a type of scarring (cicatricial) alopecia that causes hair loss and inflammation. It is a follicular form of lichen planus, a common yet chronic mucocutaneous disease which affects hairier areas of the body.

Cause

The cause of the condition is believed to be auto-immune like alopecia areata, although there is also a link between lichen planopilaris and certain drugs. Exposure or allergic reaction to certain types of chemical or drug can cause what is known as “lichenoid” reactions weeks or even years after contact, although the cause of these reactions is not yet known.

The condition is known to affect middle-aged adults, appearing as distinct patches of hair loss, scarring and inflammation surrounding hair follicles. In some cases, hair loss can be permanent.

Other symptoms include reddish purple – or occasionally, white and shiny – papules (small, elevated areas) on the skin. These papules are generally uneven in shape and can often be very itchy for the sufferer.

Treatment

Known treatments for cases of lichen planopilaris include oral steroids, Plaquenil, Accutane and topical steroid liquids.

If you suspect you, or a family member, has the condition, you should see your doctor immediately for a formal diagnosis.

For many female hair loss sufferers, advice and support from others with similar conditions can be an essential lifeline. Simply by talking about your feelings and concerns in relation to your hair loss can really help to relieve your anxiety, so you can stop hiding away and go out there and live your life.

One valuable support network for women with hair loss is Bald Girls Do Lunch, a non-profit organisation set up in 2007. Although it mainly operates in the US, holding events and bringing women with alopecia together, the organisation offers advice, medical information and support to people with hair loss worldwide via its website.

The founder of the organisation, Thea Chassin, has had alopecia areata universalis for many years after the condition showed itself in 1997. Thea recently spoke to a publication in Pasa Robles in California, where Bald Girls Do Lunch is due to visit in the next few weeks. She said:

“It cannot be overstated how valuable it is for women who may feel secretive and ashamed about having alopecia areata to finally meet others like themselves,”

“We encourage lifestyle options of all types, so women come to our events with hats, scarves or rocking their bald look. The Bald Girls Do Lunch network is the remedy for feeling alone with this condition.”

One of the scariest parts of losing your hair suddenly, whether through a hair loss condition or due to chemotherapy treatment, is the lack of control you feel over what’s happening to you. In some cases, all you can do is watch as your hair falls out and your appearance changes dramatically. This can be devastating to your self-esteem and your confidence in how you look.

Taking back control

Some women who start to lose their hair in patches make the bold decision to shave it all off completely, pre-empting what is likely to happen eventually. This way, you have control over your appearance as you choose to embrace temporary baldness.

An example of this is the Scottish TV presenter and arguably the most famous alopecia sufferer, Gail Porter. After years of baldness, her hair started to grow back for a short time before falling out all over again. Gail shaved it all off before going completely bald, preferring to do this rather than passively watch the hair fall out.

Other women take control of their hair loss in different ways, using human hair wigs, wraps and headscarves to disguise hair loss. There are even more advanced hair management options available, such as Medi Connections and the Intralace system.

A new device designed to reduce hair loss during chemotherapy treatment for cancer has been successfully tested and approved for use in Europe, as well as in Canada and Japan.

The Dignicap system has been developed by a Swedish firm called Dignitana, who claim that the cap is able to limit hair loss for cancer patients undergoing chemotherapy.

The cap, consisting of a form-fitted silicon cap, a mobile cooling unit and a neoprene outer cap to keep everything in place, works by chilling the scalp and shrinking the blood vessels. This reduces the dose of chemotherapy that reaches the hair follicles, thereby limiting hair loss whilst still allowing the treatment to work properly.

The Dignicap system has not yet been FDA approved in the USA, but it is in clinical use in some other parts of the world. Trials have shown a number of positive results; namely, that the cap helps to decrease hair loss during chemotherapy, is safe to use and is well-tolerated by patients.

Susan Melin, breast cancer specialist and Wake Forest Baptist associate professor of internal medicine-haematology and oncology, commented on the device, saying:

“One of the first questions my patients ask is whether they will lose their hair with the chemotherapy recommended for their breast cancer.

“Preventing chemotherapy-induced hair loss by using the scalp cooling cap may relieve severe psychological and emotional stress and improve the patient’s quality of life.”

Hair loss at any age can be alarming, but a condition in children can leave parents extremely worried. One potential cause of children’s hair loss is trichotillomania, an impulse-control disorder in which the child tugs at and pulls out his/her own hair.

Trichotillomania in children can be very distressing for parents, especially as not all children will admit to their behaviour. The condition is often associated with feelings of embarrassment or shame, which is why so many instances of trichotillomania go unreported, undiagnosed and untreated.

The good news for parents is that depending on the child’s age, behaviours associated with trichotillomania will go away on their own and the hair should grow back. If the condition shows itself when the child is under five years old, it is considered to be self-limiting and the child will grow out of the behaviour in time. Intervention is not normally required.

For older children and in more serious, persistent cases of trichotillomania, a type of psychosocial therapy may be needed. This may be in the form of habit reversal training, which teaches the child to recognise the trigger or the impulse to pull hair and learn new responses to it. Some types of anti-depressant medication can also be prescribed, although its success in curing the condition has not been fully proven.

If you notice your hair is starting to thin or fall out, you may immediately head online to seek out the cause and to look for some answers. Whilst the online community can be helpful when it comes to dealing with the emotional effects of hair loss, you really need to see a doctor first to get a formal diagnosis.

On visiting your GP, you are likely to be asked about:

• Diet
• Stress
• Hormonal changes (i.e. pregnancy or the menopause)
• Illness or major surgery
• Hair care and mistreatment (i.e. excessive dyeing or straightening)

Unless your hair loss condition is straightforward, you are then likely to be referred to a specialist, such as a dermatologist or trichologist for diagnosis. The specialist may perform a number of tests to determine what is causing your hair to full out, so you can expect any of the following:

• The pull test – this is where groups of hairs on different areas of the scalp are gently pulled to see if they loosen.

• The pluck test – this is where hair is pulled out by the roots for further examination

• Daily hair count – if the pull test is negative (less than three hairs fall out), the patient is asked to track and collect the number of hairs that fall out a day

• Scalp biopsy – a tiny sample of hair around the bald or thinning patch is taken for analysis