Most forms of alopecia and other hair loss conditions are temporary, although there is never any guarantee that the hair will grow back. In some cases it takes months and grows back on its own, whilst in others it takes years and a whole heap of different treatments. Only your doctor or trichologist can advise you on how your particular hair loss condition will affect you, and for how long.

In one rare and fairly aggressive condition, however, the hair will never grow back. This is a very difficult fact for sufferers to deal with.

The condition is called cicatricial alopecia, a term referring to a group of rare hair loss disorders in which the hair follicles are destroyed and replaced with scar tissue. For some people, the hair loss will be gradual. For others, it will be rapid, as well as itchy and painful.

There are two main types of cicatricial alopecia – primary conditions in which follicles are destroyed by an inflammatory process, and secondary disorders in which the destruction is caused by an infection, burn, tumour or other injury.

Diagnosis and treatment

Cicatricial alopecia can be identified by a trichologist following a scalp biopsy and evaluation, which may include a hair pull test. This should lead to a formal diagnosis. Treatment of the condition, depending on the variety, is complex and varies from case to case. However, the hair is not likely to grow back.
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Most people have heard of alopecia as a cause of hair loss, and some may even know the three main varieties. These are alopecia areata (patchy loss of hair), alopecia totalis (complete loss of hair on the head) and alopecia universalis (complete loss of hair all over the body).

As with all medical conditions in humans, however, there are many more varieties of alopecia, although occurrences of them tend to be quite rare.

One such variety is alopecia mucinosa, a cutaneous condition (meaning that it affects hair, skin and nails) which can cause hair loss. Also known as ‘Pinkus’ follicular mucinosis, the condition causes symptoms such as reddened papules, lesions and flat bald patches to form on the scalp, face and neck.

It is the abnormal accumulation of mucin, a normal substance, in the cells of hair follicles.

What causes alopecia mucinosa?

The exact causes of the condition are not known, although it is often linked to problems with the immune system. Alopecia mucinosa is also associated with systemic diseases and lymphoma.

Treatment of the condition

The generally prescribed treatments for alopecia mucinosa include topical corticosteroids (applied to the skin), oral antibiotics and topical and systemic photochemotherapy (PUVA).

Nutrition has always been linked to healthy hair and normal growth, which is why a poor diet can negatively affect it. If your diet is lacking in certain nutrients, vitamins and minerals, you could potentially experience some degree of hair loss.

One of these important nutrients is iron, which is needed for making red blood cells, carrying oxygen from the lungs to the tissues via haemoglobin and helping with enzyme reactions. If you have too little iron in your body, you may suffer from iron deficiency anaemia. This can happen due to:

• Chronic bleeding
• Malabsorption syndromes, or a substance interfering with iron absorption
• Blood donation
• Inadequate intake – this can occur if you don’t get enough iron in your diet.

Hair loss

Amongst other symptoms including fatigue, irritability and weakness, people with iron deficiency anaemia often experience hair loss. Along with grooved or brittle nails, this is an outward sign of the deficiency, one which tends to cause the most distress for sufferers.

Diagnosis and treatment

In order to treat your iron deficiency and in turn, your hair loss, you need to first see your GP for a formal diagnosis. You are then likely to be advised to take iron diet supplements or increase the amount of iron-rich foods you eat (i.e. red meats, leafy vegetables, poultry etc).

If you are worried that your child is suffering from hair loss, you are likely to have been scouring the internet for potential causes and solutions. One cause you may have come across is fungal infection, but can this really cause hair loss in children?

The short answer to this question is yes – fungal infections of the scalp can cause children to lose their hair in patches through a condition called Tinea capitis. This condition, also known as ‘ringworm of the scalp’ often occurs in pre-pubertal children, and it is uncommon in adults. It is also more likely to occur in boys rather than girls.

Symptoms to look out for

If your child has Tinea capitis, you will notice one or many of the following symptoms:

• Scaly or thickened swellings
• Expanding red rings
• Dandruff
• Severe itching of the scalp
• Bald patches

If you notice these symptoms or any others indicative of hair loss, it is important to take your child to your GP or hair loss specialist for a formal diagnosis.

Treatment

Treating Tinea capitis is relatively straightforward, as it simply requires a safe and affordable medication to be taken orally by the affected child over a period of six to eight weeks.

If you have noticed that your hair is falling out, thinning or is more brittle than normal, it’s important to try not to panic. You may not be suffering from a serious hair loss condition such as alopecia or telogen effluvium; you might find it’s just a temporary problem.

Temporary hair loss can be caused by any of the following:

Medical

• Medical conditions – i.e. diabetes, thyroid disease.
• Drugs and medication – i.e. hormone replacement therapy medication, contraceptive pills
• Cancer treatments such as chemotherapy and radiotherapy

Diet

• Lack of essential vitamins and minerals such as vitamin B-12, protein and iron
• Eating disorders – i.e. bulimia or anorexia

Poor hair care

• Aggressive over-brushing
• Too much heat used in styling
• Hairstyles which put too much tension on the scalp – this can cause a female hair loss condition called traction alopecia
• Excessive application of hair dyes, highlights or other chemical or bleaching treatments

A number of these factors and causes are easy to remedy, meaning that your hair loss is preventable. However, for hair loss caused by cancer treatment or a hereditary condition (i.e. telogen effluvium, or pattern baldness), you may have to face up to the fact that you will lose some of your hair.

If you are suffering from a hair loss condition or are worried about losing your hair, it can be useful to know more about the hair growth cycle itself.

There are three main stages in a normal hair growth cycle:

Anagen phase

This is the growth phase, which can last up to eight years. During this time, the hair grows approximately 0.5 inches per month or 6 inches per year. The longer the follicles remain in the anagen phase, the longer and faster the hair will grow.

Catagen phase

This is known as the transitional phase, in which the hair follicles renew themselves before the next phase begins. It generally lasts around two weeks.

Telogen phase

The telogen phase is also known as the resting phase, as it involves the follicles remaining dormant for an extended period of time. This phase generally lasts between one and four months, and 10 -15 per cent of a person’s hairs are in this phase at any one time. Telogen also causes normal hair shedding; it is only when a person develops the hair loss condition telogen effluvium that massive, diffuse shedding is experienced.