Alopecia Areata represents an autoimmune form of hair loss where the bulb is attacked by circulating lymphocytes. It usually does not respond well to hair transplantation or medical treatments used in MPHL or FPHL. Topical or locally injected steroids are usually required to calm the inflammation. Once the hairs re-enter the growth phase they may be enhanced with topical minoxidil.
Arrector pili muscle is a tiny muscle that connects the base of the hair follicle with the skin. When it contracts, it literally makes the attached follicular unit ‘stand up on end.’ This occurrence is also better known as goose bumps!
Dermoscopy is a helpful tool to identify whether hair miniaturization is present. It involves using a polarized light to capture magnified images of the scalp and hair. It can also be helpful to see the distribution and number of hairs in the scalp. It also can be helpful to diagnose underlying skin conditions of the scalp such as seborrhea, psoriasis, or scarring alopecias. (See figures)
Depilatories are chemical creams used to soften and dissolve the hair shaft. They are applied as directed and then wiped away to leave a smooth skin surface. Great care should be used.
Keloid is a thick, itchy scar that can develop in a site of previous incision. We occasionally see them in donor scars of the scalp. They are slightly more common in African-Americans. They can respond to injections of steroid or to topical silicone dioxide cream, gel or sheeting. The best situation is to avoid them entirely!
Laser hair removal takes advantage of the fact that laser energy can be preferentially taken up by the pigment in hair shafts. It generally requires 6-10 treatments and may require occasional touch-ups over time.
Psoriasis is a chronic condition of the scalp resulting in dry, itchy, silvery scales. This condition responds well to topical steroid shampoos and solutions, ultraviolet light, and some of the newer biologic agents.
Sebaceous glands are found attached to nearly every hair follicle in the body. The help lubricate and protect the hair shaft. There is evidence that some stem cells exist in the sebaceous gland. By including this important organ each 1-4 hair graft, we help ensure the growth of the transplanted follicles.
Seborrheic Dermatitis is a clinical condition of the scalp which results in redness, itching, and flaking. It can be a chronic condition requiring prescription or OTC shampoos such as Head & Shoulders, Selsun Blue, Nizoral. Look for ingredients such as zinc pyrithione, ketoconazole, or selenium sulfide to treat this.
Telogen Effluvium represents sudden-onset, limited shedding due to major physiologic stress. It is not usually due to everyday work stress. It can be seen after childbirth, after high fever, prolonged illness/hospitalization, general anesthesia, crash dieting, or traumatic life events like death or divorce. Many patients have a slight shedding during the summer months, when the maximal number of hairs are in the telogen (resting) phase. The condition usually self-resolves over about 12 months. However if it lasts longer it may represent another hair loss condition such as early female pattern hair loss or diffuse alopecia areata.
Tinea Capitis is a fungal infection of the scalp. It can present as localized patches of hair loss with itching and scale.
Vaniqa® is a topical cream applied to areas of unwanted hair growth. Its active ingredient, eflornithine, works by blocking the enzyme ornithine decarboxylase which is a crucial enzyme in the hair growth process.