Dermatology. Alopecia. patientinformation. Rotherham Hospital Your health, your choice, our passion

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1 Dermatology Alopecia patientinformation Rotherham Hospital Your health, your choice, our passion

2

3 What is alopecia? Alopecia is a general medical term for all forms of hair loss, from the patchy baldness of alopecia areata, which in some cases becomes total loss, to the diffuse thinning and male pattern baldness of alopecia androgenetica. Hair loss can be sudden, frightening and severe. Although it is not life threatening or even physically painful, alopecia causes a high level of psychological and emotional suffering. Types and symptoms Alopecia areata (patchy baldness) Affects men, women and children. It usually starts with a tiny patch of baldness. Other patches may follow and as one patch re-grows hair often falls out in another. Alopecia areata may spread all over the scalp. The affected hair follicles slow down production, become very small and often grow no hair that is visible above the surface for months or years. The follicles normally remain alive and are ready to resume normal hair production whenever they receive the appropriate signal or trigger. In a third of all cases, patients will have only one small patch of baldness. The hair re-grows spontaneously and they never suffer a further episode. Two thirds of patients suffer the patchy baldness of Alopecia areata throughout their lives. Alopecia areata can develop into total loss of scalp hair (alopecia totalis) or the loss of all body hair including the scalp - alopecia universalis - which occurs in about one fifth of cases. 3

4 Alopecia androgenetica (male pattern baldness) A large number of women suffer from thinning hair. In a woman, this can be the female version of alopecia androgenetica, the natural balding of ageing. It often occurs after the menopause but is also prevalent in younger women who are genetically predisposed to the condition. It can manifest itself when triggered by such factors as eating disorders or an over-sensitivity to the progestogens contained in some types of contraceptive pill. Male pattern baldness often causes a great deal of distress, particularly in men whose work brings then into contact with the public. It can cause a marked fall in self-esteem. Telogen effluvium ( human moult ) Hair loss occurs after the body has suffered severe trauma. It can occur after a high fever, childbirth or extreme shock. Hair loss related to medication Some drugs prescribed for other conditions can cause hair thinning, including some psychiatric drugs (eg. Anti-depressants), anticoagulants eg. Warfarin and chemotherapy treatment. Self-inflicted hair loss (Trichotillomania) Trichotillomania is an obsessional compulsive disorder in which many patients pull out their own hair. 4

5 Causes of alopecia Alopecia areata is believed to be an autoimmune disease in which the body rejects the hair follicles as foreign. Atopic syndrome often plays a part and alopecia areata frequently occurs in patients who have had asthma or eczema from birth. Other factors which can be involved in its onset are thyroid conditions, anaemia and stress. It can also be a familial problem. One in five patients can recall a relative with a similar condition. Many younger women develop alopecia androgenetica because they have an over-sensitivity to the male hormones (androgens) in the blood. When they have this sensitivity contraceptive pills containing progestogen can make the problem worse. Hormone replacement therapy (HRT) is similar to the pill and many women find that their hair becomes thinner during this treatment. The stress of modern life is also a common cause. 5

6 Treatments for alopecia Re-growth success is not always easy to achieve and doctors are cautious of raising false hopes by offering treatment. For alopecia areata and its related conditions, re-growth success has been achieved by using a combination therapy of topical steroid creams plus topical minoxidil, systemic steroids (such as prednisolone), and occasionally, zinc. The use of powerful steroids can sometimes be enough to kick start the hair into re-growth although doctors urge caution and careful monitoring for side effects. In severe cases, and those of total loss, the phenol derivative diphencyprone can be successful. In less severe cases of both alopecia androgenetica and alopecia areata, minoxidil alone applied to the area can sometimes promote re-growth. Anti-androgen drugs such as cyproterone acetate can also help in alopecia androgenetica. Finasteride, the drug for the treatment of enlarged male prostate has recently been licensed for the treatment of hair loss in men. 6

7 Support groups Hairline International The Alopecia Patients Society Lyons Court 1668 High Street Knowle West Midlands B93 0LY Reg. Charity No Telephone Fax For information on membership please enclose an A4 SAE. Hair International is a national support network for those who have lost or are losing their hair and supports all Alopecia patients whatever their type of hair loss. The organisation: l Provides information on the condition and its medical treatments l Maintains a network of contacts to share experiences l Advises on suitable prostheses and available experts l Campaigns to raise public awareness 7

8 Support groups Alopecia UK 5 Titchwell Road London SW18 3LW Telelphone Information about entitlement to free wigs is given in the NHS leaflet HC11. 8

9 Notes 9

10 Useful contact numbers NHS Direct Telephone Patient Services Telephone Health Info Telephone Stop Smoking Service Telephone For GP out of hours, contact your surgery Useful websites If you require this document in another language, large print, braille or audio version, please contact Patient Information on or Produced by Dr M. Wood, November Version 4.0. Revised November 2006, March 2009, February Revision due February The Rotherham NHS Foundation Trust All rights reserved. 10

11 How to find us Hospital site plan Woodlands P Two Way traffic One Way traffic Public Parking Leapfrog Day Nursery Child Development Centre Oakwood Hall Greenoaks P Oakwood Hall Annexe P Oldfield Centre Moorgate Wing OAKWOOD HALL DRIVE Day Surgery Centre Maternity Entrance Rotherham Hospital Main Entrance Accident & Emergency P PAY AND DISPLAY P PAY AND DISPLAY P PAY AND DISPLAY One Way Bus stop BAKER STREET MOORGATE One way Bus stop ROAD A618 Bus stop Security Centre TO WOODSIDE Rotherham main routes To Leeds Parkgate To Doncaster 35 Thorpe Hesley B6089 A633 M1 North 34 South To Sheffield 34 Kimberworth Park A629 Kimberworth A630 A6109 Woodside A631 Brinsworth A630 To Sheffield TOWN CENTRE A Treeton A630 Clifton Moorgate A618 A631 East Dene Rotherham Hospital A6123 Whiston A618 Herringthorpe A631 M1 Wickersley Bramley M1 32 A631 To A1, M62 & Hull M18 1 To Nottingham and the South

12 LS 95 02/12 V4 WFO How to contact us Dermatology Reception Monday to Friday 9.00am to 4.30pm Telephone Dermatology Department Monday to Friday 8.00am until 8.00pm Saturdays and Bank Holidays 9.00am until 5.00pm Telephone Switchboard Telephone Rotherham Hospital Moorgate Road Oakwood Rotherham S60 2UD Telephone Sustainable Forests / Low chlorine

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