The alopecia are responsible for hair loss in some localized areas of the scalp. The total or partial absence of hair can occur as a factor genetic isolation (isolated alopecia) or in combination with abnormalities of other organs (ectodermal dysplasia, syndromes, ichthyosis, premature aging, telangiectasia, DNA instability, chromosomal disorders, etc..) or by association with abnormalities in the structure of the stem pilaris (moniletrix syndrome Menkes syndrome impettinabili hair, trichothiodystrophy). Androgenetic Alopecia
's androgenetic alopecia or seborrheic or common baldness is a progressive thinning of the part of the fronto-occipital scalp. Alopecia is more common, affecting most of the population of the white race, even with different severity. In other ethnic groups is less common.
The clinical picture involves a thinning face time with the formation of the "bald" in the male and female thinning in the frontal and parietal cortices, which preserves the frontal hair line. A framework of masculine type occurs in the female treated with androgen. A minority of males has, for unknown reasons, a framework for women. The patient complains of a modest increase in hair loss with a characteristic peak fall , but may present acute episodes of hair loss . According to some there is a bald person in the small risk of coronary heart disease.
The disease begins around puberty with the beginning dell'increzione androgen, and progresses with age at different rates from individual to individual depending on heredity. Males with his father and maternal grandfather are usually completely bald already advanced in the second decade of life. The females in the same conditions are of obvious thinning in the fourth decade, but rarely reaches the stage corresponding male.
There is no evidence that hair loss depends on a reduced blood supply to the scalp. The key element is actually the pathogenic activity of 5a-reductase type II, which converts testosterone into dihydrotestosterone. The values \u200b\u200bof dihydrotestosterone and androstenedione in follicles in the anagen phase of the patients are in fact much higher than in controls and 5a-reduced metabolites are increased in the frontal than occipital areas, always spared baldness.
In women the course can be accelerated by specific endocrine conditions (menopause PCOS. Virilizing tumors) or by treatment with androgens.
least in the early stages you do not have the disappearance of the follicle, but only the regression of the terminal to vellus hair, a bit more 'up, like that of infants. In the young bald, in fact, the vellus are easily visible with the incident light. In older age overlap phenomena atrophic scalp, which becomes thin and shiny. In this phase also vellus disappeared. A second pathological process is the loss Pilari cycles of individuality characteristic of the normal adult scalp and thus their timing.
Remedies for Alopecia?
Topical therapy consists of the traditional preparations rubefacient or hormone (estrogen-progestin. Antiandrogens) are commercially available. Their alleged activities is not documented.
More documented is the action of minoxidil, an antihypertensive piperidine-pyrimidine used in solution to 2-5%. Application twice daily results, not before the third month of therapy to reverse the process of transformation from vellus hair to terminal hair in about 30% of males. In women the effect is better. However, the suspension or reduction of minoxidil alone involves regression to the previous situation. Side effects are local irritant dermatitis due to glycol vehicle and allergic contact dermatitis. Episodes are relatively common yellowing of white hair. In women the effect Tricogen is expressed not only on the scalp also on the face, limbs and trunk, apparently to transcutaneous absorption. There may be rare effects such as hypotension, but they are very small if the drug is used properly. It should be avoided by the application on inflamed skin (seborrheic dermatitis or irritant dermatitis or allergic).
Systemic therapy makes use of antiandrogen drugs. Documented Finasteride is the action of an inhibitor of 5a-reductase type II . It is generally used for the dose of 1 mg / per giornp. In third. Of cases the result aesthetically pleasing within two years. However, if the treatment is stopped, in about 20 months to return to the situation in which the patient would come if he had not started treatment. At the doses given, the effects of any color in the medium term are irrelevant. As in pregnancy finasteride might induce the feminization of male fetus, the drug is contraindicated in women of childbearing potential. It would not seem active in menopausal women.
In women, therefore, the only drug used is minoxidil. can, In addition, correct rituals endocrine abnormalities, particularly polycystic ovary syndrome.
nell'autotrapianto Surgical therapy consists mainly, but also on the reduction of hairless, the expansion of the area that keeps the hair, scalp and the extension of the transposition of flaps of the same. The technique of surgical
provides micro transplantation and transplantation of follicular units, ie groups of 2-3 hairs. In practice, the occipital area are taken full-thickness skin strips 5 cm wide and about 15 cm long, containing the hair, taking care not to damage their bulbi.Mentre the surgical wound is saturated, the obtained strip is divided into pieces containing a variable number of hair.
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