Scientific collaboration between Professor Marco Toscani and Dr. Pasquale Fino, Chair of Plastic, Reconstructive and Aesthetic Surgery, Umberto I Health Center – “Sapienza” University of Rome.
Psychogenic alopecia is a type of hair loss related to stress. Though not yet scientifically explained, this connection is well-known in the experience of those working with the problem. In addition to stress, other causes are personality disorders, states of anxiety and depression, all of which are conditions of acute or chronic stress.
The mechanism of action is nevertheless related to a “somatization” process or rather to a physical reflection of psychological stress; this makes the condition different than traction alopecia (hair loss from pulling), which is also related to a psychological disorder but of the behavioural type (it is a mechanical action that leads to the condition of hair loss).
Before defining the hair loss as psychogenic, spot baldness and pattern hair loss need to be excluded. This is not a simple diagnosis and the conditions may even overlap. More than one study has implicated the hypothalamus and the pituitary gland in the biological reaction to stress, which leads to the release of adrenocorticotropic hormones in the circulation that affect cells involved in hair formation and nourishment: cells producing sebum, keratinocytes, fibroblasts and immune cells. This reaction leads to: hypersecretion of sebum that often turns into seborrheic dermatitis; trichodynia (sensation of scalp pain), especially around the crown; perifollicular inflammation (reddened skin around the hair region).
All of these symptoms may also occur in the other two types of hair loss mentioned above.
Unlike spot baldness, which generally proceeds in patches, female stress-related hair loss leads to a scattered thinning of hair, more marked in the crown area, without recession of the hairline. In men, in addition to general thinning, the condition also leads to a receding hairline.
Obviously the best cure is removal of the stress, but this is particularly difficult, especially in individuals suffering from psychogenic hair loss who are definitely people that tend to have difficulty releasing their tension. It may prove hard to remove the cause for the stress and even psychotherapeutic approaches may take a lot of time without ever guaranteeing complete removal of the stress.
Treatment definitely requires consistency and perseverance. The therapy includes: minoxidil, finasteride and laser therapy, which do not remove the cause but are a valuable aid in countering the effects of the stress.
Scalp itchiness of varying intensity is a sensation perceived by many people of both sexes.
Itchiness is a scalp problem that leads those afflicted to scratch their skin and is often associated with pain. Many causes of this illness are recognized, which shouldn’t be underestimated as it may cause hair loss or thinning.
Seborrheic hair loss is a form of premature hair loss that generally afflicts men in their youth (onset between 20 and 30 years of age), mainly affecting the frontal region and the crown. The cause, as the name of the condition suggests, is related to an excess production of sebum that provokes or accelerates hair loss.
The hair on our bodies has a particular structure and is divided into thin and thick hair. Thin hair, also called lanugo or vellus, is located on all skin surfaces except for the palms of the hands and the soles of the feet. Thick hair, also called terminal hair, is dark and located only in some areas such as the scalp, the armpits, the pubic area, the beard area in the case of men, etc…
Excess sweat production on the entire surface of the body or just in some areas (especially the scalp, palms of the hands, soles of the feet) is called hyperhidrosis.
Some of the causes that may lead to temporary hyperhidrosis are physical hyperactivity, fevers, saunas, vomiting and dysentery. Causes that may instead lead to a repeated state of hyperhidrosis are hyperthyroidism, hypoglycemia and alcoholism
Trichotillomania is a type of hair loss due to voluntary pulling by the patient which often ends up breaking the hair shaft. In general, the patient twists the hair around a finger.
The gesture is occasional when going to sleep or concentrating on a task, but may become repetitive or obsessive.
A shedding of hair is considered physiologically normal when hair loss is limited to around one hundred hairs per day. During an individual’s life hair grows, falls out and regrows around twenty times. Each cycle, especially for females, may last up to six years and if hair loss is found within this time frame, it is considered absolutely physiological.
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