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Scientific Area

Psychogenic alopecia (psychological baldness)

CATEGORIES SCIENTIFIC AREA

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.

Quando lo stress è la causa dell’alopecia

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.

Le cure dell’alopecia da stress (o alopecia psicogena)

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 psoriasis

La psoriasi è una frequente dermatosi cronica eritemo-squamosa con squama tipica (psoriasica), circoscritta o diffusa.
La psoriasi è un problema del cuoio capelluto non annoverata tra le cause che comportano la caduta dei capelli.

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Dry hair

Both men and women of any age may have dry hair. This situation is endured not only as an aesthetic problem, but in time may represent a problem concerning hair health. Dry hair often appears weak, fragile and tends to become brittle and to break.
Dry hair often has split ends and other forms of damage to the shaft.

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Premature hair loss

Recent studies have demonstrated that around one in five young men tend to lose their hair prematurely over time.
This problem does not affect only young men but also young women.

In the majority of cases, it is androgenetic alopecia (pattern hair loss) and therefore is hereditary/genetic. However, it is important to remember that often factors of psychological origin like performance anxiety, trauma and emotional stress take over, thereby becoming a source and cause of hair loss from stress.

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Structure and chemical composition of hair

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…

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Hair loss from trichotillomania

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.

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Damaged hair

Changes in the hair shaft lead to deterioration with the appearance of ruined or damaged hair.
In healthy hair, the cuticle is whole, with overlapping shingles. Hair with whole ends appears shiny, elastic and brushes easily.

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