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Hair loss (telogen defluvium)

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.

What does Telogen Defluvium (or Defluvium) mean?

With the term Telogen Defluvium we mean a modest, not excessive, loss of hair in the telogen phase, but which tends to often be irreversible, with the precise characteristics of hair in decay or involution. The hair that falls out is usually short and fine, with bulbs that are undeveloped and reduced in size.

Terapie efficaci del Telogen Effluvio acuto

Telogen Defluvium is nothing other than Androgenetic Defluvium (pattern hair loss).
With Telogen Defluvium the number of hairs lost does not exceed 100. With the pull test only two or three hairs at most are usually obtained. This means that due to the defluvium, the anagen phase has become temporally shorter (compared to its usually length), thus reducing the ability of hair follicles to sustain hair growth.
An alteration of the trichogram is almost non-existent with a number of hair in the anagen phase at around 80% due to a temporal reduction of the anagen phase of the hair follicle.

Due to a very short anagen phase, between 10% and 60% of fallen hair are short, thin and with bulbs that have a very thin diameter. They are moreover located on the surface of the dermis compared to hair that has a normal growth cycle. This hair is in between terminal hair and vellus hair.
It is included among hair in the involution phase with a short anagen phase and therefore is considered like hair in the premature telogen phase which falls out before its time. It is short and thin because it does not have time to develop (short anagen phase), it appears small and involute after a very short anagen phase and is characteristic of this form of hair loss. The follicle remains histologically present for a long time, even if it is not as deep and contains a hair that is increasingly involute. Only very late does this hair go towards hyalinosis.

This is a pathological process that may manifest in various bodily structures, characterized by the intra- and extra-cellular accumulation of material, called hyaliane, which damages the structure and function of the affected areas, resulting in progressive atrophy. The hair loss resulting from this is similar to a scarring form with loss of the skin adnexa.
We can distinguish between an acute form of Telogen Defluvium (very intense and characterized by a temporary loss of hair) and a chronic form of Telogen Defluvium (a modest type with a constant loss of hair).
In men common causes of Telogen Defluvium are both pattern hair loss (chronic telogen defluvium) and male frontoparietal alopecia (chronic telogen defluvium).
Instead, in women common causes of Telogen Defluvium are more numerous. Among them we note: pattern hair loss from drugs (acute telogen defluvium), post-menopause hair loss (acute telogen defluvium), hair loss from androgen secreting tumors (acute telogen defluvium), hereditary hair loss (chronic telogen defluvium), polycystic ovary hair loss, congenital adrenal hyperplasia hair loss (acute telogen defluvium), hair loss from anorexia nervosa (acute telogen defluvium) and lastly hair loss from hyperprolactinemia (acute telogen defluvium).

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 (telogen effluvium)

The term Telogen Effluvium was introduced for the first time by Kligman (*) in 1961 to introduce an acute hair loss of benign origin that follows an intense and short period of stress of different types. Subsequently, Rebora (**) introduced the concept of chronic Telogen Effluvium.

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Alopécia areata

A alopécia areata é uma doença ligada a um distúrbio crônico da imunidade que afeta os folículos na fase anágena (crescimento) e que geralmente causa manchas sem pelos no couro cabeludo e em outras áreas do corpo.

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Brittle hair

Brittle hair is hair that appears opaque and without shininess. It is characterized by glaringly visible damage and deterioration of the shaft.
The causes that lead to the problem of brittle hair may be of endogenous and exogenous origin.

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Alopécia cicatricial

A alopécia cicatricial ocorre por processos patológicos que levam à destruição do folículo piloso. Muitas vezes, o diagnóstico clínico ou por biópsia que diferencia suas várias formas é difícil, ou mesmo, impossível.

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Scalp pain

Scalp pain and irritation (or trichodynia) are pathological conditions that affect both women (in a greater percentage) and men (in a lower percentage). The pain felt on the scalp, spontaneous or caused by treatment, and in particular around the roots of the hair, may be more or less intense, alternating at times between periods of disappearance, associated with burning, tingling or itching.

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