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When you have an autoimmune disease, your immune system attacks your own body. With alopecia areata, it’s the hair follicles that are attacked. This causes the hair to come out, often in clumps the size and shape of a quarter. The amount of hair loss is different in everyone. Some people lose it only in a few spots. Others lose a lot.
It’s rare, but you can lose all the hair on your head (alopecia areata totalis) or entire body (alopecia areata universalis).
Telogen Effluvium (TE) is probably the most common form of hair loss dermatologists see. If you’ve seen a lot of extra hair on your pillow, brush, or shower drain, you probably have what is called Telogen Effluvium. In essence though, TE happens when there is a change in the number of hair follicles growing hair. If the number of hair follicles producing hair drops significantly for any reason during the resting, or telogen phase, there will be a significant increase in dormant, telogen stage hair follicles. The result is shedding, or TE hair loss.
TE appears as a diffuse thinning of hair on the scalp, which may not be even all over. It can be a bit more severe in some areas of the scalp than others.
The shed hairs are typically telogen hairs, which can be recognized by a small bulb of keratin on the root end. Whether the keratinized lump is pigmented or unpigmented makes no difference; the hair fibers are still typical telogen hairs.
People with TE never completely lose all their scalp hair, but the hair can be noticeably thin in severe cases. While TE is often limited to the scalp, in more serious cases TE can affect other areas, like the eyebrows or pubic region.
Tinea Capitis, commonly known as ringworm of the scalp, is a fungal infection often seen in children. It can show up in a number of ways, but often as scaly patches of hair loss on the head. The patches are usually round or oval. The hairs may be broken off at the surface of the skin and look like black dots on the scalp.