A host of dermatologic situations can cause localized hair fall in women. The pattern that they produce is usually quite different from the diffuse arrangement of female genetic hair loss and is easily differentiated from it by an experienced dermatologist. Occasionally, the analysis is difficult to make and tests, such as a scalp biopsy are necessary. Localized hair shedding in women may be sub-divided into scarring and non-scarring types.
Alopecia Areata is a genetic, autoimmune disorder that typifies the non-scarring type. It manifests with the sudden onset of various, round patches of hair loss associated with normal underlying skin. It usually replies quite well to local injections of cortico-steroids.
Localized hair fall can be also be caused by stable pulling on scalp hair, either through braiding, tight clips or hair systems. Traction alopecia, the medical term for this condition, often causes reversible thinning but, if the tugging on the follicles continue for an extended period of time, the hair shedding can be stable. The most common presentation is thinning, or complete hair shedding, at the frontal hairline and in the temples of women who wear their hair pulled tightly back. Early traction alopecia can reverse itself by simply wearing the hair loss. A hair transplant may be needed to restore the hair that is permanently lost from sustained traction.
Scarring hair loss can be caused by a variety of medical or dermatologic conditions such as Discoid Lupus, Lichen Planus, and infections. It can also be caused by thermal burns or local radiation therapy. Face-lift surgery may result in permanent localized hair fall that can be particularly bothersome if it occurs at the frontal hairline or around the temples. Fortunately, localized hair loss from injury or from medical problems are often susceptible to hair transplantation.
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