Concept
Non scarring hair loss, also known as noncicatricial alopecia is the loss of hair without any scarring being present. There is typically little inflammation and irritation, but hair loss is significant. This is in contrast to scarring hair loss during which hair follicles are replaced with scar tissue as a result of inflammation. Hair loss may be spread throughout the scalp (diffuse) or at certain spots (focal). The loss may be sudden or gradual with accompanying stress. The most common cause is androgenetic alopecia, also known as male pattern or female pattern hair loss due to the effects of dihydrotestosterone (DHT) on the hair follicles. A variety of factors may lead to this condition such as hormonal effects, age, diet, autoimmunity, emotional stress, physical stress, drug effects, genetics, or infections. Depending on the cause, treatment options include: topical minoxidil, oral finasteride, anti-fungal medications, steroids, hair transplantation, or platelet rich plasma (PRP) therapy. Alternatives for total hair loss include the use of hairpieces or hair fibers. Patients will notice either focal or diffuse loss of hair. This may occur due to thinning or shedding of the hair over a sudden or gradual period of time. Stress may be present, and the emotional impact of hair loss is important as it may cause significant distress. Other signs may point to specific causes of the condition. Poor diet may lead to tiredness, other side effects of chemotherapy drugs may be seen, infection can cause itching, stress may lead to pulling of hair or falling of hair. Hair loss may be present in the family, highlighting genetic causes. Causes of noncicatricial alopecia can be separated based on focal or diffuse hair loss: Diffuse: Androgenetic alopecia: androgenic DHT leads to catagenic miniaturization of hair follicles.