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What is Retrograde Alopecia? Major Causes, Effects, and Treatment

What does RETROGRADE ALOPECIA refer to?

The first notion which every medical term requires is to perceive its meaning in medical terminology. Hence the term “retrograde” refers to anything which undergoes deterioration, or catabolism (reduction) that will be against the usual growing pattern. On the other hand, the term “ALOPECIA” is known vernacularly as “HAIRFALL, HAIRLOSS, BALDNESS or BALDHEADED”.

“RETROGRADE ALOPECIA is the loss or miniaturizations of hairs at the bottom of the hairline and is proceeding towards the top of the head”

Another term “HYPOTRICHOSIS” also elaborates “ALOPECIA” but it’s a congenital disorder caused by an autosomal recessive gene. In this condition, the hairs are compactly curled, hard in texture and dry. This disorder is being faced from birth because the gene ( LIPHLPAR6, or DSG4 gene) that encodes the specific protein for hair growth is mutated. The hypotrichosis affected individual has only a few inch hairs in areas where hairs grow normally like eyelashes, scalp etc. Nowadays retrograde alopecia is imposing vast psychological complexes among society due to which dermatological practices have also been striving to cope up this issue.

CATEGORIZATION OF RETROGRADE ALOPECIA

Following are the types which specify the Alopecia in various forms:

  1. Female-pattern alopecia/ HAIRLOSS
  2. Male-pattern alopecia/ HAIRLOSS
  3. TELOGEN EFFLUVIUM
  4. ALOPECIA AREATA
  • The female pattern alopecia initiates by the weakening of hairs leading to extraction of hairs from the hair follicle and finally causing hair fall. Its orientated area is limited to the skin of the head.
  • The male pattern alopecia OR MPHL (male pattern hair-loss) targets only a brief portion of the scalp of the head. As some studies reveal that baldness is an X-linked trait hence this disorder is more pronounced in males. In MPHL the vertex or most cranial portion of the head is affected and hairs become fragile or deprived of that portion.
  • In TELOGEN EFFLUVIUM, the subject faces short-term hair-fall due to trauma faced by some system of the body and it leads to massive degradation of resting hairs. But after the body starts recovering from the trauma the hairs grow again. For example, as in CANCER PATIENTS hair, fall occurs after treating with chemotherapy.
  • ALOPECIA AREATA effects a coin-shaped portion, either on the scalp or other parts of the body, from hair loss. Therefore, it is also known as “SPOT BALDNESS”. It is an autoimmune disorder. This condition also aggravates the psychological trauma.

Further three classes of ALOPECIA AREATA are

  1. Alopecia areata
  2. Alopecia areata totalis
  3. Alopecia areata universalis.

In all these 3 types of alopecia areata, the hair follicles retain the life and are prepared to continue normal hair production whenever they get the appropriate signal.

retrograde alopecia

SEMIOLOGY OF RETROGRADE ALOPECIA

It is a fact that while discussing the symptoms of this disorder the average number of hairs on an individual head, that is 1 hundred thousand to 150 thousand, will suffer deprivation from their natural habitat. When this hair loss exceeds the average loss in a day which is 100 and lost hairs are not replaced by new ones then it signalling toward alopecia. In the medical profession, the signs or symptoms or semiology of retrograde alopecia can be classified drastically in three major aspects:

  1. Symptoms revealed on SKIN
  2. Psychological symptoms
  3. Systemic symptoms leading to alopecia (HORMONAL IMBALANCE)

The symptoms of RETROGRADE ALOPECIA on the skin are observed macroscopically and it includes seborrhea (dandruff), scarring, skin erosion or lesions on the skin, circular fashion hair loss, and VITILIGO (discolouration of various patches on the skin).

SEBORRHEIC DERMATITIS is defined as inflammation of the dermal layer of skin causing malfunctioning of sebum glands and affects the oil-producing glands in the skin especially on the scalp, around the mouth and other body parts. The less severe form of this disease is DANDRUFF which occurs with aggravating the inflammation process. In most chronic cases inflamed, irritable, reddish and scale-like skin patches are observed. Alopecia occurs when sebaceous glands of the skin are malfunctioned and causes crust formation due to which hair follicles are unable to cause proliferation of hairs. It may also occur due to fungal infection causing hindrance in hair growth.

When we come across psychological symptoms associated with retrograde alopecia, then we all know that as hairs are one the god gifted blessing to every human being which plays a vital role in enhancing personality and also gives the subject its youthful appearance. It’s a norm in every society that baldness impacts every human being psychologically and mentally and this norm is truer for women. In 1960 as the branch of psychology which emphasizes that people with good personality are more prevalent towards achieving life goals also reveals that people having a deficit of hairs are more prone to depression, anxiety, social stigma introverts, and bullying among society. These all factors prevail the medical science progress to strive for treatment and cure of retrograde ALOPECIA.

Among the systemic disorders including particularly hormonal disturbance causes an imbalance in the production of DIHYDROTESTOSTERONE (DHT) which testosterone derived androgen. Androgens are characterized as that hormone which specifies sex-oriented characters in men. Testosterone is the hormone which is found in both sexes (male & female). Approximately 10% of the testosterone is being converted into DHT by an enzyme known as 5alpha reductase and it plays a vital role in causing hair fall. When DHT initiated its binding to receptors present on hair follicle then consequently it leads to thinning of hairs and then hair fall.

Also Read: Ichthyosis in Dogs 

Treatment of RETROGRADE ALOPECIA

The treatment for retrograde alopecia depends on the severity of the disorder and is classified according to the patient’s desire:

  1. Medication
  2. Surgical manipulation
  3. Diet supplementation

So far the use of drugs or medicines to treat retrograde alopecia is concerned first of all the subject must consult his/her dermatologist before taking any sort of drugs and should share his/her genetic history and all outcomes with the doctor. Generally, the following drugs are frequently used to treat alopecia related disorders whether it belongs to any type of alopecia:

  • Minoxidil: an orally taken drug which is specifically used for treating MPHL and it mechanism is based on the fact that reduces the production of DHT (DIHYDROTESTOSTERONE). But this drug must be carefully taken if the subject is above 18 years old. This medicine also acts as a vasodilator. Minoxidil is also available in spray bottles and can be sprayed on the scalp to treat hair fall.
  • Synthetic steroid hormone: Corticosteroids are injected on monthly basis to treat retrograde alopecia and this hormonal therapy reveals the result after months.
  • FINASTERIDE: This drug is sold under the brand name PROSCAR or PROPECIA and can only be purchased under dermatological prescription. It is specifically used to treat MALE pattern hair fall.
  • BIOTIN: an essential vitamin which is required by the body in order to accomplish metabolic activity as it acts as micronutrients. Its main function is to enhance hair thickness and ultimately it causes hair growth.

retrograde alopecia

SURGICAL MANIPULATION

  • Hair transplantation is a procedure which is on top list nowadays in dermatological clinics and every next door patient affected with hair loss problems want this treatment. It is divided into the following main categories:
  1. Punch hair transplantation: This is a phenomenon, which comprises extracting a patch of skin containing hairs with the help of an instrument called punch i.e. punch graft, which acts as a donor graft and it, is then implanted to a recipient area having the same stencil for the donor area.
  2. Alopecia reduction surgery: It is a surgical procedure in which the alopecia affected area is excised surgically and the opposite sides of the skin are sutured. This procedure has some limitations that it can only be employed on a large patch of skin affected with hair fall.
  3. Flap hair transplantation procedures: it is surgical manipulation in which flaps from hair rich portion of the scalp are taken and then grafted to alopecia affected area which gives growth to hairs after few months very close to natural hairs.
  • PRP or plasma rich platelet therapy is a procedure which comprises of plasma being infiltrated in the affected scalp.

Cure of RETROGRADE ALOPECIA

The main aspect which is needed to be focused while mentioning the cure of retrograde alopecia is that DIET plays a vital role in maintaining hair health. A malnourished and underfed individual will definitely face hair related issues. Some dietary prerequisites which can be taken in order to avoid retrograde alopecia include:

  1. Supplementing the daily diet schedule with biotin-rich food that is egg yolk, spinach, wheat straws and white mushrooms. Hence deficiency of biotin causes brittleness of hairs and hair loss more common in people having alcohol drinking habits.
  2. By using aloe vera, black sesame seed, flaxseed, poppy seed, black sesame, fennel seed, and Indian gooseberry in diet plans may also strengthen the hairs and avoids alopecia in advance ages
  3. By correcting the fault in thyroid functioning because T4, T3 and calcitonin are hormones responsible for making major metabolic changes in the body.
  4. In advance ages, the prevailing factor in aggravating the situation is psychological disorders including stress, depression and social in acceptance causing retrograde alopecia. It can simply be cured by promoting social acceptance for people affected with retrograde alopecia either through congenital causes or advance ages.
  5. By opting for the proper regime of massaging hair oil alopecia can be cured.

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