The terms hypotrichosis and “hypertrichosis” are often associated and confused with each other, but they both have different meanings: people who suffer from hypotrichosis have reduced body hair than usual (Greek: hypo: less) and thus often suffer from hair loss. People with hypertrichosis instead have excessive hair growth due to a gene effect, which is why hair grows all over the body, especially on the face. This is why they are often called “wolf people”.
What is hypotrichosis?
Hypotrichosis is the reduced number of hairs, which is often noticeable by hair loss and can result with other impairments such as growth disorders, hair change disorders and ectoparasites (blood-sucking anthropods such as mosquitoes, lice or ticks). Hypotrichosis is often associated with alopecia, or hair loss, but it tends to describe permanent hair loss in a specific region, whereas in the disease hypotrichosis, hair growth stops in several parts of the body.
Causes
The causes of hypotrichosis are similar to those of hair loss: they can be very different, but they are usually the following origins: genetic susceptibilities, disorders of the immune system, taking medications,
Infectious diseases, congenital changes, and thyroid dysfunction. Genetic hair root sensitivities often occur in men due to an impairment of the male sex hormone testosterone: the growth phase of the hair, also called the anagen phase, starts to become shorter and hair follicles (structures surrounding the hair) start to shrink. This leads to the production of only small, thin woolly hairs (vellus hairs) that are barely visible. No more hairs are produced and the vellus hairs can either remain or also fall out. If the immune system is disturbed, the body’s own defense cells attack the hair roots, whereupon hair growth is stopped and the hair falls out. Outside the disease hypotrichosis, the hair roots can nevertheless reawaken and hair production starts again; this is also called dormancy. Taking medications and thyroid dysfunction can lead to damage of hair roots and complete stop of hair growth: In hyperthyroidism (hyperthyroidism), the thyroid gland produces an excessive amount of the hormones thyroxine and triiodothyronine, which results in damage to the hair follicles. In hypotrichosis with juvenile macular dystrophy, a gene defect is the cause: mutations are present in the gene CDH3, which encodes a calcium-binding protein. This leads to complex heterozygosity, two different mutant alleles.
Symptoms, complaints, and signs
Hair loss is manifested by a number of distinct symptoms and complaints. Initially, hypotrichosis can be recognized by the thinning patches that appear seemingly overnight on various parts of the body. Some patients experience pain on the scalp and other areas of the body that are normally heavily hairy. Prolonged hypotrichosis can also cause emotional distress. Many sufferers develop psychological disorders in the course of the disease, such as social anxiety, depressive moods or inferiority complexes. In particular, people in whom hair loss occurs suddenly suffer from the external changes and require the support of a therapist. Depending on the cause, hypotrichosis can cause further symptoms and complaints. For example, if the hair loss is based on an autoimmune disease, scarring of the scalp may occur, which is often associated with pain and skin irritation. If an imbalance in the hormonal balance is the cause, further physical changes and diseases may occur. If the complaints are based on a disease of the scalp, symptoms of the skin may occur. Redness and itching of the scalp, dandruff and psoriasis are typical. In addition, hypotrichosis originating from the scalp may be associated with excessively dry skin.
Diagnosis and course of the disease
The disease is often quickly noticeable even without a special examination, especially in cases of hair loss in several areas of the body. But for diagnosis, a tirichogram is usually used; This is an examination method that determines the current status of the hair root.For this purpose, the patient must not wash the hair for at least five days before the examination, and the hair must not be dyed two weeks beforehand. Hair samples are torn out or epilated, and the trichogram then provides information about the current growth behavior of the hair, so hair characteristics can be determined quickly. If parasite infestation is also found due to hypotrichosis, skin scrapings are also used for examination: Samples of healthy as well as diseased skin are taken through a scalpel and then examined under a light microscope. In this way, the cause of the disease can be better determined. Hypotrichosis can also occur in association with various syndromes, such as Nicolaides-Baraitser syndrome or juvenile macular dystrophy. Nicolaides-Baraitser syndrome is a congenital disorder associated not only with hypotrichosis, but also with short stature, malformations of the fingers, and seizure disorders. If the mentioned syndrome occurs with hypotrichosis, the hair growth disorder is usually congenital. Hypotrichosis with juvenile macular dystrophy is a very rare genetic defect, which is only hereditary. It should be examined at the latest when the child enters school, since an accompanying visual impairment can occur during childhood. For the first examination the so-called ophthalmoscopy is used: The visible parts of the eye, such as the retina and visible arteries, are examined.
When should you see a doctor?
If hair loss occurs quite suddenly and lasts for several weeks, a doctor should be consulted. Circular hair loss must be clarified and treated by a doctor in any case, because the complaints are often based on a health problem. If hypotrichosis occurs in the context of scarring of the scalp, without any injuries to the scalp being noticed, a doctor should be consulted. Possibly, an autoimmune disease is causative, which must be diagnosed and treated by a doctor. Infectious diseases, hormonal disorders and thyroid dysfunction are also possible causes of hair loss. Those who belong to the risk groups should always go to the doctor with the signs of hypotrichosis. This is especially true if the hair loss occurs quite suddenly or causes mental discomfort in the course. If inferiority complexes or depressive moods arise as a result of the hair loss, it is best to consult a therapist. The treatment of the actual hypotrichosis must be closely monitored by a physician to avoid any side effects or interactions of the prescribed medication.
Treatment and therapy
In the case of andro-genetic hypotrichosis, women and men have the option of taking preparations that can stop hair loss. Minoxidil is a drug that was originally used for hypertension, however, it turned out that when taking the drug, hair grew steadily all over the body. The dosages of minoxidil are different for men and women. If hypotrichosis occurs due to hyperthyroidism, the thyroid disease should be treated.
Prevention
Because hypotrichosis can have a wide variety of causes, prevention depends on the origin. If taking medications is the reason for the disease, they should be discontinued. In addition, hyperthyroidism should be treated if the hair loss is associated with it. However, the most common cause of hypotrichosis is difficult to prevent: since hair loss in many areas of the body originates with a gene defect and it is therefore hereditary, so the disease can not be completely prevented; therapies by such as medication or chemotherapy may possibly help in the prevention, but in no way guarantee complete recovery.
Aftercare
Hypotrichosis can lead to psychological discomfort as the disease progresses. That is why psychotherapeutic treatment is useful during aftercare. This helps against inferiority complexes and depressive moods, which can occur especially with sudden hair loss. Further follow-up treatment depends on the cause of the disease and the associated development. In the case of autoimmune deficiency, the scalp may scar, causing irritation and pain. Redness and dandruff are also possible. These complaints can be alleviated with the help of ointments or medications.In consultation with the physician, those affected learn what they can do about the problems. In the case of hormonal changes and stress as triggers, a change in lifestyle may help. Patients should work with their doctor or a nutrition expert to put together a diet. With this response to the body’s warning signals, it is possible to reduce hair problems. Consistent follow-up focuses on nutrient-rich foods such as nuts, vegetables, fish and whole grains. Abstaining from alcohol and nicotine can also be helpful. For well-being, there are also natural remedies that have a positive effect on the patient’s skin appearance. Together with sufficient exercise and social contacts, the quality of life increases considerably.
What you can do yourself
In addition to medical therapy, hypotrichosis can be treated by yourself with the help of various home remedies and tips. First of all, it is important to stop the causative hair loss. Most often, stress and hormonal changes, but also an unhealthy lifestyle are responsible for the thinning spots on the head. It is recommended to pay attention to the signals of the body and to work out a suitable diet together with a nutritionist. Foods such as vegetables, whole grains, healthy oils, nuts and fish contain important nutrients that promote hair growth. Nicotine and alcohol should be avoided. Depending on the cause, it is also possible to treat the scalp with natural remedies such as fenugreek decoction, aloe vera or healing clay. Evening primrose oil also stimulates hair growth and thus also reduces hypotrichosis. A proven household remedy is rubbing alcohol, which is massaged into the hair as a rinse. Glycerin, coltsfoot flowers and vinegar can also help with hypotrichosis. Massage promotes blood circulation and stimulates hair growth. If these measures do not reduce hypotrichosis, the lack of hair must be accepted. Self-esteem, which is often reduced, can be restored by various measures, for example by exercising or participating in a self-help group.
