Hellenicaesthetics

Diffuse Alopecia

Diffuse alopecia is marked by generalized thinning of the hair across the scalp, rather than the formation of distinct bald patches. It is more frequently observed in women than in men and can develop gradually or suddenly.

Although the visible reduction in hair volume can be distressing—often leading to emotional strain, reduced self-esteem, and social or professional discomfort—there is encouraging news: modern treatment options have proven highly effective. With proper diagnosis and a tailored treatment plan, it is possible to restore hair density, improve scalp health, and help patients regain their confidence and quality of life.

DIFFUSE ALOPECIA

Effective treatments

Autologous Growth Factors – PRP Therapy

Autologous PRP (Platelet-Rich Plasma) hair mesotherapy with growth factors has shown promising results in the treatment of diffuse alopecia. It is now widely used as a standalone or complementary therapy alongside supportive or pharmaceutical treatments.

The procedure involves injecting concentrated growth factors derived from the patient’s own blood into the affected areas of the scalp to stimulate hair follicle activity and promote natural regrowth. Each session lasts about 30 to 45 minutes and is minimally invasive, requiring no local anaesthesia. Treatments are typically repeated monthly until satisfactory hair density is restored.

Minoxidil Treatment for Hair Loss

Topical minoxidil, in 2% or 5% solutions, applied twice daily, is effective in managing chronic diffuse alopecia, and has demonstrated notable results in both male and female androgenetic alopecia.

As one of the few clinically proven pharmacological treatments for hair thinning and loss, minoxidil has been used safely and effectively worldwide for over two decades. It helps to stimulate hair follicles, prolong the growth phase, and increase hair density, making it a trusted option in long-term hair restoration strategies.

RESULTS

Treatments for hair loss & Hair transplantation

Diffuse alopecia – Types

Acute with sudden loss of hair

Subacute in which the hair is lost over several months

Chronic Diffuse Alopecia in which the phase of thinning is repeated and overall lasts more than 6 months

The life cycle of hair

1. Anagen phase
2. Catagen phase
3. Telogen phase

Diagnosis in men

The hair growth cycle is composed of three distinct phases: anagen (growth phase), catagen (transitional phase), and telogen (resting phase). In a healthy scalp, approximately 95% of hairs are in the anagen phase, which can last for several years, while the catagen and telogen phases are much shorter, lasting only a few weeks to months.

Female hair loss often occurs when there is a premature shift from the anagen phase to the catagen and telogen phases, shortening the growth cycle and reducing overall hair density. In certain types of female hair loss, the anagen phase may last only a few months instead of years.

It is normal to shed 100–150 hairs per day, particularly during activities like washing or combing, and this does not necessarily indicate a pathological condition. However, if hair loss exceeds 150 hairs per day, it may be a sign of underlying hair loss disorders, and medical evaluation and treatment should be considered.e-shaped band of hair usually remains intact along the sides and back (occipital area) of the scalp.

Complete baldness is uncommon, and the pattern of hair loss is key to diagnosis.

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Androgenetic Alopecia
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DIFFUSE ALOPECIA

Common causes

Telogen Effluvium

Telogen effluvium occurs when a large number of hairs prematurely and suddenly shift into the telogen phase—the resting and shedding stage of the hair cycle. Under normal conditions, hair remains in the anagen (growth) phase for several years before gradually transitioning. In telogen effluvium, however, this transition happens too early, before new hairs are ready to replace them, leading to diffuse hair shedding and noticeable thinning.

Anagen or Dystrophic Alopecia

Severe hair shedding—affecting up to 90% of the scalp hair—can result from exposure to chemical or toxic agents, such as chemotherapy drugs or radiation therapy. This abrupt loss occurs because these agents disrupt the normal hair growth cycle, forcing hairs into the telogen phase or directly damaging the follicles. Fortunately, in most cases, hair regrowth begins once the exposure stops, and the follicles gradually resume normal function.

Mixed Alopecia

Mixed alopecia occurs when multiple factors contribute to hair loss, affecting hair follicles in different ways. In some follicles, the anagen (growth) phase ends prematurely, leading to early shedding. In others, hair growth ceases even while the follicle remains in the anagen phase, disrupting the natural cycle. This complex interaction results in combined patterns of hair thinning, often requiring a multifaceted treatment approach tailored to the underlying causes.

FAQs

Frequently Asked Questions

Causes of Diffuse Alopecia

Diffuse alopecia is characterized by widespread thinning of hair across the scalp and may result from a wide variety of internal and external factors. These include:

  1. Physical Stress Major surgeries
    • Severe infections or high fever
    • Acute blood loss
    • Postpartum hormonal shifts (commonly 1–3 months after childbirth)
  2. Emotional Stress Sudden or intense psychological distress, often triggering acute telogen effluvium
  3. Chronic and Systemic Diseases
    • Anaemia (especially iron deficiency)
    • Autoimmune disorders such as systemic lupus erythematosus, dermatomyositis
    • Chronic infections like HIV, secondary syphilis
    • Liver or kidney failure
    • Inflammatory bowel disease, amyloidosis, and lymphoproliferative syndromes
    • Skin conditions: psoriasis, seborrheic dermatitis, allergic contact dermatitis
  4. Endocrine and Hormonal Disorders Thyroid dysfunction (hypo- or hyperthyroidism)
    • Diabetes
    • Menopause-related hormonal changes
  5. Nutritional Deficiencies and Dietary Factors Protein, iron, zinc, and essential fatty acids deficiency
    • Eating disorders (e.g., anorexia nervosa)
    • Vitamin D and biotin deficiencies
    • Malabsorption syndromes and pancreatic disorders
  6. Medications Oral contraceptives
    • Androgens
    • Retinoids (acne treatment)
    • Antithyroid drugs
    • Antidepressants
    • Anticoagulants
    • Excess vitamin A
    • Heart medications and NSAIDs
    • Chemotherapy drugs – cause anagen effluvium due to their cytotoxic action on actively growing hair
  7. Radiation Exposure
    • Hair loss localized to the radiated areas
    • Low-dose radiation may result in reversible thinning, with mild changes in hair texture

In many cases, diffuse hair loss is reversible once the underlying cause is identified and addressed. Early diagnosis and treatment are key to restoring hair health.

Treatment of Diffuse Alopecia

Diffuse alopecia is often reversible, and with timely and targeted intervention, hair density can be restored. Treatment focuses on identifying and eliminating the cause, supporting healthy hair regrowth, and preventing progression to chronic or androgenetic alopecia.

  • 🔍 Diagnosis and Identification of the Cause
    • Patient cooperation with a specialist (dermatologist or plastic surgeon) is essential.
    • Acute telogen effluvium: Often linked to a clear trigger (stress, illness, medication). Once the cause is removed, shedding usually resolves within a few months.
    • Chronic telogen effluvium: More complex, possibly multifactorial and may require longer investigation and management.
  • 🥗 Nutritional Support Balanced diet rich in:
    • Proteins
    • Iron
    • Zinc
    • Essential fatty acids
    • Supplements may include:
    • Vitamin C (enhances iron absorption)
    • B-complex vitamins (support stress response and hair health)
    • Biotin and zinc (support hair growth and structure)
  • 💊 Medication Review If a medication is suspected to cause hair loss:
    • It may be discontinued or substituted (with doctor’s supervision) for at least 3 months to assess impact.
    • Ongoing evaluation for underlying medical conditions (thyroid disorders, autoimmune disease, etc.) is crucial.
  • 💆 Supportive Treatments No specific medication is universally approved for diffuse alopecia, but supportive options help:
    • Minoxidil topical treatment (for persistent thinning)
    • PRP therapy (Platelet-Rich Plasma) to stimulate follicular activity
    • Stress management strategies (if psychological stress is a trigger)
  • 🧪 Special Cases: Chemotherapy-Induced Alopecia
    • In many cases, hair regrows after chemotherapy.
    • However, in individuals genetically predisposed to androgenetic alopecia, regrowth may only occur in unaffected areas.
    • This can lead to an accelerated or advanced presentation of male pattern baldness (Hamilton-Norwood grade V–VII).
In such cases, FUE hair transplantation may be considered, especially if the psychological impact is significant. However, it is not a routine treatment for diffuse alopecia and must be thoroughly evaluated by a specialist.
  • 🩺 Professional Evaluation Is Key
    • Treatment success depends on personalized evaluation by a dermatologist or hair restoration expert, who will assess the patient's condition and history to tailor an appropriate treatment strategy.
In conclusion, diffuse alopecia requires a holistic approach combining lifestyle, nutrition, possible medical adjustments, and supportive therapies. In select advanced or distressing cases, hair transplantation may be a viable option after thorough assessment.

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