Hair Loss

Agent Hair Loss – 2022

hair loss

Agent Hair Loss

Hair loss comes suddenly in clusters and quickly results in total and universal alopecia. Anagenic hair is always widest at the base, with…

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Agent hair loss (effluvium)

Hair loss in the growth phase – as the rapid cell proliferation in the hair follicle is affected, caused by tumor dose chemotherapy, all hair falls out and gives total alopecia.

Androgenic hair loss

Male hair loss occurs due to increased sensitivity to testosterone in the hair follicle and eventually undergoes involution (regeneration). It affects genetically predisposed men and can begin after puberty already at the age of 17-18 years. It usually occurs in middle age in more than half of all men.

There is hair loss in women (androgenetic), as in male hair loss, there is a genetic predisposition and hair follicles that are sensitive to testosterone. It begins later than men, at the age of 25-30, and affects about 10% of women.

Age-related (senile) hair loss

As a part of general aging, there is a 20-30% decrease in the number of active hair follicles. It affects both men and women. It can also start early in adulthood (presenile).

Telogenic effluvium


It is common for adolescents, especially girls with very long hair, to experience profuse hair loss and seek strong anxiety about developing alopecia. In the youngest, it may be the first sign of the development of the adult hairline, but most often this is a physiologically ordinary problem of telogenic discharge. Patients often report:

  • More hair on the brush / comb when brushing / combing
  • Increased amount of hair in the drain after hair wash

No pathological changes (eg, shedding, redness, skin thickening-plaque) are observed in the hair or scalp, and there is no decrease in hair density. A telogenic hair is characterized by a proximal round bulb (club hair).

The history of the traumatic episode is usually given 2-4 months before the diagnosis, for example:

  • fever sickness
  • Stress
  • Where applicable, partus

It is important to provide information about physiological telogenic hair loss and to draw attention to good prognosis. Some people are helped by cutting their hair short – so daily hair loss is noticeably less.

There is no need for treatment, the exact information that the hair density is restored when it returns to the growth phase after 3-6 months. Hair loss is always messy and never total.

In addition to the information about the benign process, a strong (group III) steroid can be given as a solution (Betnovat, Diproderm, Elocon) 1-2 times a day for 1-3 months as supportive treatment.

In hair loss caused by diseases and medical side effects, the course may be less dramatic and longer over time. Case in point, you’ll see hair density decrease with no visible scalp changes. Then, depending on the result of an accurate history and routine testing, any treatment is selected:

  • CRP
  • hb
  • LPK
  • urine stick
  • Thyroid Prover (TSH, T4)
  • Possible directed sampling eg ANA, RF, anti-CCP

Suspicious drugs, especially those with a time connection, can be postponed if possible.

Agent Hair Loss


Hair loss comes suddenly in clusters and quickly results in total and universal alopecia. Anagenic hair is always widest at the base, with sharp borders, not rounded.


In some cases, special hypothermia treatment can minimize hair loss.

Detailed information about the course is recommended, which is important before the timely introduction of cytostatics and wig tests. The successive hair growth comes after finishing the treatment. However, “new” hair may be of different quality and characteristics, sometimes with a certain reduction in hair density.

Androgenic Hair Loss


Occipital flint resulting in increased temporal lobes, regression of the hairline, and increased hair loss on the scalp. Individual progression where the most common outcome is complete scalp balding and a ring of hair around it.


Numerous treatments and (sub)treatments have been started, but there is no treatment that actually makes hair regrowth. Topically, minoxidil (Rogaine) induced some regrowth on maximal palm-sized occipital flint in controlled studies. The treatment is given externally 2 times a day and regrowth comes after 4-8 months. Treatment should be continued daily to protect the hair. If the treatment is stopped, the hair will fall out within 3-4 months. The best cosmetic results come from a hair transplant done according to proven science – but it is both costly and time consuming. A tupé or wig can work well for those who are motivated.


On the scalp – corresponding to male flint – appears as a significantly reduced hair follicle – the scalp shines. Scalp changes are not seen.


Treatment results are not as satisfactory as for men, and cosmetic solutions such as wigs may be a good solution.

Age-related (senile) hair loss


Reduction in hair density and reduction in hairline. No noticeable scalp changes, but dry dandruff may occur.


Local group III steroids (Betnovat, Diproderm, Elocon) can be prescribed monthly and the effect can be evaluated.


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