Hair diseases are complex disorders and may develop due to more than one factor. Hair loss is a distressing condition for patients and affects men and women of all ages.
Causes of Hair Diseases are as follows; Male pattern genetic hair loss, female pattern genetic hair loss, telogen effluvium, alopecia areata, hair breakage, and structural hair disorders.
Hair loss due to the skin and fungal diseases are causes of hair diseases and hair loss also.
What are the Diagnosis and Evaluation Methods of Hair Diseases?
As in all diseases, the patient’s history, examination, and blood tests are the most important methods in the diagnosis and evaluation of hair diseases. Also, the diagnosis of hair loss can be stronger with the following methods.
Invasive Methods
Skin Biopsy: It includes the diagnosis of skin biopsy taken from the diseased area by examining pathologically. Usually, 4-5 mm diameter tissue will be sufficient.
Noninvasive Methods
Photofinder: With the support of this special software, it is a technological system used in the diagnosis. It is easy to follow-up on hair loss with magnification up to 70 times, 1000 HD image quality, and the stage of the hair.
Standard Washing Test: It is the process of washing the hair for a certain period and collecting it in a gauze pad and counting them according to their length. This test is very effective in the differential diagnosis of genetic hair loss, especially in female patients.
Hair Pluck Test: It is the process of pulling 60-80 hair holes and examining them under a microscope. The stage of hair loss is shown under a microscope.
Hair Check: This includes learning about the reduction by measuring a certain amount of hair in a certain area and following the treatment and recovery. On the other hand, the usual period of this check is 3 months. It allows doctors to objectively follow the improvement or deterioration of the patient who is following up due to hair loss.
Dermatoscopic examination: It includes the examination of hair follicles and scalp with a dermatoscope.
Examination Of The Hair: It is common in the diagnosis of hair structural disorders. This examination is also relevant for the diseases affecting the hair shaft, and congenital hair diseases.
Types of Hair Diseases
Folliculitis: It is the inflammation of the structure. The other definition of this is a pilosebaceous unit. The hair is located in the form of a sheath in the skin. This inflammation’s name is superficial folliculitis and it is so close to the skin surface. It is seen as painful redness and swelling surrounding the hair and sometimes as pus in the middle. If the inflammation goes deep through the pilosabe unit, deep folliculitis occurs. As the inflammation deepens in the furuncle, swelling, and sensitivity increase.
Folliculitis begins with erythema, papule, pustule, or vesicle around the hair follicle in the scalp. After this early period, a keratin plug occurs with the excessive proliferation of scalp cells in the area where the hair comes out of the skin. This process results in permanent or temporary hair loss. It is a commonly seen hair disease.
All Inflammatory Hair Diseases Of The Scalp Cause Folliculitis
Depending on the degree of inflammation in the hair follicle and the cause of folliculitis, permanent or temporary hair loss occurs. Bacteria, viruses, and fungal agents cause infective folliculitis in the scalp.
Additionally, high sweating conditions such as diabetes, excessively tight clothing, obesity, use of topical products, and scalp cosmetics increase the development of folliculitis.
Fungal Folliculitis Caused Hair Diseases
As fungal agents are the most common causes of folliculitis in the scalp.
Alopecia of the scalp; The scalp has gray dandruff plaques, without inflammation, in the form of a large round one or multiple interlocking round rings. The hair on the plaques broke 4-6 mm in length and superficial folliculitis can be seen.
Trichophytic tinea- alopecia of the scalp; follicles are affected in less number of the scalp. For this reason, there are plaques in which smaller hair is completely shed. Plaques spill on hair. And, superficial folliculitis can occur.
Kerion Celsi; It is the fungal form of the scalp with inflammation. Inflammation develops with an excessive reaction against dermatophytes that settle on the scalp. Its onset starts like a simple fungal infection, then edema, pustules, and crusting develop rapidly on the skin.
Favus hair disease; It begins as small erythematous-crusty patches. When the crusts are removed, yellow-sulfur-yellow pustular structures are observed, It has an unpleasant odor. Hair is dull, dry, and, mostly in grey color.
Pityrosporum folliculitis; Although it is located in the scalp, it is often seen at the scalp border. Superficial folliculitis is observed in the affected area.
Folliculitis of Candida; painful, papules, nodules, and pustular lesions develop.
Bacterial Folliculitis Caused Hair Diseases
Bacterial folliculitis can be located centrally or in an association. Often the causative agents are Staphylococcus aureus, Streptococcus, Proteus, Pseudomonas, or coliform bacilli.
Superficial Folliculitis; the infection settles where the hair grows from the full drain. It also begins with pain and papules occur. Then white-yellow pustules may develop. Staph with nasal colonization. It starts with the contamination of the scalp.
Deep folliculitis; There is inflammation along the hair follicle. Deep folliculitis can turn into sycosis, then furuncle and carbuncle. The infection turns into an abscess in this change and affects the surrounding hair follicles. If the infection does not reach the hair follicles, it does not cause permanent hair loss.
Folliculitis decalvans capillitia: It causes permanent hair loss in the scalp. It is frequently seen in adult males. Immunosuppressive diabetes, chronic renal failure, gammopathies are common. The inflammation that starts in the hair follicles spreads towards the surrounding and deep.
Tufted hair folliculitis hair disease; Normally, 1-4 hairs grow from the follicular unit, while 5-20 hairs grow in this folliculitis. Therefore, the scalp looks like a brush. For this reason, it becomes alopecic as if the hair around it has fallen. It is frequently seen on the scalp in the occipital and parietal areas.
Acne eruptions; This hair disease develops with chemical contact on the scalp. Acnes frequently occur in the front area of the scalp.
