Alopecia nervosa: symptoms, causes and treatment

Hair loss is clinically known as alopecia. And it is that both men and women can suffer from hair loss from a certain age, for various reasons.

Alopecia can have many different origins, often its causes are genetic or stem from a poor diet, nutritional deficiencies can lead to pathological conditions such as anemia, where iron deficiency is likely to cause alopecia.

One of the most common causes of hair loss is stress. Stress is a condition that adds to all the other factors and is one of the main reasons why people with alopecia lose more or less hair.

In cases where stress is the main cause of hair loss, we speak of alopecia nervosa.. In this article we will talk about this pathology, describing its causes, symptoms, possible treatments and the different types of hair loss caused by stress.

    What is alopecia nervosa?

    Nervous alopecia is a disease in which it occurs hair loss due to situations of stress, anxiety, depression or other conditions that affect the nerves.

    Alopecia nervosa can appear in people without previous hair loss problems, suddenly hair can start to fall out without any preconditions. Alopecia nervosa can also make hair loss worse in people who already have problems with hair loss.

    Problems affecting the nerves are quite common in our society today. The modern pace and lifestyle can cause stress and anxiety in many people. These two conditions they are responsible for many dermatological problems, such as hair loss. In a situation of prolonged or intense stress, 7 out of 10 hair follicles can be affected, according to experts.

      Causes of Hair Loss

      A recent study published in the journal Nature demonstrated the physiological relationship between hair loss and stress.

      The hair follicle is the part of the scalp where the stem cells responsible for hair growth are concentrated, it rises from a tube-like fold. The hair or hair is composed of keratinized cells generated and renewed by the hair follicle. The hair follicle is constantly working, it is one of the most dynamic structures in the whole body.

      In the study conducted by Nature, it was shown The so-called stress hormone cortisol affects hair follicle stem cells. The cortisol subjects the stem cells to a prolonged quiescent phase, there is no follicle or hair regeneration, and eventually baldness occurs.

        Types of stress-related hair loss

        Stress is responsible for hair loss. There are three types of hair loss associated with high levels of stress:

        1. Telogen Effluvium

        Telogen effluvium (TE) occurs when there is a change in the number of follicles responsible for hair growth. If this change occurs during the telogen phase, the resting phase of hair growth can cause hair loss.

        The loss of follicles is not homogeneous, usually does not occur throughout the head, it appears in specific areas. Especially the hair is lost in the center of the head, which leads to the appearance of plaques. People affected by TE usually do not lose all scalp hair.

        In the most severe cases of this condition, people with ET may experience hair loss in other parts of the body, such as the eyebrows or genital area.

        Telogen effluvium is the second most common type of hair loss and a frequent cause of dermatological consultation. Hair loss can occur in both men and women, regardless of age.

        ET does not permanently damage hair follicles, so the associated hair loss is reversible. When the follicles recover, the hair regrows and within a few months the spots disappear. For this to happen, the underlying cause responsible for the ET must be addressed, in this case stress. If the stress or anxiety situation persists over time, it can affect more follicles and permanently.

        2. Alopecia Areata

        Alopecia areata (AA) is an autoimmune disease. The immune system recognizes follicles as foreign bodies and attacks them, causing hair loss. The origin of alopecia areata, as well as other autoimmune diseases, can be stress.

        Hair loss it may appear as patches, usually round, or distributed over the entire scalp. Alopecia areata in its most severe form can affect the whole body and attack hair in all areas, this condition is known as alopecia universalis.

        Alopecia areata can have periods of remission where the hair grows back. However, there is still no definitive treatment for this autoimmune disease. Although there are pharmacological treatments to help people who suffer from hair loss of more than 50%. This condition is more common than previously thought and affects around 2 in every 100 people in Spain.

          3. Trichotillomania

          Trichotillomania is a type of traumatic alopecia, collected within the DSM-5 (Diagnostic and Statistical Manual of Mental Disorders) and is part of obsessive-compulsive disorders.

          Trichotillomania is defined as pulling your hair out continuously, causing noticeable hair loss. The person with trichotillomania may have their hair pulled out from the scalp or other parts of the body.

          Pulled hair usually occurs when the person is bored or distracted, and does so unconsciously. Sometimes tugs can also be used to relieve stress or other negative emotions, in which case they are aware.

          Hair loss caused by trichotillomania is noticeable, especially on the face: scalp, eyebrows and eyelashes. This causes discomfort in those affected, which causes more stress and aggravates the disorder, producing a kind of vicious circle.

            Is permanent hair loss caused by stress?

            One of the most concerning questions for people with alopecia nervosa is whether the hair loss is permanent. If the main cause is stress, hair may regrow over time, although the rate of recovery varies from person to person.

            Human hair growth responds to a cycle divided into four phases with its different times. The average human scalp has about 100,000 follicles, with each hair follicle being in a different phase of the growth cycle. Depending on the growth phase of the follicle, it will take more or less time to develop.

            • The anagen phase. It lasts from two to seven years, this is the hair growth phase.
            • The catagen phase. This is the short phase, lasts about two weeks and occurs when the hair follicle begins to shrink.
            • The telogen phase. At this stage, the follicle is at rest, which usually lasts three months.
            • The exogenous phase. At this point, the follicle detaches from the hair and new growth begins.

            If the hair loss was triggered by stress, controlling stress could be the key to regaining a healthy rate of hair growth.

            Alopecia nervosa treatment

            There are a number of strategies that can be followed to reduce hair loss associated with stress and promote recovery, including healthy eating, stress management techniques, and medication treatment.

            1. Diet and nutrition

            A healthy and balanced diet is essential for overall health, which includes the scalp. Although the diet should provide a number of essential vitamins, some are very helpful in hair growth. They can be included in the diet or as supplements. The vitamins C, B and E help prevent hair loss.

            In the face of any health problem, proper hydration is essential, as all cells in the body depend on water to function. Health professionals recommend drinking between 2.7 and 3.7 liters of water per day. Not all water comes directly from beverages, food also includes water, so around 8 glasses of water a day is recommended for proper hydration.

            2. Stress Management

            Learning to manage stress levels effectively can help reduce the risk of increased hair loss. People may try different stress management techniques before finding the one that works best for them and matches their personality. Though there is Some popular ways to reduce stresssuch as:

            • The practice of physical exercise
            • Make time for your hobbies
            • write a diary
            • Breathing and meditation techniques.

            3. Topical treatments

            A series of creams, oils and other topical products They can help with hair loss, minoxidil, corticosteroids and castor oil are often used to combat alopecia problems.

            Bibliographic references

            • Bishop S. (2013). Stress can play a role in hair loss, but other triggers could be the cause.
            • Choi, S., Zhang, B., Ma, S. and others (2021). Corticosterone inhibits GAS6 to govern hair follicle stem cell quiescence.
            • FongP, et al. (2015). In silico prediction of prostaglandin D2 synthase inhibitors from plant constituents for the treatment of hair loss

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