Sharp hair loss is a frequent complaint in the office, both for men and women, and deserves a careful medical investigation to discover its cause. This will influence the prescription of the most appropriate treatment protocol for each patient. The problem may be of genetic origin, but several factors are capable of triggering the hair loss: stress, poor diet, very restrictive diets, sudden hormonal changes (as in the postpartum and menopause), thyroid disorders, prolonged use of certain medications, anemia and excess chemical in the hair (such as straightening, dyeing and frequent discolorations).

First of all, it is necessary to differentiate the physiological fall from the dysfunctional fall. The hair cycle has three phases: anagen, catagen and telogen. In the first, the anagen or growth phase, lasting up to ten years, is where 80% of the wires are found. The catagen, with 10% of the wires, lasts from two to three weeks. The telogen, or phase of fall, also with 10% of the wires, lasts from three to four months.

The most common dysfunctional falls are effluvium and baldness (androgenetic alopecia). The effluvium, divided into anagen or telogen, corresponds to a large volume capillary loss in a short period of time. Anagen effluvium can be caused by chemotherapy and exposure to toxic agents (arsenic, lead, ionizing radiation and immunosuppressive drugs, such as cyclosporins).

The problem may be of genetic origin, but several factors are capable of triggering the hair loss

Telogen effluvium is more common in women. It can be acute or chronic. The hair loss in the telogen effluvium occurs from two to four months after a specific event, such as acute stress, rigid diets, puerperium, serious infections, high fever, hormonal changes and acute anemia. It is usually self-limiting. The fall is diffuse and lasts up to four months. When it persists after this time, it is called a chronic telogen effluvium.

Baldness, on the other hand, is considered the main cause of hair thinning and thinning. It occurs due to the action of testosterone in the hair follicle, associated with heredity. The problem is more frequent in men, affecting up to 80% of the male population. But it also affects 40% of women. It manifests itself causing the miniaturization of the hair, which corresponds to the reduction of the hair follicle by the action of dehydrotestosterone (DHT), that is, by genetically determined hormonal action, there is an atrophy of the hair.

In men, the baldness process begins with the temporal regions and the apex of the scalp. In women, the decrease is usually more diffuse and is revealed by a thinning of the strands at the front and top of the head. Female hormones help protect the hair from DHT action, but after menopause, the condition can manifest itself more intensely, due to the absence of these hormones.

In any case, medical monitoring is essential, as it is common for pathologies to appear associated. Before the first symptoms, see a dermatologist. By the patient’s history and the result of specific exams – such as trichogram or dermoscopy of the scalp – he is able to identify the cause of the problem. The early approach will prevent thinning and atrophy of the hair follicle, preventing permanent hair loss.

The treatments available in the office aim to replace some nutrients and the consequent recovery of the diameter and the amount of hair, stimulating the first phase of hair growth, anagen. One of the most effective protocols is capillary mesotherapy, which consists of applying medications, substances and vitamins directly to the scalp, very close to the follicles, by injections or micropeaks. It can also be done immediately after the fractional laser, which creates microchannels in the scalp skin, through which the medication is absorbed more quickly.

The fractional medium infrared laser, a novelty in the offices, acts by doing biostimulation, that is, an inflammatory reaction that happens after the procedure and is enough to restore the miniaturized follicle, transforming it into a thicker and healthier hair. They are treatments with weekly or monthly intervals, depending on the severity. The result, most of the time, is excellent for men and women. In general, they do not need oral use of the dreaded (by men) finasteride.