Alopecia is a round or oval, limited or unlimited hair loss without any visible inflammatory reaction. Scalp is the most frequent involvement and may accompany with nail involvement. It is a disease in which hairs were lost in scalp, eyebrow, eyelashes and around the body, oval or sharply limited hair loss in the whole body were seen without leaving a trace. Most of the complaints related with disease are due to hair loss.

Hair loss has the two most common causes. Hormonal disorders and autoimmune diseases. Apart from these, reasons like dietary insufficiency, anemia and iron deficiency (iron deficiency can lead to hair loss without anemia), zinc deficiency, vitamin deficiency (B12, folate and biotin), drugs, pregnancy, diabetes, liver and kidney diseases, making strict diet, chemical use, central nervous system diseases and stress can be seen.

Hormonal disorders:

There are estrogen, progesterone, testosterone hormones in women and men.

Estrogen/testosterone ratio in women is 8/1. Policistic ovary syndrome causes testosterone increase, and if the progesterone hormone, balancing the estrogen, is insufficient, excess testosterone is converted to DHT () by the estrogen hormone. Hair follicles have DHT receptors and DHT binds to these receptors to miniaturize the follicle, causing hair loss. In other body hairs, proliferation and thickening develop.

The estrogen/testosterone ratio in men is 1/20. Testosterone production decreases and xeroestrogens increase due to aging, unhealthy nutrition and environmental toxins, and when the progesterone hormone, which balances the effects of estrogen, is inadequate, DHT production increases and causes hair loss by causing miniaturization of hair follicles.

Production of dihydrotestesterone(DHT) from testosterone is made with 5-alpha-reductase enzyme.

Medicines that block the enzyme 5 alphareductase are used in treatment of hair loss. Finasteride blocks type 1receptors, while Duosterid blocks type 1 and 2 receptors. Thus DHT production stops. At the same time, BPH is also prevented in men. However, DHT is an important hormone in men and its deficiency causes many problems. For this reason, this treatment have many drawbacks. Growth in the breast, difficulty in erection, thinning of the voice occurs.

Progesterone Hormone therapy is the most harmless and safe way to treat hair loss due to excess DHT in women and men.

Autoimmune diseases

Diseases that arise when the immune system perceives its own tissues as a foreign matter and damage them, is called autoimmune disease.

Antigenic proteins that are incompatible with the body, which accumulate in the hair follicles, cause the follicle to be perceived as foreign matter by the immune system in the hair follicle disease. Immune system lymphocytes damage the hair follicle and the hair is lost. Other autoimmune diseases can be seen in these patients like vitiligo, psoriasis, rheumatism, type 1 diabetes and so on.

Drugs that suppress the immune system such as cortisone and methotrexate are used to treat hair loss caused by autoimmune disease. This treatment does not remove the problem.

Ideal treatment;

* Identify the causes of hair follicles perceived as foreign matter.

* Hair follicles should get its original health by removing these causes.

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