Alopecia is an involuntary loss of hair usually in the scalp that may occur anywhere over the body.
Scarring alopecia is severe inflammation of the hair follicle result in irreversible damage.
Non-scarring alopecias are reversible.
Alopecia may  be abrupt or gradual in onset.
Most common causes include androgenic alopecia (male & female pattern baldness) & alopecia areata.
History should be reviewed for medications, severe diet restriction, vitamin A supplementation, thyroid symptoms, concomitant illness & stress factor.

Surgical Intervention

Hair Transplantation
  • Surgical option for androgenic alopecia and androgenic alopecia where hairs from the back and sides of the scalp are transplanted to balding areas in the front
    • Usually need 2-4 sessions depending on the number of grafts transplanted per session
    • Success depends on the viability of grafts harvested and inserted into areas with hair loss
    • Mini-grafts and micro-grafts with 2-4 follicles allows for a more natural looking result
  • Follicular unit transplantation (FUT) may be considered for both men and women with alopecia areata with sufficient donor hair
  • Has limited aesthetic benefit for MPHL with Norwood/Hamilton stages I-II
  • Not optimal surgical candidate for FPHL with Ludwig I stage; best candidate are patients with Ludwig stage II
Scalp Reduction (Alopecia Reduction Surgery)
  • Treatment option for male patients with hair loss at the back of the scalp
  • Area with hair loss is surgically removed and hair-bearing scalp is stretched to fill in the void left by the excised scalp
  • May be performed with hair transplantation or scalp expansion
  • Has limited aesthetic benefit for MPHL with Norwood/Hamilton stages I-III because of potential for scarring
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