Patchy Hair Loss

What Is Patchy Hair Loss?

Forget a full head of hair – from Bruce Willis to The Rock, bald men in Hollywood are currently and regularly seen as sexy and suave. But what about those of us who don’t exactly have a full head of hair, yet aren’t completely bald? If you’ve started noticing islands of baldness around different areas of your scalp, you are currently experiencing what is called ‘patchy hair loss’

Patchiness in your scalp hair can look like single or multiple areas, and be small or large in size. It can happen anywhere hair exists, including your beard or eyebrows. Having longer hair, especially in women, can hide the existence of patchy hair loss. But until you get a shorter cut or are already a male having short hair, patchy islands of hair loss can become suddenly obvious.

What exactly is patchy hair loss? It is not a medical condition in itself, but a pattern of hair loss caused by other factors. Read on to find out more!

Scroll to see different causes
of Patchy Hair Loss

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Treatments

Unless related to an injury to the scalp that damages hair follicles over the area, patchy hair loss can be worrisome as it may appear suddenly without any obvious cause. Fret not, as here are a few common causes of patchy hair loss:

Alopecia Areata

What is it?: Alopecia Areata (AA) is an autoimmune disorder that affects about 1 in 50 people at any one point in life. A person’s own immune system starts to damage healthy hair follicles, and this happens typically from a sudden trigger of emotional stress. It doesn’t only occur to the hair on the head but it can also involve hair loss on other parts of the body with hair like eyebrow and facial hair. 

Who gets it?: It can often occur in childhood, but the main population suffering from this are adults of age 30-60 years old, male and female alike. (Interesting fact – Singaporean folklore often attributes this sudden patch of baldness to supernatural beings shaving one’s head!)

What are the symptoms?:  Alopecia areata looks like one or more small, round bald patches on the scalp that can get bigger. 

How is it diagnosed?: On consultation, your full medical history will be assessed. A scalp examination is done whereby our hair restoration physician will examine the area of hair loss under high-powered magnification. What they are looking out for are characteristics such as broken hairs and empty areas to rule out other causes (like scalp infections). If the cause of the patchy hair loss is still unclear, more invasive tests may need to be carried out such as hair root microscopy or a biopsy where a sample of tissue is analysed in a lab.

How Do I Treat Alopecia Areata?

The cause of AA is from an autoimmune response, and treating the immune response can typically help. However, we need to look deeper into what is triggering the body into this autoimmune response.

  1. Target affected areas – Suppressing the immune response in areas of balding can be done through injection of a medium-potency corticosteroid (e.g. triamcinolone acetonide). This helps to prevent further attack on the hair follicle, and may need to be done more than once. The earlier it is treated, the better hair growth you may get since long-term damage can permanently harm the follicle.
  2. Control medical conditions – If a person is suffering from other medical conditions that are contributing to this autoimmune hair loss, those conditions need to be addressed through medication (e.g. oral tablets that control the immune system, disease-modifying drugs) to prevent hair loss from recurring.
  3. Evaluate lifestyle factors – Stress and improper nutrition can suppress a person’s immune system and contribute to AA. Having proper coping strategies for stress and a well-balanced diet is important to encourage healing.

Hair usually grows back within a year. Usually, the small patches of hair loss can regrow without treatment or using a topical minoxidil and scalp rejuvenation treatment courses. Severe AA causing damaged follicles may require more intensive male hair loss treatment and female hair loss treatment

Read more about the hair supplements that are used to treat hair loss.

What is it?: Our hair follicles are found in the middle layer of our skin. If a traumatic injury happens to our scalp where it injures not just the superficial layer but also the deeper middle layer, it has a chance of damaging our hair follicles, forming scar tissue. Once scar tissue is formed, hair may no longer be able to grow and a patch of baldness is seen.

Who gets it?: Those who experience injuries to the scalp. This includes surgery, laser surgery, burns, or physical abrasions such as severe falls or cuts to the scalp.

What are the symptoms?: Oftentimes it looks like normal healthy skin with no overlying hair if the skin has healed well. Sometimes, a scar may be seen on the patch. 

How is it diagnosed?: A medical history usually shows a traumatic event that happened resulting in a scarred scalp. It could happen in childhood, or during an accident where memory loss is involved (such as a drunken night out). Our hair restoration physicians will examine the scalp for scarring and assess for the possibility of scar correction with hair transplant. Further testing is usually unnecessary since the causes of traumatic injury are obvious.

How Do I Treat Traumatic Hair Loss?

Hair loss that is due to a scar that has not regrown hair for more than 6 months is unlikely to recover on its own. Procedures that can help are:

  1. Hair restoration surgery – This may involve scalp reduction, flap surgery, or follicular unit extraction and transplantation. The treatment chosen depends on the location, size of patch, and baldness severity; also, age, gender, and genetic factors matter. Our doctors will have a detailed discussion regarding the pros and cons of each technique, and which will be best suited for your age and condition.
  2. Cosmetic coverage – Small areas of scarred, patchy baldness can benefit from scalp micropigmentation (SMP) or embroidery. It is a form of semi-permanent tattooing which attempts to mimic the look of hairs on the scalp.

A thorough consultation with our hair restoration specialist can often determine which procedure will suit you best.

Tinea Capitis 

What is it?: Also known as ringworm on the scalp, tinea capitis is a fungal infection occurring on the skin of the head. Scalp infections like seborrheic dermatitis, where there is an overgrowth of the yeast fungus, can lead to tinea capitis.

Who gets it?: It occurs most commonly in children 3-7 years old. It may also occur in male or female adults that are immunocompromised making them more vulnerable to infection, who come into contact with bacteria on animals, or have sebum issues.

What are the symptoms?:  A typical feature are itchy and scaly, rough patches. The scalp can have thick or silvery patches that may also have swelling and discharge. Where the hair has broken off, there may be small black dots. Rarely, fever also occurs.

How is it diagnosed?: High-powered microscopy and skin scrapings often confirm the diagnosis. Occasionally, a culture of skin scrapings are sent for lab testing to identify the fungus, though not always necessary.

How Do I Treat Tinea Capitis? 

  1. Target the fungus – Tinea capitis treatments target those fungal patches through oral or topical antifungal medication.
  2. Treat medical conditions – Concurrent medical conditions that may cause the immune system to be suppressed and contribute to overgrowth of yeast or fungus should be treated as well. This helps to prevent tinea capitis recurrence.
  3. Hygiene matters – Parents need to monitor their children’s scalp while they are on a consistent scalp hygiene routine. This prevents a sweaty and oily environment where fungus flourishes. 

While the fungus may be treated relatively quickly within weeks, the hair loss left in its wake may take longer than that to regrow. The initial months post-infection are left for more conservative hair restoration methods, until the patchy baldness is confirmed to have permanent hair loss. Only then will hair transplantation be considered. 

Trichotillomania

What is it?: Trichotillomania (“TRY-KOH-TEA-LOW-MAY-KNEE-AH”) is also known as unconscious hair plucking or hair pulling. It is a  psychological disorder where a person feels the overwhelming need to pull out their own hair. 

Who gets it?: Symptoms typically appear between the ages of 10 to 13. It is often associated with poor stress or anxiety coping mechanisms, or a chemical imbalance in the brain similar to obsessive compulsive disorder (OCD).

What are the symptoms?:  Patches of thin or no hair are seen over the scalp, or eyebrows and eyelashes where hair pulling occurs. Over time, the hair follicles get progressively damaged, and can lead to baldness since hair is normally pulled until it is totally uprooted. Scarring and skin infections may occur from the forced pulling. It is common to see sufferers picking at their skin or eating hair that has been pulled out.

How is it diagnosed?: Often, the patient will deny these symptoms and cover up hair loss by changing their hairstyle, wearing a hairpiece/wig, or caps/shawls. The hair restoration physician will clarify the history of hair pulling and assess the degree of hair loss. 

How Do I Treat Trichotillomania? 

  1. Address mental health – A professional mental health practitioner such as a psychiatrist gets down to the root cause of trichotillomania. Therapy such as cognitive behavioural therapy (CBT) for chronic stress, anxiety, and depression can help the individual become aware of their triggers and eventually stop the cycle of hair pulling. Medication may be prescribed to curb the urge to pull the hair or pick at skin. 
  2. Restore skin health – Damaged hair follicles and skin picking increases the risk of getting skin infections. Dressings, oral antibiotics, and barrier creams help the skin to heal to prevent permanent scarring.
  3. Cosmetic coverage – Wigs, headwear, or semi-permanent cosmetic coverage like scalp micropigmentation once skin infections are gone can help prevent embarrassment and improve one’s self-image until the hair pulling completely stops.
  4. Hair restoration surgery – The doctor will suggest hair restoration only after the mental health condition is concurrently treated. Severely damaged skin and hair follicles and result in permanent hair loss. Hair restoration surgery can then restore large areas of baldness. In very extreme situations, a person may not be suitable for surgery and will instead require external cosmetic coverage to cover baldness.

For more resources on trichotillomania in Singapore, please visit this website.

If you are unsure what is causing your patchy hair loss, reach out to consult our hair restoration physicians today. As a hair loss clinic in Singapore with experienced professionals, we are certified to assess and treat your scalp conditions!

Treatments
Available

At Terra Medical

Hair transplantation is considered the only permanent solution to hair loss, with an average 90% success rate. Not just reserved for the hair on your scalp, hair transplantation techniques can also be used for facial hair and to fill in scarred bald patches from traumatic injuries. 

Terra Scalpboosters aim to ‘boost’ your scalp health by injecting a specially concocted cosmeceutical formulation paired with a superior cell-membrane activation technology to stimulate your hair follicles into growing faster, stronger, and healthier. Read on more to find out what it’s all about!

"Autologous Micrograft Transfer" treatment procedure offers a lot of great benefits, which makes this therapy an effective and safe one. One such benefit is that it has minimal downtime! Unlike hair transplant surgery where you may need to set aside 5-7 days before being able to continue most of your daily activities, you will be able to walk out the door right into the next thing on your schedule after a Autologous Micrograft Transfer treatment.

There have been many reviews and studies done on the safety and efficacy of low-level laser light therapy in men and women experiencing hair loss. When the wavelengths of light penetrate the scalp, it stimulates the stem cells that help to ‘communicate’ to the hair follicles for increasing hair growth. The low-level laser also increases blood flow and production of ATP, an energy-carrying molecule found in the cells of all living things, and metabolic processes in the cell to deliver more nutrients and oxygen which stimulate faster hair growth. We call this ‘activating’ the hair follicles.

Terra Medical offers array of hair supplements that are clinically proven to improve your hair health. Do ensure to consult our medical practioner if you’re unclear of which to take for optimal improvement. 

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