Alopecia: the Patient’s Viewpoint

Updated 3/2017 -- all links (except to my own posts) removed as many no longer active. 

The New York Times has a series called Patient Voices which gives insights from the patients with the disease, physical and emotional changes in their lives, and accommodations made.  The most recent series is on patients with alopecia or hair loss.

The Voices of Alopecia by Tara Parker-Pope (July 6, 2010)

This week, Patient Voices explores alopecia, an autoimmune disease that leads to a few bald patches to the loss of every hair on a person’s body.

To hear what it’s like to live with alopecia, listen to the Patient Voices audio slide show that features adults, children and their parents who are coping with the condition.

Patient Voices: Alopecia  Listen to these seven people tell what it is like to live with alopecia?

Matt Kelly, 43, lost his hair at age 38 over a 6 week time span.

Jennifer DeFreece, 29, developed alopecia totalis as a child.

Margaret Staib, 42, an artist with three daughters.

Rafi Wasselman, 16, says his best medicine is his collection of caps.

Maureen McGettigan, 47, began losing her hair at age 16.

Annie Kazmi, 33, tells her daughter Noori’s story.  Then Noori tells her own.

A ‘Forest Fire of Hair Loss,’ and Its Scars written by Karen Barrow tells Matt Kelley’s story.

……….Mr. Kelley, now 43, has alopecia areata, an autoimmune disease that causes the body to attack its own hair follicles. Alopecia, which does not include normal male-pattern baldness, affects nearly 2 percent of the global population and has no universally effective treatment. Its progression is unpredictable and can range from a few bald patches to a completely hairless scalp to the loss of every hair on a person’s body — known as alopecia universalis. Sometimes the hair regrows, sometimes it does not, and sometimes it grows in only to fall out again years later.

The associated “Ask an Expert About Alopecia” gives NYT’s readers the opportunity to have their questions regarding alopecia answered by Dr. Maria Hordinsky, chair of the dermatology department at the University of Minnesota.

Scalp Reconstruction – an Article Review

Updated 3/2017 -- photos and all links (except to my own posts) removed as many no longer active. and it was easier than checking each one.

The March issue of Plastic Surgery Practice has a very nice article on scalp reconstruction (full reference below). The short article is an overview of HRS (hair restoration surgery) options for massive hair loss resulting from illness or injury.

The degree of deformity generally determines the treatment choice. Advancements in HRS in the past 2 decades are significant in yielding natural and almost undetectable results. Using a combination of HRS and cosmetic and reconstructive techniques, most deformities can be treated effectively.

There are many HRS techniques available, including follicular unit transplantation (FUT), follicular unit extraction (FUE), scalp reduction, scalp flaps, and tissue expansion.

The article gives some nice tips for use of tissue expanders:

• Planning is critical. Patient/family counseling regarding temporary deformity is crucial.
• It is best to overestimate the needed expansion and choose the largest commercially available expander that fits the patient’s anatomy.
• The vertical dimension is the most important factor providing the greatest gain in flap expansion. When the distance over the expanded tissue minus the base width of the expander is equal to 120% of the defect width, the expansion is complete.
• Overexpansion even by a modest amount will increase patient safety by providing excess tissue to cover the defect, allowing closure with minimal or no tension.
• If the entire defect cannot be removed and the residual defect is significant, leave the expander in place for a second expansion.

The article also mentions Operation Restore , a charity program which matches prospective hair loss patients with volunteer ISHRS physicians to obtain hair restoration services to help restore the physical and emotional wellness of the individual. The foundation will provide financial, travel, lodging, and medical assistance to eligible patients. The ISHRS Pro Bono Program was also featured in Association Forum Magazine.

Other posts you may find interesting:
Scalp Avulsion Injuries
Eyebrow Reconstruction
Hair Transplantation

REFERENCE

Scalp Reconstruction: An Aesthetic Challenge; Plastic Surgery Practice, March 2010, pp 14-18; E. Antonio Mangubat, MD

Reconstruction of Acquired Scalp Defects: An Algorithmic Approach; Plastic & Reconstr Surg, Vol 116(4):54e-72e, September 15, 2005. Leedy, Jason E. M.D.; Janis, Jeffrey E. M.D.; Rohrich, Rod J. M.D.