Alopecia (Hair Loss)

What it is

Alopecia is the term that covers the different forms of hair loss or thinning. In women, the most common are telogen effluvium, a diffuse, temporary shedding after stress, childbirth, surgery, crash diets or illness; androgenetic alopecia, which progressively thins the hair at the top of the head; and alopecia areata, of autoimmune origin, which causes round bald patches. Scarring alopecias, which are rarer, require prompt diagnosis to prevent permanent loss. At Femi Saúde, Dr. Ana Kappes examines the scalp with trichoscopy, investigates hormonal, nutritional and inflammatory causes, and puts together a plan that may include topical and oral medications, injections and other procedures, always tracking progress with comparative records.

Most common symptoms

• Noticeable hair loss while showering and brushing
• Thinning strands and a more visible scalp
• Round, smooth bald patches on the scalp
• Thinning along the part line or at the crown
• Itching, burning or flaking on the scalp
• Changes in the eyebrows, eyelashes or body hair

Causes and risk factors

• Physical or emotional stress, childbirth and surgery
• Deficiency of iron, vitamin D and other nutrients
• Thyroid and hormonal changes, such as polyendocrine metabolic ovarian syndrome (SOMP)
• Genetic predisposition and sensitivity to androgens
• Autoimmune and inflammatory scalp conditions
• Medications and harsh chemical treatments

How it is diagnosed

The consultation begins with a detailed conversation about when the hair loss started and its pattern, recent events, the menstrual cycle, diet, medications and family history. The dermatologist examines the scalp with trichoscopy, a form of dermoscopy for the hair that shows signs characteristic of each type of alopecia, and may perform a pull test. Blood tests investigate iron, vitamin D, thyroid function, hormones and other causes. In scarring alopecias or hard-to-define cases, a scalp biopsy confirms the diagnosis and guides treatment.

How we treat it at Femi Saúde

Treatment depends on the cause. In telogen effluvium, correcting the triggering factor and any nutritional deficiencies is usually enough for recovery. In androgenetic alopecia, topical or oral minoxidil, anti-androgens, and procedures such as microneedling and injections strengthen the hair and slow progression. Alopecia areata responds to intralesional corticosteroids and, in extensive cases, to modern immunomodulatory medications. Scarring alopecias require specific anti-inflammatory medications to contain disease activity. In each situation, the dermatology team at Femi Saúde determines the most suitable combinations, monitors the response with photos and trichoscopy, and adjusts the plan over the following months, respecting the rhythm of the hair growth cycle.

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