Retrograde Alopecia: Understanding, Causes, and Treatment Options
Retrograde alopecia, a less commonly discussed form of hair loss, primarily affects the nape of the neck and the sides of the scalp, presenting a unique pattern that distinguishes it from more widely recognized types of alopecia such as androgenetic alopecia (male or female pattern baldness). This condition is characterized by a gradual thinning of hair, often leading to noticeable bald patches around the ears and at the back of the head. In this comprehensive article, we will explore the intricacies of retrograde alopecia, including its causes, symptoms, diagnosis, and various treatment options available.
Understanding Retrograde Alopecia
Retrograde alopecia is a type of hair loss that manifests as a receding hairline at the nape of the neck and above the ears, startring by thinning at the bottom and progressing upwards in a band-like pattern. Unlike androgenetic alopecia, which typically starts at the temples and crown, retrograde alopecia primarily affects the perimeter of the scalp. This condition often emerges after puberty, much like androgenetic alopecia, and can occur alongside other types of hair loss.
Symptoms of Retrograde Alopecia
The symptoms of retrograde alopecia can vary, but they often include:
Thinning Hair: Hair loss typically starts gradually, with thinning observed around the nape of the neck and above the ears. The hair may take on a vellus-like quality, resembling fine, short hairs.
Band-like Hair Loss: The most distinct feature of retrograde alopecia is the band-like pattern of hair loss at the back of the head, which can progress upwards over time.
Texture Changes: Individuals may notice changes in the texture of their hair, where the affected areas may become increasingly fine or brittle.
Scalp Sensitivity: Some patients may experience tenderness or sensitivity in the areas affected by hair loss.
How is Retrograde Alopecia Different?
While most individuals are familiar with male or female pattern baldness, retrograde alopecia exhibits a distinctive hair loss pattern that sets it apart. The condition primarily affects the perimeter of the scalp rather than the crown or frontal areas. Additionally, retrograde alopecia often presents in a symmetrical pattern, where the loss is observed evenly on both sides of the head.
Causes of Retrograde Alopecia
The exact causes of retrograde alopecia are not entirely understood, but several factors are believed to contribute to the condition:
Genetic Factors
Genetics play a significant role in many forms of hair loss, and retrograde alopecia is no exception. Individuals with a family history of hair loss, particularly those who have relatives with similar hair loss patterns, may be predisposed to developing retrograde alopecia.
Hormonal Influence
Hormonal imbalances, particularly involving androgens, may influence hair growth cycles. While retrograde alopecia is not as strongly linked to androgens as androgenetic alopecia, fluctuations in hormone levels could contribute to the weakening of hair follicles along the scalp’s perimeter.
Autoimmune Disorders
In some cases, retrograde alopecia may be associated with autoimmune disorders, where the body’s immune system mistakenly attacks hair follicles. This autoimmune response can lead to the gradual thinning or loss of hair along the occipital region and other affected areas.
External Factors
External factors, such as traction from tight hairstyles, scalp infections, and chronic irritation, can also contribute to retrograde alopecia. For instance, repeated stress on hair follicles due to tight ponytails, braids, or other hairstyles can weaken the hair shaft over time. Individuals who frequently wear tight hairstyles or use harsh hair products may be at an increased risk.
Diagnosing Retrograde Alopecia
Accurate diagnosis is crucial for effectively managing retrograde alopecia. A dermatologist or hair loss specialist will typically start with a thorough medical history and a physical examination of the scalp. Specific diagnostic methods may include:
Scalp Examination
A close examination of the scalp helps identify the pattern and extent of hair loss. In retrograde alopecia, thinning hair is often observed in a band-like pattern around the nape of the neck and occasionally above and in front of the ears.
Dermoscopy
Dermoscopy, a non-invasive imaging technique, allows specialists to closely examine the scalp’s surface. This method helps in assessing the health of hair follicles and the presence of any inflammation or scarring that might indicate retrograde alopecia.
Biopsy
In some cases, a scalp biopsy may be necessary to confirm the diagnosis. A small sample of scalp tissue is taken and examined under a microscope to determine the exact cause of hair loss, such as the presence of inflammation or changes in the hair follicles.
Treatment Options for Retrograde Alopecia
Once diagnosed, treatment for retrograde alopecia aims to halt further hair loss and, in some cases, stimulate regrowth. Treatment options vary depending on the severity and underlying cause of the condition.
Topical Treatments
Topical treatments, such as minoxidil, may help stimulate hair growth in areas affected by retrograde alopecia. While it is more commonly used for androgenetic alopecia, minoxidil can be effective in promoting hair growth by increasing blood flow to hair follicles.
Corticosteroids
For cases of retrograde alopecia linked to autoimmune responses, corticosteroids may be prescribed. These anti-inflammatory medications can reduce the immune system’s attack on hair follicles, thereby slowing or stopping hair loss. Corticosteroids can be administered topically, orally, or via injections directly into the affected area.
Hair Transplant Surgery
Inmore advanced cases where significant hair loss has occurred, a hair transplant in the UK might be considered. This procedure involves transplanting hair follicles from a donor area (typically the back or sides of the scalp) to the thinning or balding areas affected by retrograde alopecia. Hair transplant surgery is often considered when other treatments have not been effective.
Lifestyle Modifications
Addressing external factors that contribute to hair loss is also crucial. For instance, avoiding tight hairstyles, reducing the use of harsh hair treatments, and maintaining a healthy diet rich in vitamins and minerals can help support overall hair health and prevent further damage to hair follicles.
Considerations for Hair Transplant Donor Areas
If retrograde alopecia has significantly affected the sides and back of the scalp, where donor hair is typically harvested for transplantation, it becomes challenging to extract enough healthy hair follicles to achieve successful and natural-looking results. This is important for long-term consideration of hair loss goals if you wish to undergo a hair transplant, as you may have less hair available in the donor area for any future surgery. If hair in the donor area which is usually not susceptible to hair loss turns out to be susceptibe, it makes the likelihood of those transplanted follicles lasting long term very slim, rendering the procedure pointless.
Ultimately, for patients with severe retrograde alopecia, a hair transplant may not be a viable option due to the lack of sufficient donor hair.
Conclusion
Retrograde alopecia is a distinct form of hair loss that affects the nape of the neck and sometimes the temple area above and in front of the ears. While the exact cause is not entirely understood, genetic factors, hormonal influences, autoimmune disorders, and external factors all play a role. Accurate diagnosis and tailored treatment are essential for managing this condition effectively. Whether through topical treatments, corticosteroids, or hair transplant surgery, there are options available to help those affected by retrograde alopecia. If you suspect you may be suffering from this condition, it is crucial to seek professional medical advice to explore appropriate treatment pathways and develop a comprehensive management plan to preserve your hair and scalp health.
Get back to Great Hair
in 3 Easy Steps:
01
Arrange Free Consultation
Speak to one of our specialist consultants for expert advice on our range of different hair loss treatments
02
Book Your Procedure
Place a deposit to reserve a time slot at one of the My Hair UK clinics across the UK
03
Attend Your Surgery
Arrive on the day and our specialist surgical team will look after your every need
