LLR Policy for Alopecia

Category

Threshold Criteria

Alopecia is the general medical term for hair loss. There are several types of hair loss with different symptoms and causes.

Male and female pattern baldness

This is the most common type of baldness which follows a pattern in men of receding hairline, followed by thinning of the hair on the crown and temples, leaving a horseshoe shape around the back and sides of the head. In women hair usually only thins on the top of the head.

In men it is hereditary and is thought to be caused by over sensitive hair follicles, linked to having too much of a certain male hormone.

Female pattern baldness is less well understood, though it tends to be more noticeable in women who have been through the menopause.

Alopecia areata

Alopecia areata causes patches of baldness about the size of a large coin. They usually appear on the scalp but can occur anywhere on the body. It can occur at any age, but mostly affects teenagers and young adults.

In most cases of alopecia areata, hair will grow back in a few months. At first, hair may grow back fine and white, but over time it should thicken and regain its normal colour.

Alopecia areata is caused by a problem with the immune system (the body’s natural defence against infection and illness). It’s more common among people with other autoimmune conditions, such as an overactive thyroid, diabetes or Down’s Syndrome.

Leaving alopecia areata  untreated is a legitimate option for many patients as spontaneous remission occur in up to 80% of patients with limited patchy hair loss of short duration (<1 year).

Scarring alopecia

Scarring alopecia is usually caused by complications of another condition. In this type of alopecia, the hair follicle is completely destroyed. This means your hair won’t grow back. Early intervention can prevent further and permanent hair loss.

Depending on the condition, the skin where the hair has fallen out is likely to be affected in some way.

Conditions which can cause scarring alopecia include:

• Scleroderma – a condition affecting the body’s connective (supporting) tissues, resulting in hard, puffy and itchy skin
• Lichen Planus – an itchy rash affecting many areas of the body
• Discoid Lupus – a mild form of lupus affecting the skin, causing scaly marks and hair loss
• Folliculitis Decalvans – a rare form of alopecia that most commonly affects men, causing baldness and scarring of the affected areas
• Frontal Fibrosing Alopecia – a type of alopecia that affects post-menopausal women where the hair follicles are damaged, and the hair falls out and is unable to grow back

Eligibility

Guidance