¿Existen las urgencias del pelo?

Do hair emergencies exist?

We review the main hair conditions that may arise and the urgency with which you should seek consultation (and thus I help you control your anxiety).

Let's put the question into context: a medical emergency is considered by the WHO as a situation of diverse cause and variable severity that generates the awareness of an imminent need for attention. When speaking of hospital emergencies, it is specified that this must compromise the integrity or life of the patient and require immediate treatment. And what about hair? Well, the first thing is that there is practically no situation of hair alteration, without being associated with other symptoms, that could immediately endanger the patient's life.

Okay, and then you think, great, I'm not going to die… BUT I'M GOING TO GO BALD FOREVER and that generates a feeling of an imminent need for attention. In this post, I'm going to explain the different situations of hair alteration and whether or not they truly require "urgent" attention. Because, although it is true that the most frequent types of alopecia are conditions that progress slowly and can be reversed with treatment, there are two important ideas:

  1. The sooner an alopecia condition is treated, the better the chances of a good outcome.
  1. There are some conditions that cause permanent alopecia; in other words, the areas where hair loss occurs cannot be recovered.

Let's look at the possible situations:

First situation: A lock of hair or an area falls out, leaving your scalp exposed. Meaning, it leaves you with a completely bald patch. In this case, it is recommended to seek early clinical evaluation. It could be alopecia areata or other less frequent conditions of scarring alopecia. In both cases, early attention improves outcomes.

Second situation: Sensation of intense burning or itching on the scalp, associated with crusts or pimples. In this case, early evaluation is also recommended to prevent inflammation from destroying the hair. The more intense the symptoms, and especially if accompanied by pimples or scaling, the more important it will be.

Third situation: Abundant hair loss. This is one of the most frequent complaints from patients, and in most cases, it does not imply a serious situation.

When there is an increased hair loss that is generalized throughout the head, it is usually due to hair turnover that in most cases is self-resolving. Its treatment shortens the shedding time and promotes growth. You should seek faster attention if you notice that the hair loss persists for more than 4 weeks or if, when falling, you see areas of the scalp that become exposed.

Fourth situation: Sensation of beginning to thin in some area. This is generally synonymous with androgenetic alopecia conditions. In these cases, you should not worry, but you should take action, as the sooner treatments are started, the better the results will be.

So when do I go? My recommendation is: if you notice any hair alteration, any of them, get moving and go to a specialized consultation as soon as you can, because it is always better to prevent and treat as soon as possible. Obviously, if you identify with any of the situations described as more urgent, don't get overwhelmed, it doesn't mean that your expectations are bad, just that there is that possibility. Severe cases of permanent alopecia, if diagnosed and treated early, achieve very good results, so don't get overwhelmed.

And as I always tell my patients in this regard: "Don't worry, take action." Okay, it sounds cliché, but if you're worried about your hair and you're going to have to make time to get it checked out, isn't sooner better? Because you're going to "spend" the time anyway.

Bernárdez C, Molina-Ruiz AM, Requena L. Histologic features of alopecias-part I: nonscarring alopecias. Actas Dermosifiliogr. 2015;106(3):158–167. doi:10.1016/j.ad.2014.07.006

Bernárdez C, Molina-Ruiz AM, Requena L. Histologic features of alopecias: part II: scarring alopecias. Actas Dermosifiliogr. 2015;106(4):260–270. doi:10.1016/j.ad.2014.06.016

Gupta AK, Mays RR, Dotzert MS, Versteeg SG, Shear NH, Piguet V. Efficacy of non-surgical treatments for androgenetic alopecia: a systematic review and network meta-analysis. J Eur Acad Dermatol Venereol. 2018;32(12):2112–2125. doi:10.1111/jdv.15081

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