Sir,
Senescent alopecia or involutional alopecia or senile alopecia (SA) is the most frequent denomination of alopecia occurring in people aged 50 years or older with no history or evidence of androgenetic alopecia (AGA).
Clinical presentation is characterized as diffuse nonandrogen-dependent hair thinning [Figure 1] due to programmed age-dependent decrease in the number of thick terminal hairs.
Figure 1.
Clinical aspect of SA. SA: Senile alopecia
Trichoscopy [Figure 2] reveals decreased hair shaft density, honeycomb pattern, predominance of follicular units with one hair, and slight tendency toward brown perifollicular discoloration (the peripilar sign) with no evidence of hair diameter diversity, no thin or vellus hairs, and no yellow dots.[1]
Figure 2.
Trichoscopy of SA showing decreased hair shaft density, predominance of follicular units with one hair, and brown peripilar discoloration with no evidence of hair diameter diversity, no thin or vellus hairs, and no yellow dots. SA: Senile alopecia
Till now, there is no consensus studies regarding the nature of the disease.[2] Histopathologic studies[3] reveal that probably androgen plays an important role suggesting the hypothesis that SA may be considered a disease in the spectrum of AGA.
The denomination SA may affect patient sensitivity due to the close links between hair diseases and the stress they produce in our patients. Previous studies showed that alopecia leads to psychological consequences, including high levels of anxiety and depression.[4] The experience of alopecia is psychologically damaging, causes intense emotional suffering, and leads to personal, social, and work-related problems,[5] so such problems need to be dealt with carefully.
The etymology of the word ” senile ” means “suited to old age,” from French sénile (16 century). Meaning “weak or infirm from age” is first attested in 1848. This word has a pejorative sound and adds stress and anxiety to the patient. It is for this reason that we propose to change this denomination to physiological alopecia.
In conclusion, we propose a new denomination of SA by physiologic alopecia which does not affect the sensitivity of the patient.
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Conflicts of interest
There are no conflicts of interest.
REFERENCES
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