HAIR LOSS

Hair Structure:

Hair consists of two components : 

1. The Hair Follicle :

It is made up of the papilla and bulb located beneath the scalp and helps attach hair to the scalp. The bulb has active cells which grow the hair around the papilla, and the papilla provides the blood supply to the hair follicle to stimulate healthy hair growth.

 

2. The Hair Shaft :

It is the part of the hair that grows out from the follicle and is visible. It is made up of keratin protein and has three layers; the inner layer is the medulla, the second is the cortex, and the outer layer is the cuticle that has a protective role. 

Hair Growth Cycle:

The hair growth cycle is composed of four distinct phases. Each phase has its timeline, which can be affected by age, nutrition, and overall health. So, the study of these stages is necessary to know better how hair grows and provide us with a view of what steps to be taken to deal with premature hair loss.

The Anagen Phase:
It is the period of growth and is the most prolonged phase. The cells of the hair bulb divide quickly and create new hair. It can last from three to five years as determined by genetics. After which, hair follicles become dominant.

The Catagen Phase:
It is the period of transition and tends to last for about a week or two. The hair follicles shrink, and hair growth slows down. It is also cutting the hair strand off from its nourishing blood supply. Then it is called club hair.

The Telogen Phase:
It is the period of resting and lasts around three months, and the follicle remains dormant. While new hairs start to form in a follicle, a new hair begins its growth phase.

The Exogen Phase:
It is the shedding phase, lasting about 2 to 5 months. The resting club hairs will fall out to allow the new hair to come through the hair follicle. The new hair shaft appears once the telogen phase is complete. It will result in average hair loss that is known as shedding.

 

The pattern of hair loss:

There can be;
1. Male Pattern Baldness, in which there is either a receding front hairline, loss of hair on the scalp's vertex, or a combination of both.


2. Female Pattern Baldness, there is an equally distributive hair thinning throughout the scalp.
 

Epidemiology of Hair Loss:

According to the American Hair Loss Association, two-thirds of American men have appreciable hair loss by 35. Approximately 85% of men have significant hair thinning by the age of 50.
Research shows that in women, the prevalence of hair loss is 6% in women less than 50 and 38% in those over 70. However, some other studies have shown that it is as high as 32% in women over 20 years of age.

Causes for Hair Loss:


Hair Loss takes place when new hair doesn't replace the hair that was shed. There are various causes, including;

 

1. Hormones:

                       Hormonal changes due to pregnancy, childbirth, menopause, and thyroid problems can lead to hair loss. In males, a combination of genetics and male hormone dihydrotestosterone results in hair loss.

2. Genetics:
                    It could be the result of a hereditary condition that happens along with aging. This condition is called androgenic alopecia. Also, localized autosomal recessive hypotrichosis occurs in a variety of people.

3. Autoimmune Conditions:

  • Alopecia areata: The body's immune system attacks healthy hair follicles that cause hair to fall out, and round bald patches appear suddenly

  • Lupus: Lupus causes widespread inflammation throughout the body skin, including the scalp, and that usually causes thinning of hair and loosening of hair in several people in clumps.

  • Scalp psoriasis: This disease doesn't cause hair loss itself, but scratching or picking at the scaly spots, various harsh treatments, and the stress associated with the condition can lead to temporary hair loss. But usually, after the symptoms clear, the hair grows back.

4. Stress:
               Due to high-stress levels, the following conditions are seen;

  • Trichotillomania is a mental disorder in which there is an urge of pulling one's hair from the scalp

  • Telogen effluvium is a condition characterized by a rapid transition of hair from anagen phase to telogen phase and the exogen phase that results in more daily hair loss than usual.

5. Nutrition: 

                      Iron, Zinc, Niacin, Biotin, Fatty Acids, and Selenium deficiencies frequently resulted in hair loss. Vitamin D deficiency and Protein malnutrition are also great contributors.

6. Infections: 

  • Tinea capitis is a fungal infection that penetrates very deep into the hair shaft, causing itchiness and hair loss. The hair may break off at different levels, such as the scalp's surface or just above the surface, leaving hair stubs.

  • Folliculitis is the inflammation of hair follicles due to staph bacteria or a fungus. When it affects the scalp, it usually causes temporary hair loss; however, it can be permanent in some people.

7. Medications:
It can also occur due to side effects of various medications, including ;

  • Antihypertensives, including Diuretics, ACE inhibitors, and Beta-Blockers.

  • Prescription Antibiotics can deplete vitamin B and hemoglobin that disrupt Hair Growth, eventually leading to thinning hair and hair loss.

  • Antithyroid drugs are also reported to cause hair loss.

  • Anticonvulsants such as Valproic Acid can lead to hair loss

  • Gout medications like allopurinol also cause hair loss

  • Birth control pills 

8. Chemotherapy:
Chemotherapy drugs such as Methotrexate target all rapidly dividing cells. It doesn't differentiate between healthy hair cells and cancerous cells. Depending upon the drugs and their doses and the amount of hair cell destruction, anything from mere thinning to complete baldness can occur.

Treatment:


For some conditions, such as alopecia areata, there might be no treatment needed, and hair may regrow within a year. However, for some, certain medications or other options are available to reverse or slow down the process;

1. Treat the underlying cause:
Correct the nutritional deficiencies, including those of Proteins, including taking lean meats, fish, and beans. Zinc, Folic acid, vitamin D, and Iron supplements are also prescribed if they are deficient.
Since stress is a significant cause,de-stress with meditation, counseling, avoiding daily stressors may have many positive health benefits.

2. Medications:
Over-the-counter minoxidil comes in a variety of forms, including liquids, foams, and shampoo. Another medication usually described to males is Finasteride, but it may have various side effects such as diminished sex drive and impaired sexual function.

3. Scalp Reduction Procedure:
In the scalp reduction procedure, apart from the scalp, where there is no hair, growth is removed, and the area is closed with a piece from another area of the scalp with hair.

4. Hair Transplant Surgery:
It involves removing small plugs of skin, each with a few hairs, and placing them on the bald parts of your scalp. This usually works in people with inherited baldness, and since it is progressive, multiple surgeries over time are required.

5. Laser Therapy:
A low-level laser device as a treatment for hereditary hair loss has been approved. It includes irradiation of photons into scalp tissues that are absorbed by weak cells to encourage hair growth. Overall, an improvement in hair density is seen.

Important Notice:

This website and its contents are for the purposes of general information and education only and are not to be used for diagnosis or treatment without the supervision of a healthcare provider.

Email drdar@drdarmd.com for general information

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