HAIR LOSS

Hair loss is an extremely distressing condition for sufferers. Fortunately, most cases of hair loss resolve, either with appropriate treatment, or spontaneously.

There are many different causes of hair loss, and three of the more common conditions are discussed.
 

Alopecia Areata (A.A.)

This is one of many autoimmune conditions that can affect individuals. In AA, blood cells called lymphocytes (which normally fight infection) swarm around hair follicles, causing the hair shafts to fall out prematurely. Fortunately, they do not destroy or scar the hair follicle, and in many cases, hair growth returns. When and at what rate the hair growth returns is unpredictable.

The basis of AA, like other autoimmune diseases, is thought to be genetic. However, illness and emotional stress is described to be a trigger factor in many cases.

The most common kind of AA is seen in patients who lose round patches of hair in the scalp, or beard area. More severe forms of the condition are alopecia totalis (total loss of scalp hair) and alopecia universalis (loss of all body hair).
 

Treatment

Although there is no one reliable treatment for the condtion, your dermatologist will discuss with you the various options available:

British Guidelines for the Management of Alopecia Areata
 

Telogen Effluvium (T.E.)

Every person has a proportion of scalp hairs in the “telogen” phase of the hair cycle. This is the phase of the hair cycle when that particular hair has stopped growing, is ready to fall out and makes way for a new healthy hair pushing up.

It is normal for approximately 100 hairs to be lost per day during brushing or shampooing of hair. In certain situations, the number of hairs being shed increases significantly, and is very alarming for the individual.
 

Common trigger factors include:

The trigger factor can precede the period of hair shedding by 2 to 3 months. The increased rate of hair shedding can sometimes last quite a few months.

In a small proportion of cases, the term “Chronic telogen effluvium” is used. In this condition, individuals suffer increased hair shedding for extended periods, without obvious trigger factors.

Neither acute nor chronic forms of telogen effluvium cause baldness. In the majority of cases, hair growth completely returns to its previous state. In some patients, telogen effluvium may unmask an underlying tendency to genetic balding (androgenetc alopecia), which can be seen in both men and women.

Your dermatologist will determine whether a scalp biopy or blood tests are required to confirm the diagnosis, and exclude other causes of hair loss.
 

Androgenetic Alopecia

Both men and women can suffer from gradual thinning of their scalp hair with age. The speed at which the thinning occurs varies between individuals.

In males, a genetically determined sensitivity to the effect of a hormone calleddihydrotestosterone (DHT) is thought to be the cause of premature thinning in affected individuals. DHT is an enzyme which can cause the gradual miniaturization of hair follicules, particularly over the crown of the scalp, and each side of the frontal scalp.

Researchers have shown that 5-alpha reductase is an enzyme that regulates production of DHT. The effect of this enzyme can be blocked by oral medications. Please discuss with your dermatologist whether this, or options are available to you in treating androgenetic alopecia.