Hair has always been at the center of attraction for humans since times unknown. From the “secret” of Samson’s strength in his hair to the importance of “kesh” in Sikhism, the obsession of the human race with hair is quite evident.
In today’s fast moving and stressful life, we often ignore our small problems as insignificant until it takes the form of an annoying long-term problem, sometimes becoming a part of our identity.
The same situation arises in case of hair problems. Before getting professional advice from a dermatologist, a lot of people ignore their hair fall problem in a hope that it will resolve on its own, followed by countless trials of non proven home remedies and alternative medicine. Failures of such remedies create a sense of hopelessness and frustration, which prevents the patients from getting any more treatments.
There are some common conditions leading to hair fall/hair loss, which we would like to discuss here in an attempt to educate the society.
Androgenic alopecia affects both men and women and is commonly known as patterned hair loss, Male pattern hair loss (MPHL) & Female pattern hair loss (FPHL) in respective genders. It is usually inherited from maternal or paternal side of the family, though we see sporadic cases from time to time. Universally this is an extremely common disorder that affects roughly 50% of men and perhaps as many women older than 40 years. As many as 13% of premenopausal women reportedly have some evidence of androgenetic alopecia. However, the incidence increases greatly in women following menopause, and, according to some authors, it may affect 75% of women older than 65 years.
There is a progressive and gradual miniaturization of scalp hair under influence of male sex hormone Dihydrotestosterone (DHT), which is formed from Testosterone.
In males the condition progresses with recession of hairline or thinning of hair in the crown area or both. Over time the bald area increases slowly joining from all sides and leaving only a strip of hair, which continues from above the ears on either side and meets at the back of the head. The hairs in this area are relatively resistant to thinning by the androgenic process.
In females the hair loss follows a different pattern, a more diffuse pattern. Females don’t experience the infamous hairline recession experienced by males, instead they lose hair from the midscalp area. The early signs are widening of the partition line, which slowly progresses in a Christmas tree pattern.
Androgenetic alopecia is amenable to treatment with lotions and pills, but usually is progressive and the treatment is usually directed at slowing the rate of hair thinning or at the most halting it. At present hair transplantation is the only practical solution to bring back lost hair.
Telogen Effluvium is the name for a common cause of temporary hair loss due to the excessive shedding of resting or telogen hair after some shock to the system.
In a normal healthy person’s scalp, about 85% of the hair follicles are actively growing hair (anagen hair) and about 15% are resting hair (telogen hair). A few hairs may also be in catagen i.e. the transition phase. A hair follicle usually grows anagen hair for 4 years or so, then rests for about 4 months. A new anagen hair begins to grow under the resting telogen hair and pushes it out. Thus, it is normal to lose up to about 100 hairs a day on one’s comb, brush, in the basin, or on the pillow, as a result of the normal scalp hair cycle.
If there is some shock to the body, as many as 70% of the anagen hairs can be precipitated into telogen, thus reversing the usual ratio. Typical triggers include childbirth, a major illness like typhoid, jaundice, malaria, dengue, etc., surgeries, psychological stress, crash dieting, etc.
The good part about telogen effluvium is that it is temporary even if it continues for a long period. Eventually, the hair regrows. Treatment in such cases just speeds up the recovery.
Alopecia Areata occurs when the body’s immune system attacks its own hair follicles and prevents it from growing new hair. It can affect any hair-bearing area of the body.
Individuals with alopecia areata notice focal areas of the body (scalp or otherwise) becoming completely devoid of hair and shedding of hair in clumps. The amount of hair loss and areas affected is different in every patient. Some lose hair only from a few spots whereas some cases may deteriorate to losing hair from the whole scalp (alopecia totalis) or even the whole body (alopecia Universalis).
The prognosis of this condition is generally good, as in the hair regrows, but it’s largely unpredictable as the condition does have a tendency to recur and sometimes can even by completely nonresponsive to treatment.
There are infections, cicatricial alopecia, hair shaft abnormalities, and a few more conditions, which lead to hair loss in a small percentage of patients.
We invite and encourage you to not ignore hair problems and get professional help while there is still time.