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Medical Dermatology Conditions

Hair Loss

Hair Loss / Alopecia

Hair loss or alopecia as it is sometimes referred to affects both men and women. As each instance of hair loss occurs due to the unique result of several combinations of factors, each instance needs to be diagnosed and treated as a separate issue.

Doctors basically differentiate hair loss into whether it Is localized (only a few discrete areas on the scalp), or diffused; between scarring and non-scarring patterns of hair loss – this is very important, because scarring alopecia implies destruction of the hair follicles, and results in permanent hair loss. It is not easy or even likely that a layman can determine whether he or she has scarring or non-scarring alopecia, so professional medical advice is needed as we would potentially be dealing with a very specific entity known as TELOGEN EFFLUVIUM.

Hair Growth Cycles

In order to establish whether hairfall is normal or not, we first need to understand the normal hair cycle.

Normal hair grows in cycles and goes through 3 stages:

  • A growing phase (Anagen)
  • A resting phase (Telogen)
  • A falling phase (Catagen)

Unlike some animals which shed their hair, human hair growth is asynchronous – that means that there are hairs in different stages of the cycle at any one time, and the effect of normal or physiological hairfall is therefore not too obvious, because about 80 to 90% of our scalp hairs are in the anagen phase. Hair grows at a rate of 1 to 2cm a month. At any time, it may thus be normal for a person to lose as many as 50 to 100 strands of hair daily and these usually show up on a comb or brush or on the bathroom floor, especially after washing your hair.

Types of Hair Loss

1. Male Pattern Hair Loss

Male hair loss

Male pattern hair loss is the most common form of hair loss, with approximately 50% of all men experiencing it in their lives, with some men having it even in their 20s. Various factors contribute to this condition – stress, unhealthy diet, genetics, hormonal imbalance as well as ageing are all potential causes for this. Hair loss in men occurs mainly in 2 different patterns – an M shaped loss of hair around the forehead or an O shaped loss of hair around the crown.

2. Female Pattern Hair Loss

Female hair loss treatment

The main cause of Female pattern hair loss is genetic, just as in males. However, this hair loss can also be accelerated by various other factors, including stress, oral medication and other hormonal changes as a result of pregnancy and menopause. Postpartum hair loss (hair loss after pregnancy) is normal and quite common.

Many women usually notice that their hair falls out in clumps right after giving birth and this hair loss accelerates for several months after. The official term for this form of hair loss is postpartum alopecia and it can affect up to 90% of women. Postpartum alopecia is related to the changing levels of progesterone and oestrogen during pregnancy – this causes hair to remain in the growth stage constantly during the second and third trimester of pregnancy and gives pregnant women their characteristic “thick and lustrous hair”.

After childbirth however, the hormones level out and cause the next stage of the hair cycle to occur – the falling phase – which leads to postpartum hair loss. This period generally lasts for a few months before returning to normal. If the problem persists beyond 6 months however, it is advisable for you to consult with a medical expert.

3. Telogen Effluvium

In most people, 5-15% of the hair on the scalp is in telogen at any given time. Telogen effluvium is triggered when a physiologic stress or hormonal change causes a large number of hairs to enter telogen at one time. Shedding does not occur until the new anagen hairs begin to grow, which takes 2-3 months usually. The emerging hairs help to force the resting hairs out of the follicle, which is why most people notice sudden increase in hair fall a few months after delivery, or after an acute illness. Post pregnancy telogen effluvium is one of the most common conditions we deal with in Thomson Specialist Skin Centre.

The good news is that prognosis is excellent, and in almost all cases, recovery occurs within 6 months. It is uncommon for hair loss to persist longer than this, unless there are other medical issues that can also cause hair loss, such as androgenetic alopecia, iron deficiency, or thyroid disorders. You should continue to seek medical advice if the hair loss persists beyond this time frame.

4. Alopecia Areata

Hair loss can occur from various areas of the body, including the scalp. This condition is usually triggered by emotional stress and genetic factors. Hair loss is not confined to one particular spot on the scalp and comes and goes from various spots, and can lead to permanent hair loss.

Treatments for Hair Loss

Often, no specific treatment is required for telogen effluvium. We do occasionally prescribe supplements and in some cases topical therapy. We generally advise patients to continue to use a gentle shampoo, and to minimise activities that might result in excessive hair loss, such as rough combing/ brushing of the hair, or tying it in very tight braids or buns.

In order to reduce excessive hair loss that is noted after combing the hair, use a wide-tooth comb and avoid brushes. It is perfectly fine to shampoo your hair daily, and to keep your hairstyle short. Blow drying the hair is alright, but do not place the hair dryer too close to the scalp or hair, in order to reduce the heat build-up.

1. Pilose Hair Care Range

One of the hair loss treatment products we recommend is the PILOSE hair care range. It consists of a conditioning shampoo, revitalising follicle spray and condensed activating serum. Used in combination, they strengthen weakened hair roots and protect from hair damage while promoting new hair growth and retaining hair vitality. Pilose inhibits the hormone Androgen Dihydrotesterone (DHT) and contains active ingredients such as Oligomeric Proanthocyanidin (OPC) which promotes the growth of roots and hair follicles while promoting the anagen phase. This hair care range can be used in the treatment of male and female pattern hair loss as well as alopecia areata. It is paraben free and mild and thus can be used daily.

2. Hairmax Laserband 41

HairMax is a laser light therapy that promotes hair growth. It works through a process called Photobiostimulation, delivering light energy directly to the hair follicles. This revitalises weakened hair follicles and stimulates the hair growth cycle. The HairMax LaserBand 41 is a flexible device that fits to the crown. The Flex-Fit headband is designed to fit any and all head sizes to deliver laser light energy directly to the hair follicles. The design is travel compatible as it is battery-powered, allowing freedom of movement. HairMax laser light treatment is suitable for use for both men and women who are experiencing early to moderate stages of hair loss. It has no harmful side effects and is a drug-free form of treatment that is suitable for most.

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