Hair Loss

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Hair loss can affect just your scalp or your entire body, it occurs in both men and women due to genetic and environmental factors. An excessive loss of hair has a great psychological effect on a person and leads to a loss of self esteem, as a lack of a healthy head of hair has a negative impact on our aesthetic perception of our image in general. It can be difficult to come to terms with, since the hair on your head can be a defining part of your identity. If you start to lose your hair, it can feel as if you’re losing part of your identity. This can be distressing and may even lead to depression.

Apart from normal hair loss, in which hairs are lost daily due to natural regeneration, hair loss due to pathological causes is  characterized by an excessive number of hairs that fall every day and are then not replaced by new ones. This progressively creates thinning of the hair on the scalp, commonly known as alopecia. This is the general medical term for hair loss but there are many types of hair loss with different symptoms and causes.

The number and diversity of factors causing this condition make it challenging to diagnose and treat appropriately without first  performing regular monitoring in order to obtain scientifically proven results.

Trichoscopy

Trichoscopy is always the first necessary step for the treatment of hair loss as the process of hair thinning is  so gradual that it is often not noticeable from the beginning, even by the sufferer. Moreover, the affected individual can not correctly evaluate the severity of hair loss. It can therefore be understood that a detailed and comprehensive study of the scalp is imperative before commencing any treatment.

Trichoscopy is the method used for the diagnosis of conditions affecting the scalp. Hair and scalp structures may be visualized at many-fold magnification with the aid of a dermoscope or a polarized video microscope.This gives us the ability to record every square centimetre of scalp surface before and after any prescribed treatment. By establishing a thorough inventory of the quality and thickness of hairs every 3 to 6 months we can make a more accurate diagnosis. We can then later make an objective comparison of the effectiveness of the prescribed therapy.

During trichoscopy the following are recorded and measured:

The number of existing hair follicles.
The corresponding number of bristles.
The thickness of the hair.
The number of single follicular units.

The digital images obtained, along with the diagnosis, are then used to establish a benchmark. This information is then kept on a patient’s file to enable future comparisons and more accurate monitoring of the progress.

The advantages of this treatment are as follows:

We have a clear and evidence-based diagnosis of the type of hair loss.
It is an excellent test for the efficacy of prescribed hair loss medication.
It is beneficial when monitoring ongoing hair loss treatment.
In the case of hair transplantation, we can accurately calculate the amount of available follicles in the donor area.

The first decisive step towards addressing the problem has now been made.

Digital Trichogram

A digital trichogram is a non-invasive diagnostic test which assists in examining the causes of hair loss and determining the most suitable treatment for dealing with the problem.It is a specialized hair test which assists in determining the phase at which the hairs on various areas of the scalp are at a given time, both in terms of quality and quantity. The percentage of normal and affected hairs detected assists in better assessing and treating the various scalp disorders, while also monitoring the progress and results of the various treatments.

Our clinic performs trichograms with FOTOFINDER, a state-of-the-art diagnostic piece of equipment using digital technology and an advanced computer software  to photograph, record and analyze the findings. This ensures accurate evaluation of a patient’s progress and leads to better and more effective treatment. This treatment entails taking images of a previously selected area at set intervals, followed by processing and monitoring of the results using the specialized computer software.

This method is suitable for diagnosis in cases of androgenetic alopecia, also known as male-pattern baldness, and telogen effluvium, also called  diffuse alopecia, and should be carried out on hair that has not been washed for three or four days beforehand, in order to avoid the inadvertent loss of telogen (resting) hairs. The aim is to determine the rate of hair loss progression by establishing how much of your hair is in each of the three stages of the hair growth cycle, anagen (growth), catagen (transitional) and telogen (resting). It also shows hair density and any signs of hair dystrophy. On a healthy head of hair roughly 79 to 84% of the hairs are in the growth phase, known as anagen, and the hair follicles present intense activity while the roots show an increased diameter. The resting phase, termed telogen, is characterized by the inactivity of the hair follicles and a gradual loss of hair. Roughly 10 to 18% of hairs are normally in this stage.

 

Some of the more common types of hair loss are described below,

Androgenetic Alopecia

Androgenetic alopecia, also known as male-pattern baldness, is the most common type of hair loss, affecting around half of all men by 50 years of age. It usually starts around the late twenties or early thirties and most men have some degree of hair loss by their late thirties.

It generally follows a pattern of a receding hairline, followed by thinning of the hair on the crown and temples, leaving a horseshoe shape around the back and sides of the head. Sometimes it can progress to complete baldness, although this is uncommon.Male-pattern baldness is hereditary and it is s thought to be caused by oversensitive hair follicles, linked to having too much of a certain male hormone.

As well as affecting men, it can sometimes affect women (female-pattern baldness). During female-pattern baldness, hair usually only thins on top of the head. It is not clear if female-pattern baldness is hereditary and the causes are less well understood. However, it tends to be more noticeable in women who have been through the menopause and is thought to be due to the reduction in female hormones.

Telogen Effluvium

Telogen effluvium, also known as diffuse alopecia, is a common type of alopecia where there is widespread thinning of the hair, rather than specific bald patches. Your hair may feel thinner, but you’re unlikely to lose it all and your other body hair isn’t usually affected.

Telogen effluvium can be caused by your body reacting to:

  • hormonal changes, such as those that take place when a woman is pregnant
  • intense emotional stress
  • intense physical stress, such as childbirth
  • a short-term illness, such as a severe infection or an operation
  • a long-term illness, such as cancer or liver disease
  • changes in your diet, such as crash dieting
  • some medications, such as anticoagulants (medicines that reduce the ability of your blood to clot) or beta-blockers (used to treat a number of conditions, such as high blood pressure)

In most cases of telogen effluvium, your hair will stop falling out and start to grow back within six months.

Anagen Effluvium

Anagen effluvium is widespread hair loss that can affect your scalp, face and body.

One of the most common causes of this type of hair loss is the cancer treatment chemotherapy. In some cases, other cancer treatments – including immunotherapy and radiotherapy– may also cause hair loss.The hair loss is usually noticeable within a few weeks of starting treatment. However, not all chemotherapy drugs cause hair loss and sometimes the hair loss is so small it’s hardly noticeable.

In most cases, hair loss in anagen effluvium is temporary. Your hair should start to grow back a few months after chemotherapy has stopped.

Alopecia Areata

Alopecia areata causes patches of baldness about the size of a large coin. They usually appear on the scalp but can occur anywhere on the body. It can occur at any age, but mostly affects teenagers and young adults.

In most cases of alopecia areata, hair will grow back in a few months. At first, hair may grow back fine and white, but over time it should thicken and regain its normal colour. Some people go on to develop a more severe form of hair loss, such as alopecia totalis (no scalp hair) or alopecia universalis (no hair on the scalp and body)

Alopecia areata is caused by a problem with the immune system (the body’s natural defence against infection and illness). It’s more common among people with other autoimmune conditions, such as an overactive thyroid (hyperthyroidism), diabetes or Down’s syndrome.It’s also believed some people’s genes make them more susceptible to alopecia areata, as one in five people with the condition have a family history of the condition.Alopecia areata can occur at any age, although it’s more common in people aged 15-29.

Scarring Alopecia

Scarring alopecia, also known as cicatricial alopecia, is usually caused by complications of another condition. In this type of alopecia, the hair follicle is completely destroyed. This means your hair won’t grow back. Depending on the condition, the skin where the hair has fallen out is likely to be affected in some way.

Conditions which can cause scarring alopecia include:

  • scleroderma – a condition affecting the body’s connective (supporting) tissues, resulting in hard, puffy and itchy skin
  • lichen planus – an itchy rash affecting many areas of the body
  • discoid lupus – a mild form of lupus affecting the skin, causing scaly marks and hair loss
  • folliculitis decalvans – a rare form of alopecia that most commonly affects men, causing baldness and scarring of the affected areas
  • frontal fibrosing alopecia – a type of alopecia that affects post-menopausal women where the hair follicles are damaged, and the hair falls out and is unable to grow back

Scarring alopecia occurs in both males and females, but is less common in children than adults. It accounts for about 7% of hair loss cases.