Hair Loss and Thinning

Introduction

Normal hair growth

Shedding 50 to 100 hairs a day is considered normal. When a hair is shed, it is replaced by a new hair from the same follicle located just below the skin surface. Hair is mostly made up of a form of protein, the same material found in fingernails and toenails. Everyone, regardless of age, should eat an adequate amount of protein to maintain normal hair production. Protein is found in meat, chicken, fish, eggs, some cheese, dried beans, tofu, grains, and nuts.

Causes of abnormal hair loss

Abnormal hair loss can be due to many different causes. People who notice their hair shedding in large amounts after combing or brushing, or whose hair becomes thinner or falls out, should consult a dermatologist. It’s important to find to find the cause and whether or not the problem will respond to medical treatment.

A dermatologist will evaluate a patient’s hair problem by asking questions about diet, medications taken within the last six months, family history of hair loss, any recent illness, and hair care habits. The dermatologist may ask a female patient about her menstrual cycles, pregnancies and menopause. After examining a patient’ scalp and hair, she may check a few hairs under the microscope. Laboratory tests may be required which sometimes include examining a small sample of scalp under a microscope.

Common causes of hair loss include:

• Childbirth
• High fever, severe infection, severe influenza
• Thyroid disease
• Inadequate protein in diet
• Medications
• Cancer treatment drugs
• Birth control pills
• Improper hair cosmetic use/improper hair care

Some forms of hair loss will regrow. Other forms can be treated successfully by a dermatologist. For the several forms of hair loss for which there is no cure at present, there is research in progress that looks promising for the future.

Alopecia Areata

Description

In alopecia areata round patches of hair loss appear suddenly. The hair loss is often discovered by a barber or hairdresser. The hair-growing tissue stops making hair, and the hair then falls out from the roots. Why this happens is a mystery. Alopecia areata is not contagious, not caused by foods, and not the result of nervousness. It sometimes runs in families. Some patients with alopecia areata also have thyroid gland abnormalities. If a blood test of thyroid function has not been done within the past month, we recommend one.

Alopecia areata has three stages. First there is sudden hair loss. Then the patches of hair loss may enlarge. Last, new hair grows back. This takes months, sometimes more than a year.

Treatment

Hair usually grows back by itself, but slowly. Sometimes the new hair is temporarily gray or white, but after a while the original color usually returns. The natural regrowth of hair can often be speeded up injecting a cortisone medicine into the area of hair loss. The cortisone is injected into the skin. It acts only in the area where it has been injected. Unfortunately, there is no way of preventing new areas of hair loss. However, if new areas of hair loss appear, regrowth may be helped by injecting cortisone.

Dermatology Update by Dr. Sandra Surbrugg

Recent News about Hair Loss

M en are not the only ones who experience hair loss due to male pattern baldness. Both men in women who are predisposed to "androgenetic alopecia" inherit a genetic sensitivity to male hormones, which are produced by both sexes. The male hormone testosterone is converted to the hormone DHT, which triggers genetically susceptible follicles to slowdown or cease hair production. While men with male pattern baldness tend to lose hair mostly on the front and top of their heads, women's hair generally thins out all over. Their hair never becomes as sparse as men's, nor do women become completely bald, because they're protected from excessive hair loss by the way in which they metabolize hormones.

A side from the topical treatment of minoxidil, men with male-pattern baldness have a new way to treat their hair loss. It comes in pill form and goes by the name finasteride. This drug was originally approved for the treatment of enlarged prostates, but researchers began studying its potential for hair growth after some prostate patients with male-pattern baldness noticed hair regrowth while they were taking the drug. In clinical studies, 80% of the men who took finasteride noticed either slight-to-moderate hair regrowth or a cessation of hair loss. Unfortunately, the drug is not appropriate for women with thinning hair because it causes birth defects. Additionally, a small percentage of men who took finasteride experienced diminished sexual drive and impotence as side effects, which disappeared once they stopped taking the drug. Finasteride must be taken indefinitely to sustain its effects.

A s with any drug, caution is advised. There are some possible side effects, and finasteride is not appropriate for all men. If you are experiencing male-pattern baldness and wish to learn more about this treatment, please speak with your dermatologist.

Telogen Effluvium

Description

Telogen effluvium is a common type of excessive hair loss which can occur without warning in men and women of any age. Ordinarily, the human scalp has about 100,000 hairs and, of these, around 50-100 are lost every day. In telogen effluvium the daily loss ranges from 120-400 hairs. The hair loss can occur for many reasons, but whatever the reason there is almost always complete regrowth of the lost hair without treatment.

Common causes of telogen effluvium include: normal pregnancy and delivery, surgery, fever, certain drugs, stress, chronic illness, thyroid disorders and crash dieting. In most cases the hair loss becomes noticeable between two and four months after delivery of a baby, after surgery, illness, stress, or the onset of any other causative factors.

Treatment

It is important that you not be overly concerned about this hair loss. Telogen effluvium always self-corrects, but the anxiety you generate worrying about it may prolong the course. Try to concentrate on maintaining good general nutrition and on good scalp care and you should expect to see regrowth of your hair within a few months.