Hair Loss: What Causes Thinning hair And What To Do To Reverse Alopecia?

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Hair Loss: The Causes, Symptoms And Treatments!

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Hair Loss

Hair loss, otherwise known as alopecia in medical nomenclature, is a phenomenon that we all (if we live long enough) have to deal with, eventually. But for a number of people, hair loss can occur at a time nowhere near old age, and even then dealing with it can be an especially stressful and trying experience.

Social Stigma Of Hair Loss

Hair loss in general is physically painless, but for some people the psychological and emotional distress it causes can deal more damage to them than any wound. Across many cultures, hair is a symbolic representation of one's identity, youth, vitality, and attractiveness. This is especially true for women, whose hair not only marks their femininity but also acts as an avenue for their self-expression –much more so than for men. Comb Full Of Hair

With such weighty concepts associated with our hair, it’s no wonder that losing it can cause serious detrimental effects on a person’s self-esteem and outlook on life. Those experiencing hair loss might feel especially anxious and conscious about their appearance –they might feel less confident because they see themselves as being unattractive; they might worry that they look old, sickly or unkempt; and they might feel ashamed of themselves and be alienated.

The unease that people experience with hair loss can develop into more serious problems if they don’t keep it in check. It can lead to a great deal of emotional suffering and depression as well as numerous problems in one’s career and social life. If people become more withdrawn, they might find it extremely difficult to interact and socialize with their peers –this is especially true for those hoping to enter into a relationship with someone, because chances are, other people might also share their sentiments about their appearance. Adolescents who experience hair loss are also a lot more susceptible to depression and social stigma, because they not only have to deal with the condition during a time when there is a heightened concern over one’s appearance, but they also have to deal with their peer group, who, unlike more mature individuals, might not be as understanding towards their condition.

The Hair Growth Cycle

Before learning more about hair loss, its causes, and ways to treat it, it would be helpful for us to first learn more about the nature our hair. Our hair is composed of a protein called keratin- which is the same material that our nails are made of. The strands of hair we see are connected to our skin through hair follicles, where hair growth primarily takes place. Hair grows since birth and will continue to do so until old age. It grows in a cyclical manner, with each hair follicle going through three phases of growth –anagen, catagen, and telogen- several times during one's lifetime.

The growth phase or anagen lasts for about three to seven years, and during this phase, hair looks thick and nourished as it is continually growing at a rate of about half an inch each month. About 80 to 90 percent of the hair on your scalp will be in this phase at any given time.

The catagen phase is considered a period of transition, wherein the hair detaches from its blood supply and the hair follicle shrinks. Usually, only around three percent of the hair on your scalp will be in this stage and it will last for only two weeks to a month.

The final stage, the telogen phase, is the resting period, wherein the hair stops growing, becomes weaker, thinner, and then slowly falls off so that it can be replaced by a new strand of hair. This phase accounts for the 50 or so hairs that wind up in your brush or down the shower drain every day, which is normal and is no cause for alarm. This phase lasts for about three months, and includes 10 to 15 percent of the hair on your scalp.

Types and Causes of Hair Loss

One person's bald spot or thin patch of hair might not look much different from another’s, but there are actually different types of hair loss, with varied degrees of severity and distinct causes for each case. It’s best to know what type of hair loss one has and what specifically is causing it in order to find the best possible treatment for it.

Androgenic Alopecia Androgenetic alopecia AKA androgenic alopecia is the most common type of hair loss, and it is progressive and permanent in nature. Though it is perhaps more commonly known as "male pattern baldness," don’t let the name fool you. It actually affects both men and women, albeit in different ways. For men, their hairline will begin to recede at the temples, and the area at the top of the head will thin out and eventually lose its hair, resulting in either partial or complete baldness. For women, their hair loss is less severe, since it’s generally limited to the hair at the front and sides of the scalp simply thinning out. Total baldness for women is possible, although it is considerably rare.

The occurrence of androgenic alopecia is largely determined by the presence of hormones and androgens, as well as the person's genetics. The enzyme 5-alpha-reductase produced by our prostate and adrenal glands as well as hair follicles, converts the androgen testosterone, present in both men and women, into dihydrotestosterone. Dihydrotestosterone is a metabolite involved in our growth and physical development, but it has the unpleasant characteristic of attaching to hair follicles and interrupting their growth processes, causing them to shrink and the hair’s growing duration to shorten. As a result, the strands become thinner and less durable, and with each succeeding growth cycle, the follicles continue to shrink and the scalp thickens, until eventually, the hair that falls out will no longer be replaced, leaving a bald area.

Since men produce more testosterone, they will experience greater hair loss; while women, who not only have less of the hormone, but also possess estrogen which suppresses the effects of testosterone, will experience much less.

Telogen effluvium is another common type of hair loss, caused by a disruption in the hair’s normal growth cycle. Hair from the growing phase is rushed prematurely into the resting phase, causing it to thin out and shed. There are numerous reasons why this sudden shift in the growth cycle might occur, but generally it involves some sort of shock to one’s system, which can be physical or mental in nature.

Physical trauma such as being gravely injured, undergoing a major operation or delivering a baby can trigger the sudden shift to the resting phase, as can mental trauma like severe psychological stress, or emotional distress from a traumatic event. During this time, the body has a number of hair follicles enter the resting phase in order to divert its energies to the other parts of the body where they are more needed. Depending on the situation, the hair follicles might remain in the resting phase for a prolonged period instead of transitioning back into the growth phase. Hair growth usually returns to normal once the condition which triggered the telogen effluvium is settled, though it may take months for the lost hair to grow back on its own.

Traction alopecia is a type of hair loss caused by excessive tension applied to the scalp through wearing very tight hairstyles, such as ponytails, pigtails, braids, cornrows, and the like, as well as through excessive styling and combing. Constantly wearing tight hats, helmets, bandannas, or other forms of headgear which also put tension on certain areas of the scalp can also cause this kind of hair loss. The strain can cause damage to the hair strands as well as the hair follicles, and if the strain is not eased, it can result in scarring on the scalp, which will cause permanent hair loss. Removing excess strain on the hair before any scarring occurs should return one’s hair to normal.

Alopecia areata is another type of hair loss, although not as common as the previous varieties. It is an autoimmune disorder, wherein the person’s own immune system malfunctions and attacks the cells of his or her own body, mistaking them for foreign bodies or harmful elements. This kind of hair loss is characterized by retardation of hair growth, hair follicles becoming inflamed, and the formation of one or several bald patches of varying degrees. This can range from a small, isolated bald spot on the scalp, to the disappearance of all the hair on a person's head and face.

There are no definite causes for Alopecia areata, with allergies, viral infection, and genetic predisposition being some of the suspected causes for the condition. Moreover, no definite cure for the condition has been developed, either. The treatments applied to individuals diagnosed with the condition are purely supportive in nature, attempting to reduce its effects of its symptoms.

Though the probability that people afflicted with the disorder will recover and re-grow their lost hair without the need for any additional treatments is reasonably high, at around 65 percent, the probability that the disorder might resurface and develop into a more severe form is reasonably high, also, at 25 percent.

Other causes of hair loss include:

Poor Nutrition – Having an inadequate intake of nutrients can also lead to hair loss, since the body won’t get enough nourishment to promote and sustain its growth. Proper hair care –though it is very important- isn’t the only thing one should be concerned with when it comes to preventing hair loss. Maintaining a healthy diet and getting enough necessary nutrients is essential in keeping hair healthy as well. In particular, zinc, vitamins B, C, E, and protein are some of the important nutrients involved in hair growth. Zinc and vitamin B helps prevent dandruff and can be found in foods like chickpeas. Vitamin E and iron, found in soybeans, almonds, promote healthy blood flow into the scalp. Vitamin C, found in a number of citrus fruits and vegetables, not only aids in the absorption of iron, but is also essential in the formation of collagen, a necessary element of hair growth. Eggs are a good source of protein, as well as other nutrients necessary for hair growth.

Those with eating disorders like bulimia and anorexia are especially susceptible to hair loss. People on crash diets to lose weight or special diets like vegetarianism also run the risk of hair loss, if they don’t get enough nutrients from their meals.

Illness – In certain cases, hair loss can be a sign of more serious illnesses like diabetes, lupus or hypothyroidism, which cause hair fall due to an increased susceptibility to damage with their weakening of hair follicles. Scalp infections, which can be caused by fungi such as ringworm and folliculitis, parasites like those in the Demodex family, as well as other foreign agents, can have similar effects.

Medication – Certain drugs have hair loss as a side-effect. Perhaps the best-known examples are those involved in chemotherapy. They aim to destroy rapidly-dividing cancer cells, but in the process, also harm normally-fast-dividing cells like those found in hair follicles. Some other drugs known to cause hair loss or thinning include arthritis medication, mood stabilizers like lithium, anticonvulsants like Depakote, and certain diet pills. Unlike those used in chemotherapy, these drugs can cause hair loss by inducing telogen effluvium.

Hair Treatments – The chemicals used in cosmetic hair treatments like perms, hair dyes, hair bleaching, tints, and straighteners can damage hair if not used properly or if used too much. If hair is exposed to the particularly strong chemicals in these treatments for longer than their prescribed durations, hair can become brittle and fall off due to breakage.

Trichotillomania – Another reason why people lose their hair is because they pull it out themselves. Trichotillomania is a psychological disorder wherein a person compulsively pulls his or her hair out, whether it’s from the scalp, arms, legs, eyebrows, or elsewhere on the body. It can leave a person with damaged hairs of uneven lengths– or worse, scattered bald spots.

Diagnosis Of Hair Loss

Trying to cure something you aren't ailing from or taking medication you don’t need isn’t just a waste of time and money –it's also potentially harmful. Getting properly diagnosed for hair loss is the first important step towards recovery, since pinpointing the exact cause of hair loss narrows down one's options on how to properly deal with the situation. There are a variety of diagnostic tests that can be performed to ascertain the type of hair loss a person might be experiencing, including:

Densitometry, wherein a doctor examines a person’s scalp using a magnification device called a densitometer. Using this method, one can assess the health of one’s hair follicles and see if the hair shafts have miniaturized. If they have, it might suggest that androgenetic alopecia is the cause of hair loss.

Hair Pull Tests are simple diagnostic tests which help evaluate the health of the hair present on one’s scalp. A doctor gently pulls on a small amount of hair to see whether there is an excess of strands that come out. One to three hairs coming off at a pull would be normal, but if much more hair is pulled out, it might indicate that telogen effluvium is causing hair loss.

If a scalp infection of some sort is suspected to be the cause of hair loss, a doctor might opt to take skin scrapings –getting small samples of skin from the scalp or from plucked-out hairs and examining them to verify if there is a foreign agent present and infecting the scalp.

In case the exact cause of hair loss is found to be difficult to determine, doctors might suggest taking a scalp biopsy. Biopsies involve taking a tissue sample from the patient and then examining it under a microscope or analysing it chemically in order to more precisely verify the cause of the problem. For scalp biopsies, a sample four millimeters in diameter including the deeper layers of the skin is usually taken. Take note, though, that scarring is a possible risk for taking scalp biopsies.

Hair loss can be a symptom of other illnesses such as thyroid disease or diabetes, so undergoing tests for related medical conditions which cause hair loss is also advisable. Since certain drugs have hair loss as a side-effect, taking note of medication taken would be helpful in determining the cause of hair loss, also.

In cases of androgenic alopecia, it would be useful also to determine how light or severe one’s hair loss currently is. The efficacy of the various treatments available for alopecia is largely dependent on how far progressed a person’s hair loss currently is. The Hamilton-Norwood Scale for men and the Ludwig Scale for women is used to determine a person’s present stage in his or her pattern baldness. The former is divided into seven stages while the latter is divided into four; and in both, a lower stage number corresponds to an earlier, more manageable stage with less hair loss while a higher one corresponds to a more advanced stage with a greater amount of hair loss.

Treatments Of Hair Loss

There are several treatments available for alopecia, though no true cure for it as a result of the aging process has been developed. Today’s treatments for hair loss are mostly preventive, auxiliary, or augmentative in nature –meaning that they either retard or conceal hair loss, or promote hair growth.

Finasteride, perhaps more commonly known as Propecia, is a prescription drug known to slow down hair loss, and as such, can be classified as a preventive treatment. The drug was originally intended to be administered to patients suffering from enlarged prostate glands, but it was found to have the interesting side effect of hair growth, and so, it was eventually developed to become the treatment for alopecia it is known for today.

Finasteride works by inhibiting 5-alpha-reductase’s ability to convert testosterone into dihydrotestosterone, which is the primary agent which causes androgenetic alopecia by shrinking our hair follicles. Taken regularly, Finasteride can reduce dihydrotestosterone levels by as much as 60 percent, and can halt the progression of one’s pattern baldness.

Take note, however, that there have been rare cases reported wherein the drug was found to have an adverse side-effect of weakening one’s sex drive and sexual performance. Take note also, that pregnant women should not take Finasteride, as it may cause birth defects.

Although considerably new in the treatment of hair loss, saw palmetto extract might be a viable alternative to Finasteride. Like Finasteride, not only was saw palmetto extract found to be able to alleviate the effects of enlarged prostates; it was also found to reduce hair loss through the similar mechanism of lowering our bodies’ dihydrotestosterone levels by dampening 5-alpha-reductase’s ability to convert testosterone. Moreover, it also prevents the absorption of dihydrotestosterone, making it a potentially more powerful treatment.

Unfortunately, like Finasteride also, side effects of reduced sexual performance have been reported in connection to saw palmetto extract, along with numerous others such as stomach pain, constipation, diarrhea, as well as jaundice, liver inflammation, muscle pain, bleeding disorders, and several more. Presently, further study is needed to develop and ascertain the guaranteed safety and efficacy of saw palmetto extract.

Minoxidil, also known as Rogaine, is an over-the-counter drug, and is applied topically, available in 2 and 5 percent solutions. It promotes hair growth and as such, can be considered an augmentative treatment.

Like Finasteride, Minoxidil was originally intended to treat another medical condition –in this case, as a treatment for hypertension. It was also discovered to possess hair growth as a side effect, and as such, it was eventually developed as another treatment for hair loss. Unlike Finasteride, however, it promotes hair growth instead of hampering hair loss. It does so by conditioning hair follicles for maximum hair growth. Since the medication is applied topically, irritation of the scalp might arise as a side effect for some people.

Another treatment which promotes hair growth is low level laser therapy, popularly available in the form of laser combs. Low level laser therapy is a relatively new science which can improve the health and growth of hair by altering cellular function, encouraging cellular growth by stimulating photochemical reactions in our skin, like the formation of vitamin D.

Certain commercially-available shampoos such as Nizoral contain the drug Ketoconazole –usually in one or two percent solutions- which helps fight against hair loss in two ways: as an antifungal agent, and as an anti-androgen. The drug not only destroys the foreign agent in cases where a fungal infection is the cause of hair loss, but also reduces the production of androgens such as testosterone due to its anti-androgenic properties.

For excessive hair loss or pattern baldness which has already progressed into the later stages, undergoing hair transplant surgery might be more appropriate treatment. Hair transplant techniques involve a dermatologist or cosmetic surgeon implanting tiny plugs of skin containing one or more healthy strands of hair into the bald sections of the scalp. The hair used can either be the patient’s own, taken from other areas of the body or the scalp; or from a synthetic material.

Take note, however, that hair transplant surgery will involve numerous elements to consider and might pose some risks on the person being operated on. Besides the expenses involved, finding a skilled and reliable hair transplant surgeons as well as an appropriate hair donor will be an issue. Moreover, besides the risk of scarring and infection resulting from the surgery, the possibility of a botched transplant is also possible, if ever the surgeon is unskilled or commits mistakes during the procedure.

Making use of hairpieces such as wigs and toupees is another alternative to cover one’s bald or thinning areas. Hairpieces come in an assortment of styles, makes, colors, fabrics, and prices. A variety of attachment methods are also available, from ones which utilize adhesive strips for easy attachment and removal, to ones that are attached semi-permanently through liquid adhesives and will sit securely on the head for days at a time. Hairpieces require some maintenance, not only for the unit itself, but also for the user's scalp, since some adhesives used to attach hairpieces can leave residue and irritate the skin.

Existing hair that is placed underneath a hairpiece will become more susceptible to falling out, also, so shaving off any remaining hair before wearing a hairpiece might be recommended. If possible, adopting certain hairstyles like comb-overs which conceal bald or thinning areas is also a viable alternative.

 

 

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