Hair loss is medically termed as alopecia, meaning loss of hair from any hair bearing area of the body.
Hair in primitive animals served an important function as it covered entire body surface and helped in maintaining body temperature, with the evolution of animals into human beings the hair coverage of the body declined gradually, in the end the hair coverage practically covering the scalp, eye brow, eye lashes. In human beings, function of hair is practically cosmetic as it forms an important part of appearance of a human being. Loss of hair causes significant psychological effect in many human beings.
Hair is appendage of the skin, which grows in a cycle. There are 3 phases in a hair cycle, namely
Anagen – this is the growing phase, the duration of this phase determines the length of the hair. Most of the hairs are in this phase.
Catagen – this is the stage where hair growth stops and it starts involuting. This phase lasts for few weeks
Telogen – this is the resting phase, here the hair which have stopped growing are held till they are shed off, this lasts for 2-3 months
Exogen – this is the phase of hair shedding
Every hair goes through this cycle, to keep producing the hair. Any disturbances in this hair cycle can cause significant hair loss. As some of the hairs are in a phase where they have to be shed, it is normal for some of the hairs to be shed daily. Normal average hair loss daily is 75-100 per day.
Hair loss is a very common problem for which a patient consults a dermatologist. In a broad way the cause of hair loss is most often simple, it depends the loss of hair is in a patch or it is diffuse occurring all through the scalp. Causes of these 2 different types of hair loss are varied.
Diffuse hair loss – this is much more common than the patchy hair loss. Most of the patients who come for consultation complain of diffuse hair loss. This hair loss can occur in a patterned manner in both the sexes; this is what is called as male-pattern and female-pattern baldness. The pattern of hair loss differs in males & females, in males it starts with recession of hairline from the front, while in females it starts as widening of central partening or loss of density of hair on the vertex i.e top of the head. This patterned hair loss is genetically determined process and is a gradually progressive condition.
The next common causes of hair loss particularly in a woman are Iron deficiency anaemia, thyroid disorders, malnutrition etc; this is termed as Chronic telogen effluvium. In some cases any acute sever illness like fevers (malaria, typhoid etc.), surgery, trauma, post-partum, severe stress can be followed by a bout of hair loss about 2-3 months following the event, this is called as Acute telogen effluvium. Some of the medications can also be a cause of hair loss; the common medications that can be a cause of hair loss are anti-cancer drugs, heparin, anti-thyroid drugs, retinoids etc.
The next form of hair loss is the patchy form this can be divided into scarring or non-scarring depending on the presence of opening of hair roots (hair follicles). The various causes of non-scarring patchy alopecia are:
Alopecia areata, this is a common cause of non-scarring patchy hair loss more so among children. It is an autoimmune disorder i.e the body starts damaging its own organ in this case the hair. It is most often a self-limiting disorder but sometimes when it is rapidly spreading or involves extensive areas it responds poorly to treatment. It can be precipitated by stress. There are several treatment options for managing it properly.
In children another common cause of patchy hair loss is the fungal infections of the hair on scalp i.e tinea capitis. This can present in several ways, like a scaling patch on the scalp or a patch of hair loss with broken hair at the surface of the hair root opening.
Another not so common cause of hair loss is the trichotillomania, which is an obsessive compulsive disorder in which the patient’s pulls off his/her own hair resulting in patches of hair loss. This form shows a characteristic tuft of broken and twisted hair.
Traction alopecia is a form of alopecia commonly seen at the front of the hair occurring due to some of the hair styles that exert an excessive pull on the hair.
Next form of hair loss is the scarring type, in which there is destruction of the hair roots, resulting in patches of hair loss that is permanent. It can occur because of several skin disorders like discoid lupus erythematosus, lichen planus, folliculitis decalvans, severe fungal infections like kerion, favus etc. Severe bacterial infections like recurrent folliculitis, furuncles etc. The causes of scarring alopecia are plenty. Management of scarring alopecia is difficult and most often it is permanent.
In addition to the above mentioned causes there are several more causes of hair loss.
Hair Care measures:
1. Hairs are a pure protein structure so a good diet is necessary for good hair.
2. Don’t use too harsh shampoos or cosmetics on hair.
3. Never comb hair when they are wet.
4. Don’t use shampoo’s more than 2 times in a week.
5. Don’t undergo procedures like hair straightening, curling etc.
Management of Hair loss: depends on its cause; there are several treatment options available for the various forms of hair loss. Whatever the treatment used it takes time for the response to be obtained as the hair grow in a cycle and the dynamics of the hair cycle need to be altered to get response, and it takes time for these things to happen. So, any treatment used for hair loss should be given a trial for at least 2 months before thinking of any response.
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