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Hair Loss

Ordinarily, hair grows in cycles. At any given time, most of the hair in the human scalp is engaged in a process of growth that can last for several years. The remaining hair is ‘resting,’ a phase which lasts for a few months, after which the hair falls out. This mild shedding, which may amount to as many as 100 hairs per day, is normal. The hair will be replaced by new follicles that will grow for several years themselves before falling out.

However, when the hairline starts to recede, when hair refuses to fill into particular spots, or when hair begins to come out in large clumps, there is something else at work. Genetic pattern baldness, unhealthy habits, or disease may be causing abnormal hair loss, and treatment may be able to help.

What are the different types of hair loss?

Hair loss can result from a number of causes. These include genetics, improper hair care, pregnancy, diet, disease, illness, and cancer treatment.

Male or female pattern baldness (androgenetic alopecia) – Male pattern baldness is marked by thinning hair at the crown and near the forehead. Unheeded, it can eventually eliminate all of the hair on top of the head. Female pattern baldness results in overall thinning of the hair. Pattern baldness can be inherited from either side of the family.

Hair care practices – Hair care practices that can cause hair loss include excessive brushing or combing; hairstyles, such as braids or ponytails, that pull at the hair; and overuse of chemical treatments, such as dyes and bleaches.

Pregnancy – Excessive hair loss often affects women immediately following pregnancy. Abnormal amounts of the mother’s hair can stop growing and fall out. New follicles will begin to grow in one to six months.

High levels of dihydrotestosterone (DHT) – High levels of DHT in the hair can inhibit its growth cycle, resulting in a gradual shortening of the hair, until it finally ends up resembling peach fuzz.

Nutrient Deficiency – Iron or protein deficient diets can result in hair loss. Shedding typically begins a few months after the body begins to feel the impact of the deficiency. The problem is easily correctable by an adjustment in diet.

Medications – Birth control pills and some types of medication – such as those prescribed for depression, blood pressure, and arthritis – can result in hair loss. Switching the type of medication or contraceptive is the best way to solve this problem.

Diseases – There are numerous diseases that can cause hair loss on various places throughout the body.

Alopecia areata is a disease of unknown causes that results in small, coin-like bald patches on the scalp. The disease is usually temporary, reversing within 18 months; in the interim, it is treatable with topical or injectable cortisone.

Alopecia totalis is the complete loss of scalp hair.

Alopecia universalis is the loss of all of the hair on the body.

Thyroid diseases, such as hypothyroidism and hyperthyroidism, can also result in hair loss; they are, however, treatable.

Illness – During bouts with severe illness, patients may notice excessive shedding. This usually ends when the patient returns to health.

Surgery – Major surgery can also cause the body to temporarily shut down the growth of hair. Hair loss should return to ordinary levels within a few months, once the patient has recovered.

Cancer Treatment – Though chemotherapy and radiation treatment for cancer can both cause a loss of hair, it normally grows back after treatment has ended.

How is hair loss treated?

Some types of hair loss can be reversed with the discontinuation of a behavior, a change in diet, or the return to health after illness. Pattern baldness, on the other hand, is irreversible without treatment. Fortunately, treatments are available, in the form of both medication and surgery.

Medications for the treatment of androgenetic alopecia come in both topical and oral forms. The prevalent topical medication is minoxidil, an ointment that is rubbed directly onto the scalp. The most commonly used oral medication is finasteride. Finasteride has been shown to be more effective than minoxidil, though both have shown some success at both stopping hair loss and growing new hair.

Surgical treatments are primarily designed for the treatment of male pattern baldness, though in some cases women can also benefit from them. They include hair transplantation, flap surgery, tissue expansion, and scalp reduction.

Hair transplant surgery – also referred to as hair grafting – involves the removal of hairy sections of scalp from the back and sides of the head and their subsequent replacement in spots with no hair. The scalp sections are removed in one of two ways: small grafts can be removed with a cylindrical punch, while larger sections can be cut out with a scalpel and divided up. The patient may choose to have the transplants divided into narrow strips, even more narrow slit-grafts, or tiny sections of only a few hairs. Openings are created in the bald area to receive the grafts, which are then inserted. The openings are then closed with stitches. The grafts are spaced out to allow them plenty of blood flow. The hair follicles in the transplant will die and fall out, but new, natural follicles will grow in to replace them. If extensive replacement is necessary, the surgery will often be completed in several stages spaced out a few months apart.

Flap surgery takes a strip of hairy scalp and relocates it to a bald spot while still leaving it connected to blood flow. To begin the procedure, the bald skin is removed, creating a receptor location along the edge of the hairline. Then, a matching hair-bearing flap of scalp is created immediately adjacent to the receptor site. This flap is removed, except for a hinge of skin at one end, and rotated over to its new position. Nourishing blood flows through the hinge to the rest of the flap, allowing it to keep growing. Usually, the flap is placed near the front of the scalp, so that other methods – such as tissue expansion or scalp reduction – can be used to fill in the area behind.

Tissue expansion is performed using a small empty sack that is inserted under the skin. The sack is gradually filled with saline over the course of a few months. The skin begins to grow new cells to expand around the bulge. This new skin contains hair follicles, so it can be placed over adjacent bald patches.

Scalp reduction involves the removal of bald skin around the crown of the head and the subsequent stretching of adjacent hair-bearing scalp to cover the area. Sutures hold the stretched skin in place while it acclimates to its new position. Scalp reduction is often used in conjunction with flap surgery to cover a bald crown.

If you are interested in hair loss treatment, you may want to contact a hair loss specialist for more information.

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