Hair loss is usually a gradual condition affecting millions of males and females and even children.
Often hair loss becomes a distressing and even embarrassing problem to many. Pattern of hair loss can be localized (patchy) or diffuse. Although majority of hair loss is due to age related hormone changes and in few cases caused by genetic contribution, It is important to get your condition reviewed by the doctor, as there are many other underlying acute or chronic conditions that can cause hair loss which are important not to be missed.
Why do we lose hair?
To answer this, we must understand the 3 main stages of a normal hair growth cycle:
Growing phase ( anagen)
Resting phase (catagen)
Falling phase (telogen)
The length of each phase of the cycle, as well as the length of the entire cycle, varies with the site and the age of the patient. The average length of the anagen phase is 1000 days, the catagen phase lasts only a few days; and the telogen phase lasts 100 days. Hence it is normal to lose some hair as part of this cycle, usually while washing or combing hair.
However, you will probably start worrying if u are losing excessive hair, more than 100 strands/day ( I can imagine people start asking themselves now “ does that mean I have to keep track and start counting every strand of hair that falls everyday?”).Essentially you do not need to be as OCD as that. When you start noticing a general thinning of hair or patchy hair loss over the scalp and other hair bearing areas such as the beard or eyebrows, naturally this will start to ring alarm bells for you to seek medical advice.
Common causes of hair loss and management
This typically causes a patchy loss of hair. The exact cause is not known but can sometimes be sign of an underlying thyroid disease. Other areas such eye brows, pubic and axillary hair can also be affected. Treatment is essentially not necessary as this condition is benign and self limiting (spontaneous regrowth) and recurrences are common. Treatment options depends on patient’s age and preference. For children, steroid creams can be applied whereas for adults, if the scalp involvement is < 50%, intralesional steroids injection is an option, together with topical steroids and minoxidil 5%.
The commonest cause of hair loss in both men and women. Depending on the pattern of alopecia, it is either called male pattern baldness (MPB) or female pattern baldness ( FPB). 3 main factors that contributes to this pattern of hair loss are : testosterone level (the male hormone), age (>20 years) and genetic predisposition. Only 2 medications have shown effective results : minoxidil and finasteride. Minoxidil is a topical application available as 2% and 5% solutions whereas finnasteride is an oral medication.
This hair loss usually results from trauma to the normal hair as a result of a stressor such as post child birth, surgery, crash dieting or fever that causes an abnormally large percentage of hairs to move into the resting and falling phases, and eventually causing a temporary diffuse thinning of the scalp hair. This condition will resolve spontaneously as it is a reactive process, usually after 2- 6 months
Chronic illness/ Nutritional deficiencies
Iron deficiency anaemia is an important cause of diffuse hair loss/thinning that is easily reversible with iron supplements and increasing iron intake in diet. Systemic illnesses like thyroid diseases, secondary syphilis (‘moth bitten’ appearance) and connective tissue disease are conditions that should not be missed as the causes for alopecia. Thus, several blood tests may be done when the pattern of alopecia is suspicious for these conditions.
Hair loss can also be caused by certain fungal and bacterial infection of the scalp which can be easily treated with topical antifungal and oral antibiotics
Drug Induced – for example certain blood pressure medications, oral contraceptives, & anti coagulants are known to cause/ worsen hair loss.
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