While there are a known number of causes for alopecia, finding a cure
has proven more difficult. We look at the reasons why you might be
losing your hair, and some tips to help you cope with it.
Causes
From mild thinning, to total loss of all hair from the head and body, hair loss can happen to men and women. While daily hair loss is common for everyone – on average we all tend to lose about 100 hairs a day – alopecia occurs when this loss of hair is not replaced by natural regrowth. We might notice more hair on our brush after brushing or perhaps notice that our parting is getting wider when we style our hair.
The loss of hair is a complex issue for sufferers. Our hair is such
an important part of our appearance that losing it can be a devastating
blow to our confidence. For men a full head of hair is often associated
with youth and vigour, and for women it connotes femininity and
attractiveness. While there is a 57% chance of the gene being in our
family, and therefore beyond our control, it can still make us feel less
attractive.
The most common form of hair loss is pattern hair loss which is
driven by genetics and hormones. Other forms of alopecia are related to
an auto-immune condition, where the body attacks its own hair follicles,
and causes the hair to fall out.
Pattern hair loss
For men, most hair thinning-up to 95%-is male pattern hair loss. This is characterized by hair receding from the hairline, coupled with a thinning crown. Together these become more and more pronounced until they eventually meet, leaving a horseshoe-shaped ring of hair around the back of the head. Pattern hair loss is largely based on genetic factors, and increases with age. By age 35, two-thirds of men will have started to notice some degree of hair loss.
In contrast, hair loss in women tends to be in the form of thinning
on all areas of the scalp, rather than in a distinctive pattern.
These two examples of thinning are triggered by DHT or
dihydrotestosterone. This is a potent form of the testosterone that
promotes body and facial hair. Changes in the way DHT is metabolised in
the body causes the hair follicle to deteriorate – the growth phase is
shortened, new hairs are prevented from growing, causing thinning and
eventually the follicle goes completely dormant.
These two examples of thinning are triggered by DHT or
dihydrotestosterone. This is a potent form of the testosterone that
promotes body and facial hair. Changes in the way DHT is metabolised in
the body causes the hair follicle to deteriorate – the growth phase is
shortened, new hairs are prevented from growing, causing thinning and
eventually the follicle goes completely dormant.
Hormones play a major role in the cause of baldness in men and women.
Apart from DHT, other hormones include those found in the contraceptive
pill, hormone replacement therapy, steroids and acne medication.
Trauma as a factor in hair loss
But there are other factors as well. Major physical trauma – childbirth, malnutrition, surgery or extreme stress can cause the hair to move from the growing phase of hair growth into the shedding phase. This is called “telogen effluvium” and can affect up to 90% of a person’s hair. As a result, in the period after trauma, you may find yourself shedding hair by the handful. While it is possible to fully recover from this type of hair loss, for some women telogen effluvium is a chronic disorder which can persist for months or years.
Another form of hair loss is common after chemotherapy. “Anagen
effluvium” occurs when there is any interruption to mitosis (cell
division) or metabolic activity. Because chemotherapy targets the
rapidly dividing cancer cells, it also targets other dividing cells such
as hair follicles in the growing phase. Up to 90% of hair can fall out
as a result of chemotherapy.
Another form of hair loss occurs after localised trauma to the hair
follicles – this occurs from the use of tight hairstyles that pull at
the roots of the hair. Braiding, corn rows and tight ponytails can all
contribute to hair loss over time, while your hairdryer can weaken the
cuticle of the hair and cause it to break off.
Diagnosis
Men and women who suffer from pattern hair loss do not usually require testing, because family history is usually evidence enough of the underlying cause.
But for other forms of hair loss there are some tests you can undergo
to confirm a diagnosis. The “pull test” or the “pluck test” test the
strength of the hair’s attachment to the scalp. The roots of the hair
are them examined under a microscope to determine the causes of hair
loss. Your doctor can order a biopsy if the diagnosis is uncertain.
Daily hair counts – when fallen hair is collected and counted – can be
done if all other tests prove negative.
For all types of hair thinning and especially excessive hair loss,
you should consult a doctor or dermatologist, who will be able to
diagnose any genetic or health-related cause.
Treatment
Hair transplantation is the process of moving healthy hair from the back and sides of the head to the area of thinning. These transplants are expensive and painful with a risk of infection and scarring. In addition, it takes some months before the procedure can be declared a success.Living with hair loss
If you don’t want to comb your hair over your bald spot, and don’t want to wear a toupee or a wig, the best way to deal with baldness is to accept it. This is especially the case for men, where shaved and stubbly heads have become common. For women and those suffering the effects of chemotherapy, a wig or headscarf is a common way to disguise hair loss. High quality wigs, however are very expensive.Tips to help you hold on to your hair
- Dry your hair gently. Pat, rather than vigorously rub your scalp.
- Don’t wash your hair every day. Too much shampoo can break down the natural structure of your hair. While it’s fine to wet it, don’t use product every day.
- Keep your hair short. Longer hair will accentuate the hair loss. Keeping it short will maximise coverage.
- Don’t over-brush your hair. Use your fingers and let your hair follow its natural growth pattern.
- Avoid stress, and try not to worry about your hair loss – stressing out will only exacerbate it.
- Be cautious of baldness cures. Despite their promises, they may be expensive, painful, and not a guarantee of success.
- Once balding has begun, seek treatment, but do not dwell on it. Try to accept it and move on.
- Adopt a more balanced diet to strengthen your body and your immune system.
