Hair loss (alopecia)

Dr Christophe Hsu – dermatologist. Geneva, Switzerland

Why do we lose hairs ?

• Normal hair grows in cycles and goes through 3 stages:

1. A growing phase (anagen)
2. A resting phase (catagen)
3. A falling phase  (telogen)

• At any time, it may be normal for a person to lose as many as 50 hairs a day and these usually show up on a comb or brush or at the bottom of the bathtub or sink especially after washing your hair Hair grows at 1 to 2 cm a month.

When does hair loss become abnormal ?

• Your hair loss may be abnormal if you are losing more than 100 hairs a day. This may result in a general thinning of hair or in a patchy loss of hair over the scalp and other hair bearing areas such as the beard or eyebrows.

What are the different kinds of hair loss ?

• Androgenetic Alopecia -this is the commonest cause of hair loss in both men and women. It is commonly known as male pattern baldness. It is caused by a combination of 3 factors

1. testoterone (the male hormone)
2. age (after 20 years of age)
3. hereditary. It usually affects women later in life than men.

Androgenetic Alopecia (or common balding) stage VII (according to the classification of Hamilton)

• Alopecia Areata – this usually results in a patchy loss of hair. The exact cause is unknown.

• Telogen Effluvium – diffuse loss of hair which may occur 2 to 4 months following childbirth or from high fever, acute illness, physical and emotional stress and crash dieting.
• Chronic Illness – eg. iron and other dietary deficiencies. Thyroid diseases, syphilis and connective tissue disease are examples which may cause hair loss.
• Scalp Diseases – fungal and bacterial infection, and other local scalp diseases.
• Excessive traction on the hair – for example tight curling and hair styles (corn-braiding, pony-tails).
• Drug Induced – anti-cancer drugs and anticoagulants are some of the drugs which may cause hair loss.

What shall I do when I have abnormal hair loss ?

• If you feel your hair loss is excessive you should consult your doctor. He will try to find the cause of your hair loss and may be able to treat any causative medical conditions.
• Use a wide-tooth comb and avoid brushes.
• Avoid curlers and excessive traction with curlers. It is advisable to keep your hairstyle short and avoid perm for a while.
• Be wary of what others may offer you in terms of hair treatment and cure. When in doubt, seek the advice of a doctor.
• Hair weaving is another cosmetic therapy.
• Hair transplantation is a complex procedure and requires a skilled surgeon to perform.

Contributors

Dr Christophe Hsu – dermatologist. Geneva, Switzerland

National Skin Centre. Singapore