Hair Loss

Hair Loss

The hair is our crowning glory and most people get upset when they see strands of hair on the bathroom floor and the bedroom. At any time, it is normal for a person to lose as many as 100-150 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. This is normal hair fall

Your hair loss may be abnormal if

  • You are losing more than 100-150 hairs a day
  • You see bald patches of hair loss in the scalp or other hair bearing areas such as the beard or eyebrows
  • You noticed hair thinning either as a general thinning on the crown or thinning in a specific pattern

Androgenic alopecia is the commonest cause of hair loss in both men and women. Every one of us will eventually have this form of hair loss; the onset varies from person to person. It usually affects women later in life than men. It is commonly known as male pattern hair loss or female pattern hair loss as there is a definite pattern of hair loss. In men the hair loss typically follows a pattern with receding hair line and baldness on the top of the head. In women the hair becomes thin over the entire crown.

Androgenetic alopecia is caused by 3 factors

  • Genetic
  • Male hormone testosterone
  • Age, usually after 20 years

Treatment of androgenetic alopecia

  • Topical hair serum
  • Oral finasteride
  • Laser treatment
  • Hair transplant

Beware of the numerous hair tonics that are available as some may not work for androgenetic alopecia. When in doubt, seek the advice of Dr Joyce Lim, a dermatologist.

Alopecia areata is a patchy hair loss seen in children and adults. It can be a single patch or multiple patches seen on the scalp. Sometimes the eyebrow or beard hairs may be affected. It is an autoimmune condition.

Treatment of alopecia areata

  • In some patients recovery may be spontaneous
  • Topical corticosteroids or calcineurin inhibitors
  • Steroid injections
  • Topical immunotherapy

Trichotillomania is a medical disorder that causes people to repeatedly pull out their own hairs. They often feel a constant urge to pull out the hair on the scalp. Sometimes they feel compelled to pull out their eyelashes, nose hairs, eyebrows, and other hairs on their bodies.

Treatment of tricotillomania

  • Identify the cause
  • Psychological evaluation and treatment

Telogen effluvium (or excessive hair loss)  occurs 3-4 months after a period of physical or emotional stress or after an illness or surgery or after crash dieting. During the stressful period hairs move from the growing anagen phase into the resting telogen phase. Three months later, these telogen hairs will start to fall. It can be quite scary as telogen hairs easily fall off. Just running your fingers through your scalp may result in large amounts of hairs on your hands.

However, do not panic. Telogen effluvium is a reversible hair loss. After another three months all the telogen hairs will be replaced by anagen hairs and you get back your full crown of hairs

Post pregnancy hair loss

Many women notice excessive hair loss 3 months after they had a baby. This is related to the high levels of hormones during pregnancy that causes the hair to continue growing and not go into the resting phase. After pregnancy the hormones return to normal levels and the hairs fallout. This is temporary and the normal hair cycle resumes on its own after pregnancy

Other causes of hair loss

  • Medical conditions like anaemia, thyroid disease and autoimmune disease
  • Medicines that can cause hair loss include blood thinners, medicines used for gout, high blood pressure or heart problems, vitamin A (if too much is taken), birth control pills and antidepressants.
  • Fungal infections or bacterial infections of the scalp can cause hair loss in children
  • Certain hairstyles and hair treatments can also cause hair fall. Excessive traction on the hair results in localised hair loss as seen with tight curling and hair styles (corn-braiding, pony-tails).

Be wary of non medical advice in terms of hair treatment and cure as some are not based on science.  When in doubt, seek the advice of Dr Joyce Lim, a dermatologist.