Get To The Root of hair disorders
Hairloss is common and bound to cause concern but, there's news about help for hair loss While society has traditionally regarded hair loss as a man's problem, losing your "crowning glory" also can be devastating to women, teens and even children. Not too long ago, few lasting and satisfying remedies were available for people who began to experience thinning hair or baldness. Today, thanks to research that has resulted in new medical treatments, hair loss is not necessarily permanent. The type of treatment, though, depends on the form of hair loss. First of all, some hair loss is normal and incredibly common, according to dermatologists. Typically, each person sheds about 50 to 100 hairs a day, an amount that most people don't even notice. As people age their rate of hair growth decreases. A hair disorder is evident when hair loss is out of proportion to the normal amounts of loss on the scalp, or elsewhere on the body.
There are many forms of hair loss, some of which are inherited and some of which are due to physiological stress or even a medical condition. If you have excessive hair loss, or notice your hair is becoming thinner or falling out, consult a dermatologist to find the reason for the disorder. Some common types of hair loss and treatments to stop it include:
Male pattern hair loss. The most common forms of hair loss is androgenetic alopecia, or pattern baldness which is largely hereditary. A baldness gene can come from either your mother's or father's side of the family. Pattern hair loss affects an estimated 40 million men and 20 million women. What differs is the pattern of hair loss. With men, pattern baldness usually begins in the early 20s, explains Amy McMichael, M.D., assistant professor of dermatology at Wake Forest University School of Medicine in North Carolina. It starts in the front, crown and sides of the hairline. Males are more strongly affected than females and often get completely bald. With women, hair thinning usually occurs later in life and affects the crown and front of the head, but the hairline does not recede. "Some estimates indicate that about 50 percent of all people over the age of 45 have androgenetic alopecia to some degree," Dr. McMichael says. So where does that leave you and your dermatologist when considering treatments for hair loss? Currently there are two drugs approved by the U.S. Food and Drug Administration (FDA) for the treatment of hair loss. Minoxidil, marketed as Rogaine, is a topical solution and is available over-the-counter at pharmacies. The medication causes increased blood flow to the scalp, which has been linked to increased hair growth. Dermatologists say while minoxidil doesn't work on everyone, it does have a fairly good likelihood of positive results with few side effects. But it takes about three to six months to see any effects. However, any medications used to treat androgenetic alopecia will take about that long because hair has to go through its own growing cycle. While the medication may help regrow the hair, it will not speed up the growth. Another medication used to treat thinning hair is the oral prescription drug finasteride, marketed as Propecia. Finasteride is taken daily and works by blocking the formation of dihydrotestosterone (DHT), the male hormone that is associated with a shortening of the growth phase of the hair. Too much DHT in the affected hair follicles causes thinning and baldness. Finasteride has been FDA approved for use by men only. "Right now we know it's not effective in post menopausal women and we know it has the potential to be associated with birth defects in pregnant women who are carrying a male fetus," says Maria Hordinsky, M.D, professor and director of the Division of Clinical Research at the University of Minnesota.
Other physician treatments for those experiencing hair loss include surgical hair transplants, which moves a person's own hair to the thinning area, and modified scalp reductions. Dermatologic surgeons can perform hair restoration surgery to correct hair loss and create a natural-looking hairline. The latest technological advancements have led to new options and techniques that make hair restoration safer and easier for patients with more attractive results.
Prognosis When baldness is due to the hereditary hair thinning, hair loss is permanent, but treatments, including surgical transplants may be able to regrow some hair. People who have healthy, dense hair on the sides and the back of the head makes good candidates for hair restoration surgery. These are the sites that are used as donor areas - the areas from which flaps and grafts are taken. People with well-defined baldness, thinning hair, and those with limited hair loss due to scalp injury or burns are generally good candidates for hair replacement surgery. However, hair replacement surgery may not be appropriate for those with little remaining hair.Your dermatologist will help you determine what's right for you.
Telogen effluvium
A second common form of hair loss is telogen effluvium, a temporary form of shedding that occurs as a result of some physiologic stress to the body. Pregnancy or stopping birth control pills is the most common cause. You may notice this hair loss if you see excessive strands caught in your brush, comb or shower drain. A severe infection or a disease, such as lupus erythematosus, a surgical procedure, long-term illness or even losing weight from dieting can also be associated with hair loss. Often, with physiologic stress the hair loss may occur two to six months after the stressful event so it's difficult to link cause with effect. "So basically, a dermatologist has to be a detective in order to figure this out," explains Dr. McMichael. "Because people will have a life-threatening case of pneumonia in April, but when hair starts falling out in August, they don't really connect the two events because they're better and it's over." Telogen effluvium also may be caused by medication, so when the medication is stopped, the hair eventually returns. Childbirth is another precipitant. In cases where dieting is a factor in thinning hair, a lack of protein can cause hair to fall out. Eating the proper amount of protein can reverse the condition.
Alopecia areata
Alopecia areata is another form of hair loss characterized by hair falling out in smooth, round patches on the scalp. In some cases, alopecia areata can cause the complete loss of scalp and body hair. This hereditary condition is most common in people under 30. Scientists are not sure exactly why, but it is believed that something triggers the immune system to suppress the hair follicle. Alopecia areata isn't always permanent. It can last a week, a month or even years. An initial sign of the disorder can be small circles of hair loss. While Dr. Hordinsky says sometimes the condition clusters in families with autoimmune diseases, "Most of the time it appears as a solitary disease, in an otherwise healthy individual." More than four million people in the United States have alopecia areata. Hair follicles may remain alive in all people with cases of alopecia areata so hair growth may return without treatment. Although there is no cure, in some cases treatments can help. These range from cortisone injections, daily applications of topical minoxidil and use of steroid creams and ointments to cortisone pills, scalp treatments, and even wigs depending on the severity of the case. Of course there are a number of other reasons why people suffer from hair loss such as medical illness, hormone imbalance, or serious nutritional problems. "Seeing a dermatologist for an opinion and a treatment option is probably the safest route," says Dr. McMichael. "There are a lot of companies out there who will take advantage of people who are frustrated and upset about hair loss and will recommend various vitamin treatments, or other therapies that have no effect and can be harmful." Usually, a dermatologist can make a diagnosis through a clinical exam and personal medical history, including current medications and diet, noting your hair loss pattern; and seeking signs of illnesses or scalp infection. Sometimes a scalp biopsy may be necessary. Women may also require a blood test to detect possible hormonal abnormalities.
Coping with Hair Loss When hair loss triggers anxiety
Find out what's wrong. Learn about different treatments. Contact a national or local support group, such as the National Alopecia Areata Foundation (see page 30), as they can offer assistance to people who are having trouble coping with hair loss. Ask your dermatologist to pass your name along to other patients in the practice who can offer support. Seek out those who have similar disorders, discuss them and figure out ways together of approaching everyday life with this hair loss problem. For more information about hair loss, ask your dermatologist for an educational pamphlet from the American Academy of Dermatology or log on to www.aad.org
By Karen L. Wagner, a freelance writer in Austin, Tex., who has authored numerous health articles for a variety of consumer publications.
