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Hair Loss Introduction

 

Hair loss in both men and women is defined as Alopecia.  Alopecia is the termed used to describe the loss or thinning of hair.  This condition is classified into varying categories, including scarring alopecia and non-scarring alopecia.  Unlike scarring alopecia, whereby all hair follicles are destroyed and rendered useless, non-scarring alopecia may be reversed.  The remaining categories of hair loss include;

  • Male-pattern baldness

  • Female-pattern baldness

  • Hirsutism (male-pattern hair growth affecting a minority of women)

  • Hair shaft disorders.

Hair is cyclical.  In fact, most hair loss is part of our normal growth cycles.  Three phases occur in the production and reproduction of body hair.  These phases are referenced as the anagen growth phase, catagen involutional phase, and the telogen resting phase. [1]  It is not unusual for one to lose an average of 50 to 100 hairs per day during the resting, or latent phase of the hair cycle (telogen)New hair will eventually replace these lost hairs.

 

A legitimate concern arises when there is noticeable thinning or baldness.  The defining factors determining this type of hair loss can range from genetic pre-disposition to a particular vitamin and/or mineral deficiency. The thinning or balding of hair is not an immediate threat to ones physical health, but often adversely effects an individual's psychological well-being.

 

Other causes of common hair loss may include; prescription drug therapies, skin disorders, autoimmunity, severe stress, scalp radiation, pregnancy, diseases, bacterial infections, excessive androgen production, and over processed hair.  Genetic predisposition remains the greatest determinant in the balding of hair - some 95% of both men and women.

 

 

Hair Loss Symptoms

 

Signs and symptoms of alopecia are disorder-specific, meaning that each condition exhibits unique traits and patterns regarding the accompanying hair loss.  A physician or dermatologist often evaluates a patient and determines the type and severity of a given thinning/balding pattern. [2]  The following information indicates the specific signs and symptoms of categorized hair disorders:

  • Non-scarring alopecia- characterized by circular areas of hair loss, receding hair lines, a smoothness of scalp region, and inflammation. Extreme cases may also include the loss of eyebrows, lashes, and pubic hair.
     

  • Scarring alopecia- area specific; noted by visual abnormalities, such as violet-colored skin patterns, scaling, and lesions.
     

  • Hirsutism- characterized by male-pattern hair growth in women. Other symptoms include; genital abnormalities, deepening of voice, acne, and irregular and/or lack of menstruation.
     

  • Hair shaft disorders- usually involves hair that is excessively dry, brittle and very coarse. May also be recognized by skin and other noted irregularities.

Signs and symptoms which require immediate medical assistance include; hair which falls out in clumps, patchy hair loss, development of male characteristics in females, and redness, flaking, and scarring of the scalp where hair loss has taken place.

 

Types of Hair Loss:

 

Male-Pattern Baldness

Male-pattern baldness is also known as common baldness, hereditary baldness, and Androgenetic Alopecia.  This type of baldness is distinctive and has a marked progression in the hair loss taking place on the scalp.  The cause of this type of hair loss is due to genetic susceptibility (including hair follicle sensitivity), hormones, and androgens.  It is agreed that there are three causal factors in this form of hair loss: age, inherited tendency to early baldness, and the most important factor, dihydrotestosterone (DHT).  Persons with this condition also have a prolonged latent phase in the hair cycle, which further enhances the balding process. [3]

 

DHT is a potent androgen in hair follicles and is derived directly from testosterone.  It causes the shrinking of hair follicles and causes these follicles to become dormant, or inactive.  DHT also triggers specific growth factors and suppresses cell proliferation, causing apoptotic cell death.  The inhibition of such growth factors, like TGF-beta2, paralleled with DHT suppression, has proved significant in the treatment of hair loss. [4]

 

Female-Pattern Baldness

Female-pattern baldness is also known as "diffused balding."  Like its counterpart of the male variety, it too is caused by age, genetic susceptibility, and androgen. Females with this conditions experience a slower progression than males, with signs of balding around the age of 30.  This process may continue throughout menopause, or until a permanent degradation of hair follicles takes place.  However, unlike males, female-pattern baldness rarely equates to near or complete baldness and rarely interferes with the hairline. [4] 

 

Alopecia Areata

Alopecia areata is categorized as an autoimmune skin disease.  Hair follicles are mistakenly attacked by an individual's immune system, which results in the arrest of hair growth. Alopecia areata may initially manifest itself as bald patches on one's head and can progress to complete loss of scalp hair (Alopecia totalis), or even the complete loss of all body hair (Alopecia Universalis). [5]  Nearly two percent of the entire population suffers from this disease, despite its relative obscurity.

 

 

Alopecia Universalis

Persons suffering from this condition are genetically predisposed to complete hair loss, and possible distortions of the nails.  Alopecia Universalis is classified as both an acute and permanent disorder.  Individuals with this condition are usually more susceptible to diseases of the thyroid gland and vitiligo than the general population. This form of alopecia differs from other forms which permanently damage hair follicles. The regrowth of body hair remains possible for individuals suffering from this condition regardless of time spent with the complete absence of body hair.

 

 

Other forms of hair loss

Other forms and causes of hair loss:

 

  • Telogen Effluvium

  • Chemotherapeutic Induced Hair Loss

  • Trichotillomania

 

Of interest, nearly 67% of all men, and 25% of women will suffer from significant hair loss.  25% of men begin balding before age 30, with 65% balding by the age of 60. Women experience thinning hair, primarily, within the age range of 25 to 45 years of age; with complete loss after the age of 40.  Pre and post-menopausal women have a significantly elevated risk for the development of alopecia.

 

 

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