Hair Loss
Common Hair Loss Conditions
Hair loss conditions are often divided into scarring (cicatricial) and non-scarring (non-cicatricial). By far the most common alopecias are non-scarring (non-cicatricial). This means there are clinical treatments which are effective for many people to stop or slow progression of the condition, and in some cases to regrow, thicken and strengthen the hair. The sooner treatment is started, the more effective it is likely to be.
Unfortunately though, when scarring does occur, it causes permanent, irreversible hair loss. Damage or disease of the hair bulge, typically caused by inflammation, leads to destruction of the hair follicle so it is no longer capable of producing a hair. Early diagnosis and treatment is important to prevent further follicles from being lost and either stopping or slowing progression.
Children’s conditions
Hair loss and scalp conditions in children are much more common than most people imagine. It causes the child or young person great distress at a time in their life when it is particularly important to them to fit in and be “normal” amongst their friends and peers. Children’s hair loss and flare up of scalp conditions is often caused, worsened or made more difficult to treat by other emotional stressors in their life, whether the chronic anxiety some youngers feel growing up or specific events such as exam pressure. Supporting a child with hair loss can have a huge impact on the whole family. Diagnosing the condition and its cause first is essential to determining the best course of action.
For anyone going through chemotherapy or radiotherapy treatments for cancer, hair loss is a huge added trauma. I understand how devastating it is for a child or young adult to face losing their hair. There is much support and options for coping throughout their treatment period whilst reassuring them that the hair loss is temporary and it will regrow.
Telogen Effluvium
Mainly diagnosed in women, this causes excessive diffuse (all over the scalp) hair shedding and thinning. A temporary disturbance in the hair growth cycle causes the growing (anagen) hairs to prematurely enter the resting (telogen) phase. It is caused by variety of internal factors, sometimes in combination, including emotional stress, short term illness, severe infection, surgery or medication, hormones, medical conditions like anemia or thyroid problems. Acute (sudden) onset can occur several months after the triggering event. Clients are often reluctant to wash or brush their hair because of the amount of excess hair fall.
Chronic, (ongoing) telogen effluvium is usually caused by an underlying medical condition or the use of long term medication.
The good news is that telogen effluvium does not cause scarring and can sometimes be easily resolved if the underlying cause can be correctly identified and treated. A consultation enables accurate diagnosis and establishes all causative factors so that the most appropriate treatment plan can be discussed. Newly regrowing hair may take many months and up to a year to be noticed as increased hair density. Monitoring can be reassuring to check for early signs of regrowth and adapt treatment to prevent recurrence.
Post Partum Hairloss
A form of telogen effluvium which can occur a few months after childbirth.
Anagen Effluvium
Is widespread hair loss which can affect your scalp, face and body which occurs when hair suffers a toxic shock, fracturing the hair shaft in its active growth stage (anagen).
One of the most common causes is chemotherapy to treat cancer and sometimes immunotherapy and radiotherapy too. The hair loss is usually noticeable within a few weeks of starting treatment. However, not all chemotherapy drugs cause hair loss and sometimes the hair loss is so small it’s hardly noticeable.
Hair will normally regrow spontaneously once treatment ends. There are many support groups and practical guides using temporary measures such as wigs, hats and scarves to help people cope and feel better about their appearance in whatever way suits them best.
Androgenetic alopecia – male and female pattern
Non-scarring condition where an inherited sensitivity to normal levels of testosterone causes the affected hair shafts to progressively thin (miniaturise) with each hair growth cycle.
Female Pattern Hair Loss (FPHL) is typically progressive thinning over the vertex (top) of the head and temples with a widening central parting. Responsible for only about 10% of female hair loss issues with complete balding very rare. Incidence increases with age.
Male Pattern Hair loss (MPHL) typically thinning then balding progressing from temples, crown, front hairline and vertex (top). Most common cause of male hair loss (80% of cases).
Alopecia Areata
Affecting men, women and children at any age, and particularly aged 15-29, the body’s immune system mistakenly attacks the hair follicles, prematurely stopping hair growth in the anagen phase. The hair suddenly falls out leaving one or more bald patches. There is a genetic link in 10-20% of alopecia areata cases. Treatments are targeted at “switching off” the immune response.
Traction Alopecia
Hair loss caused by hair breakage from the trauma of persistent tension pulling on the hair from various hair styles like ponytails, braids, cornrows, dreadlocks, hair extensions and certain hair bands. Damaged hair will usually grow out if the tension is stopped and there is a good hair care regime. Continued tension over a longer period can lead to scarring and permanent hair loss.
Hair breakage can also be caused by chemical processes such as permanent waves, colours, highlights and relaxers. The hair, already weakened by these chemical applications and heat damage, can be easily broken by the traction from vigorous brushing, combing, blow drying or styling.
Trichotillosis (Trichotillomania)
This is self-inflicted, patchy hair loss and breakage caused by a compulsion to continually pull out, twist or rub the hair. The patches of hair loss are easily confused with other conditions like alopecia areata. It is therefore important to seek advice and get a correct diagnosis and treatment, as the repeated pulling over time can result in scarring and permanent hair loss.
Cicatricial (scarring) Alopecias
Permanent, often progressive, hair loss present in men, women and children. Early treatment aims to halt or slow progression.
Frontal Fibrosing Alopecia
Permanent, scarring hair loss mainly affecting post-menopausal women. The condition causes a progressively widening band of pale, smooth scalp around the hairline. Inflammation and scalp sensitivity are often present in active areas. The aim of treatment is to calm the inflammation, halting or slowing progression. Hair follicles which have been lost to scarring cannot be recovered so early treatment is important.