What is Hairfall or Hair loss?

It is also known as alopecia or baldness. One of the reason for psychological distress nowadays.
Hair follicle growth occurs in cycles. Each cycle consists of a long growing phase (anagen), a short
transitional phase (catagen) and a short resting phase (telogen). At the end of the resting phase, the hair
falls out (exogen) and a new hair starts growing in the follicle beginning the cycle again.

People have between 100,000 and 150,000 hairs on their head. The number of strands normally lost in a
day varies but on an average about 40-100 hairs reach the end of their resting phase each day & fall
out.. In order to maintain a normal volume, hair must be replaced at the same rate at which it is lost.
When more than 100 hairs fall out per day, clinical hair loss (telogen effluvium) may occur. A disruption
of the growing phase causes abnormal loss of anagen hairs (anagen effluvium).

The first signs of hair thinning that people will often notice are more hairs than usual left in the
hairbrush after brushing or in the basin after shampooing or on your pillow.

Types of hair loss:-

Pattern baldness:

is inherited or genetic baldness. It is also known as androgenetic alopecia (failure of production of new hairs, not due to excessive hair loss). This type of baldness is generally permanent.

Pattern baldness or androgenetic alopecia is more common in men than in women. About 25% of men begin to bald by the time they approach age 30, and about two third are either bald or having balding pattern by age 60.

Male pattern baldness involves a receding hair line and thinning around the crown with eventual bald spots. Ultimately only a horseshoe ring of hair appear around the sides. In addition to the genes, male pattern baldness seems to require the presence of male hormone, testosterone. Males who don’t produce testosterone(because of genetic abnormalities or castration)do not develop this pattern baldness.

Female pattern baldness is similar to its male counterpart, although it is rarely as complete. This pattern of baldness in some women is due to genetics, age and male hormones that tend to increase in women after menopause. It involves a thinning of hairs throughout the scalp while the frontal hairline remains intact.

In addition to the common male and female pattern, the following are other types of hair loss some of which are temporary.

Alopecia areata:

An autoimmune disorder, where the immune system attacks the hair follicles causes hair loss on the scalp and other parts of body. Bald spots can be seen on scalp, beard, possibly eyebrows, eyelashes may falls out as well. However the hair follicles are active so there is potential of hair to regrow if the underlying problem has resolved. In some cases though, the disease can advance to total loss of hair from scalp(alopecia totalis) or complete loss of hair from body(alopecia universalis).

Tinea capitis:

Hair loss due to the fungal infection which can be easily treatable.

Hormonal changes:

This type of hair loss is due to the increase or decrease of thyroid hormones. This hair loss stops once the underlying disease is treated.

Female or male hormone (oestrogen and androgen) imbalances can be the cause of hair loss. Once this imbalance is corrected hair loss may stop. Some women experiences hair loss after parturition which is due to the hormonal changes.

Telogen effluvium is temporary hair loss, which can occur after serious illness, major surgery or emotional or physical stress.

Anagen effluvium:

Hair loss due to chemotherapy which targets rapidly dividing cells, so affects the actively growing hair cells. After the treatment finished, hairs may regrow. This type of hair loss also occur with radiation therapy but is localized to the area of treatment.

Anagen effluvium:

Hair loss due to chemotherapy which targets rapidly dividing cells, so affects the actively growing hair cells. After the treatment finished, hairs may regrow. This type of hair loss also occur with radiation therapy but is localized to the area of treatment.

Cicatrical or scarring alopecia:

Hair loss occurs when inflammation damages and scars the hair follicles and replaces it with scar tissue. The inflammation that destroys the follicle is under the skin surface so affected areas of the scalp may show little signs of inflammation. Cause of inflammation is not known. If the inflammation destroys the stem cells and sebaceous glands, then hair loss is permanent.

Diseases  such as diabetes, skin problems like lupus, kidney failure can cause hair loss.

Trichotillomania is a psychological condition where the individual has strong urges to pull out their own hair.

Medicines:

Hair loss can also happen due to medicines such as birth control pills, certain medicines used to treat gout, anticoagulants, antidepressants etc.

What causes hair loss:

Hormones, such as abnormal levels of androgens (male hormone normally produced by both male and female)

Genes, from both male and female parents, may influence a person’s predisposition to male or female pattern  baldness.

Stress, illness and childbirth can cause temporary hair loss. Ringworm caused by a fungal infection can also cause hair loss.

Drugs, including chemotherapy drugs used in cancer treatment, blood thinners, beta adrenergic  blockers used to control blood pressure, birth control pills can cause temporary hair loss.

Burns, injuries and x rays can cause temporary hair loss. In such cases normal hair growth usually returns once the injury heals unless a scar is produced. Then hair will never regrow.

Autoimmune diseases may cause alopecia areata. In alopecia areata, the immune system affects hair follicles with no known reasons. In most people with alopecia areata, the hair grows back although it may temporarily  very fine and possibly a lighter color before normal coloration and thickness returns.

Cosmetic procedures such as shampooing too often, perms, bleaching and dyeing hairs can contribute overall hair thinning by making hair weak and brittle. Tight braiding, Using rollers or hot curlers and running hair picks through tight curls can also damage and break hairs. However these procedures don’t cause baldness. In most instances, hairs grow back normally if the source of problem is removed. Severe damage to the hairs or scalp sometimes causes permanent bald patches.

Medical conditions like thyroid disorders, diabetes, iron deficiency, eating disorders and anaemia, skin diseases like psoriasis, lupus etc can cause hair loss. Most times, when underlying condition is treated, hairs will return unless there is scarring as in some forms of lupus, lichen planus or follicular disorders.

Diet. A low protein diet or severely calorie restricted diet can also cause temporary hair loss.

When to seek medical care?

Most often hair loss occurs without other signs of illnesses. You may see your doctor if you are loosing increased amount of hairs( more than 100) everyday to evaluate if there is any medical reason lurking behind it and to find out easy ways to get rid of it.

If the following symptoms occur at the same time of hair loss, you may suffer from some serious medical condition and you should see a doctor immediately.

  • Confusion
  • Poor appetite
  • Constipation
  • Diarrheoa
  • Vomiting
  • Weight loss
  • Fever
  • Trouble breathing
  • Skin problems

Homeopathic treatment

There are a lot of effective homeopathic medicines for hairfalling and the associated complaints like dandruff, premature greying etc. The medicines may vary individual to individual according to the symptomatology.

  • Phosphorus: itching of scalp, dandruff, falling out of hairs in large bunches
  • Selenium: hairs fall out from scalp, brows, beard and genitals. Scalp feels tense
  • Natrum muriaticum: hairs falls out when touched, in nursing women; face oily, shiny, as if greased
  • Sepia: hairs fallout, roots of hairs sensitive. Hairfall in nursing women. Pimples on forehead near hair.
  • Other effective remedies like arnica Montana, flouric acid, pix liquida, weisbeden, phosphoric acid, thyroidinum, pilocarpus, Kali sulph etc may help.

Written by
Dr Shweta Singh
MD (Hom)
With inputs from Dr Deepak Sharma

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