HAIRLOSS
M.B.B.S.
E-mail: sabrisaab@hotmail.com
These
days more and more people especially teenagers are suffering from a common
problem of hairloss. Boys are a little more worried as they have a fear of
getting bald at an early age, this may lead to psychological stress &
further worsening of problem. It is to pointed out here that baldness or
alopecia is different from hair loss. Alopecia can occur at any part of body
while hairloss is a term generally applied to loss of scalp hair. Alopecia is
absence of hair from a place where they normally grow this may result from
progressive hair loss. Alopecia is a wide term and there are many types of
alopecia e.g. alopecia androgenetic (hereditary condition in which there is
progressive loss of scalp hair in men), alopecia areata (hairs fall out in
patches).
In this article I am
mainly concerned with rate of fall of hairs (normal rate of hair fall is
80-100/day). The problem starts gradually and may be troublesome within few
weeks or months. The root cause of the problem is psychological stress rather
than physical. The person suffering hides this problem and an unnecessary
depression may occur. He uses a variety of expensive cosmetic preparations, some
people may visit quacks to seek some treatment this only a waste of money and
time and can cause further worsening of the problem. Amongst the various
causes of hairloss some are discussed in this articles.
Age:
baldness is a problem of old age men but hairloss may occur at any age.
Sex
and genetics: females are not
generally not affected by baldness but can suffer from hairloss. Baldness is
common among males. The sex difference may be due to sex chromosome (Y
chromosome of males)> It has been seen that if father is bald than there are
more chances that the son becomes bald by the age of 40 years.
Dietry
deficiency of proteins, iron, biotin zinc etc. may cause hairloss, food rich in
these nutrients are meat, milk, egg, green leafy vegetables, pulses, tomatoes
fish etc.
Harmonoal
imbalance: e.g. excessive activity
of testosterone and thyroid disfunction can cause hairloss.
Testosterone
(male sex hormone) affects distribution of body hairs it decreases scalp hairs
but increases body hairs axillary, pubic, chest. Any increase or decrease in
thyroid function can lead to hairloss.
Stress:
can also lead to hairloss. Stress causes the normal asynchronous growth cycle of
individual hairs to become synchronous growth cycle of individual hairs to
become synchronous as a result large number of growing (ANAGEN) hairs
simultaneously enters into dying (TELOGEN) phase. Normally 85% of scalp hair are in anagen and 15% in telogen.
Infection
of skin: e.g. fungal infections like dermatophytosis causes hairloss especially
in childrens but this is limited to the area of infected skin. Apart from fungal
infection other infection like syphilis and leprosy causes hairloss. Leprosy
generally effect the cooler parts of the body.
Druga:
like anticoagulant (heparin & Warfarin), antthyroid, antimetabolities, Vit.
A, beta blockers, levadopa, lithium can cause hairloss as a side effect but the
hair can regrow after the drug is discontinued.
Besides
all these there are others and unknown conditions which can lead to hairloss.
In the treatment the main aim is to stop hairloss prevention of
depression and to stimulate the follicle in telogen phase. All efforts shold be
done to remove the underlying cause of the hairloss for example in case of
infections antimicrobials should be used. In case of dietary deficiency one must
eat balanced diet.
The ddrug treatment includes use of various drugs, e.g. minoxidil (antihypertensive
drug) can be used topically but should be cautiously used in Hypotensives. This
drug increases microcirculation around hairfolicles, it also stimulates
hairfollicle and alter androgens but the main problem is that baldness may recur
when drug is discontinued.
Fenasteride 1 mg/day orally (a 5 alpha reductase inhibitor used in BPH)
can be used.
Recently US food and drug
administration has approved pills to fight baldness with the brand name of
propecia once a day tablet that promises to help men regrow hair and prevent
more from falling out.
But women should never use propecia
because it can cause birth defects.
There are other drugs too e.g.
triamcinolone, cyproterone (female antiandrogen) but all above mentioned drugs
have their own side effects. One must consult a skin specialist before taking
any of them.
The surgical treatment includes
autologous hair transplant surgery which is an expensive surgery in which hairs
are transplanted.
In the end it has been concluded that
it is better to prevent hair loss rather than treating baldness for prevention
one must eat balanced diet, minimum use of synthetic chemicals, dandruff should
be checked, keep hairs, hygienic, stress and drugs should be avoided.
At last it has to be pointed here that except for cosmetic use scalp hair
do not have any function in human body. As a rule of evolution the mother nature
is withdrawing hair from human body, in this sense those who do not have hair
are more advanced on the basis of evolution.