HAIRLOSS

                                                                An Article By : Imran Sabri

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.