Hair Loss

Is Losing your hair making you lose your mind ?

This slogan on the patient information brochure of Lutsine Anti Hair Loss Therapy is merely an echo of majority of people who suffer from hair loss. Hair has no vestige of vital function in man, yet its psychological function seems immeasurable! Hair is a cutaneous appendage typical of mammalian skin. As man evolved, the process of evolution led to loss of biological function of hair but inversely its cosmetic & psychological value scaled great heights. Hair plays a very important role in that it is concerned with sexual & social communications by constructing adornments such as a Lion’s mane, a male beard & a woman’s flowing tresses.

Amongst the minor functions that hair serves are:
… helps in tactile perceptions due to its rich nerve supply,
…..protects the scalp from sun & trauma,
…..protects the eyes (eyelashes & eyebrows) from foreign bodies, sunlight & sweat,
……screens the nasal passages and
……reduces friction in the body folds.

The normal scalp has approximately 100,000 hair,………….. of these 90 % are in the Anagen or growing phase which lasts for about 1000 days,………….1% are in Catagen or the transition phase which is for about a 10 days and…..10% are in Telogen or the resting phase which is for about 100 days. The old club hair is then shed & replaced by a new hair on the scalp. Here it is important to note that every shed hair is not replaced!

The activity of each hair follicle is independent of its neighbour & is called a mosaic pattern. Follicles throughout the body as well on the scalp are out of synchrony & indeed have different periodicities. Thus keeping hair growth cycles in mind & their varying time frames a loss of up to 100 hair a day is considered Medically Normal ! This does not mean that I do not treat a person who complains of hair loss because treatment is necessary when a malady affects a person either physically or psychologically ! The difference is up to a discerning doctor who chooses the right treatment after assessing the patient with a lot of patience & interest.

Treatments for hair loss abound a plentiful, some scientific, some grandmother remedies and some veer towards absurdity! But before we treat we need to check out causes of hair loss ( Alopecia ).

1. Firstly we have a significant loss of hair follicles occurring with advancing age. Between 20 to 30 yrs approx 615 follicles abound per Sq cm of the scalp, Between 30 to 50 yrs its 485/ Sq cm, And between 80 to 90 yrs it reduces to 400/ Sq cm.
2. Environmental influences…….quality of water, sun exposure, exposure to pollutants and chemicals, dirt etc can lead t o hair loss.
3. Alopecia Symptomatica…..mental or physical stress of sudden onset can precipitate hair loss.
4. Post febrile alopecia……it is not uncommon to experience some degree of hair fall which can be serious at times following a bout of fever , Typhoid or prolonged illnesses.
5. Post Partum Alopecia………is hair fall occurring after childbirth. This is a physiological phenomenon which happens because in pregnancy the passage of follicles into catagen followed by shedding of club hair is slowed down but occurs precipitously after parturition when hormonal conditions are altered particularly the oestrogen level.
6. Hormones… growth and loss are particularly sensitive to androgens, oestrogen & Thyroid hormones.
7. Systemic diseases…….immunological diseases like SLE, scleroderma etc and also certain prolonged disease can cause hair fall. Here we must make a mention of anti malignancy drugs & radiation which are notorious for precipitating hair loss.
8. Physical causes of alopecia are too tight hairdos or pins which result in traction alopecia & a condition called Trichotillomania wherein a person habitually pulls or twists the hair shaft to break it . Patients who exhibit this urge to pull out their own hair are thought to suffer from an obsessive- compulsive disorder and need to be promptly treated.
9. Fungal infections of the scalp, chronic dandruff, bacterial infections and even tick bites cause alopecia.
10. ANDROGENETIC ALOPECIA……..or male pattern baldness has a multifactorial cause. It is inherited as an autosomal dominant trait but increased susceptibility to androgenic hormones & androgen excesses may also be involved. FEMALE ANDROGENETIC ALOPECIA is also a known entity that necessitates a thorough examination to rule out any underlying hormone deficiency.
11. ALOPECIA AERATA…………commonly seen in this part of the world and constitutes about 2% of dermatology outpatients. It affects hair & nails & tends to be rather chronic. Studies have revealed an immune mechanism that is responsible for hair loss. It is seen as circular smooth patches of hair loss on the scalp or body. If not treated they can spread or conversely may heal on their own. but the prudent approach is to show it immediately to a Dermatologist & institute treatment !
12. Cicatricial Alopecias…….this defines those cases where hair loss occurs due to scarring of the scalp & these cases are irreversible. Some scarring alopecias can follow trauma or certain diseases affecting the skin.

Treatment of Hair Loss is a true test of the dermatologists clinical acumen, patience & how well he or she can explain the condition and its outcome to the patient ! The main aim of therapy is to enhance the patients appearance. Before starting any therapy it is important to asses the patients physical & mental status. a little amount of psychotherapy is a must & never should a dermatologist dismiss the patients complaints lightly. If it was not affecting the person he would not come to us. A thorough clinical examination of the scalp , skin & nails is helpful. Any scalp or skin condition if present should be treated at the start. this in itself will reduce hair fall. if there is less than 40% hair loss of total scalp population, spontaneous hair regrowth occurs, this is also the case in mild Alopecia Aerata. Choosing an adjuvant shampoo, conditioner & supplementing vitamins and minerals along with the actual medication is a must. Anti Hair Loss therapies are many……..firstly we have the plant based extracts which are marketed by pharmaceuticals, leading names are PhytoPolleine Plus… admirable combination of grandmothers remedies & scientific know-how. This range also includes shampoos ,conditioners, vitamins etc.

Then there are natural products such as Eccrinal Horse Mane extract, Placentrex, Neobio nettle extract etc What these products contain are natural trisaccharides, proteins etc which strengthen hair shaft .

Another class of hair remedies are those which contain minerals, silica etc which strengthens existing hair shafts & increase capillary perfusion at the hair roots………….Lutsine Anti hair Loss Lotion & Shampoo, Mark Birch Scalp Drops. Actual drugs used are, Minoxidil……..known as Regaine. This is the only FDA approved drug for topical application in Alopecia. It acts by increasing the blood supply to the scalp & stimulating follicular growth. It actually causes a regrowth of hair in even bald men, the drawback being long term use and maintanence therapy. Corticosteroids..locally or systemically if given in the right amounts are invaluable in controlling hair loss & bringing about a regrowth in many cases. Contact Sensitisers…such as oxpsoralens, DNCB, diphencyprone, can sensitise the scalp & cause variable regrowth. Systemically the latest drug for hair regrowth is Fenestride. Other systemic drugs used by a dermatologist include anti psychotics, tranqulisers, antidepressants etc Systemic drugs are accompanied by their own side effects & hence the need to discern & weigh the options of systemic therapies.

Lastly we come to Hair Replacement. This is again divided into…….. SURGICAL……….Hair transplant, micro-and mini graft transplants, strip grafting, scalp reduction, tissue expanders and Juri Flap, combination procedures and rotation flap techniques. all these procedures if done by skilled surgeons are excellent but at the same time are expensive & time consuming.

NON SURGICAL……..more popular techniques which include hair weaving, extensions, wigs, toupees etc These are more accessible to average individuals and if done professionally improve the appearance vastly. With modern technologies the wigs and toupees are so natural that its a wonder to look at !

There are many more treatment modalities used such as high frequency stimulation, Biolight etc which are 50 – 50, how they work even I don’t know !

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