Hair fall: Cause & Solution
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Transcript of Hair fall: Cause & Solution
HAIR FALL: REASON & SOLUTION
Dr Alok Tripathi
https://iiopinion.blogspot.in
Hair loss, also known as alopecia or baldness
■ Alopecia is the general medical term for hair loss.
■ There are many types of hair loss with different symptoms and causes.
Kind of Hair Loss
genetics and male hormones
male-pattern baldness
not clear
female-pattern baldness
autoimmune
alopecia areata
complications of another condition
scarring alopecia
cancer chemotherapy
anagen effluvium
(thinning of hair) physically or psychologically stress
telogen effluvium
Androgenetic Alopecia (AGA:
Male- and female-pattern baldness (most common)
When it affects women, it leads to diffuse alopecia over the mid-frontal scalp (female pattern hair loss) [1].
Miniaturization of hair follicle is responsible for it, which represents a progressive reduction in diameter, pigmentation and length of the hair shaft [2,3].
Also androgens induced it in genetically susceptible persons, which is manifested by increased 5α-reductase activity and dihydrotestosterone (DHT) levels in hair follicles.
In such genetically susceptible cases, the DHT binds to the androgen receptor and the hormone-receptor complex, activating the genes responsible for the transformation of the normal hair follicle in miniaturized follicles [4, 5].
The reduction in the number of terminal fibers per follicular unit will produce a diffuse alopecia [3]. The impact of androgenetic alopecia is predominantly psychological [6].
Alopecia Areata (AA) (~2%)
a nonscarring autoimmune, inflammatory scalp, and/or body hair loss condition
characterized by patchy hair loss.
Histopathology shows an increased number of the catagen and telogen follicles
and the presence of an inflammatory lymphocytic infiltrate in the peribulbar
region [6].
Scarring alopecia (cicatricial alopecia)
It can be caused by a diverse group of rare
disorders that destroy the hair follicle, replace it with
scar tissue, and cause permanent hair loss.
Scarring alopecia (cicatricial alopecia) types
• a condition affecting the body's connective (supporting) tissues, resulting in hard, puffy and itchy skinScleroderma
•an itchy rash affecting many areas of the bodyLichen Planus
• a mild form of lupus affecting the skin, causing scaly marks and hair lossdiscoid lupus
• a rare form of alopecia that most commonly affects men, causing baldness and scarring of the affected areasFolliculitis Decalvans
•a type of alopecia that affects post-menopausal women where the hair follicles are damaged, and the hair falls out and is unable to grow back
Frontal Fibrosing Alopecia
Anagen effluvium
It is the pathologic loss of anagen or growth-phase hairs. Classically, it is caused by radiation therapy to the head and systemic chemotherapy, especially
with alkylating agents.
Less common causes of hair loss without inflammation or scarring include
pulling out of hair,
•including chemotherapy, HIV/AIDS, hypothyroidism,
certain medications
•including iron deficiency. Causes of hair loss that occurs with scarring or inflammation include fungal infection,malnutrition
lupus erythematosus,
radiation therapy,
•Diagnosis of hair loss is partly based on the areas affected.[2]
sarcoidosis
Age-dependent changes & hair conditioners in damage processes of hair cuticle
the dominant damage pattern shifts from type L to E with aging.
Cuticle becomes gradually less resistant to daily grooming stress.
dominance of type E damage accelerates cuticle loss.
Reduction of 18-MEA on weathered hair is accelerated with aging on elder hair [w].
age-dependent changes in age of 40s and 50s
Alt
era
tion
in
hair
sh
aft
, su
ch a
s
diameter,
density,
cuticle becomes more fragile
hair surface properties deteriorate [x]
Hair color changes
by daily care damages on
ultra-structure
which may be occur due to damaged of
endocuticle layer in form of hole n cavity
formation [y].
Nanoscale characterization of
human hair and hair conditioners [z]
Diagnosis
1- Pluck Testpulling hair out "by the roots".
examined under a microscope to determine the
phase of growth, and is used to
diagnose a defect of telogen, anagen, or
systemic disease
Telogen
hairs have tiny bulbs without
sheaths at their roots.
Telogen effluvium
an increased % of hairs upon
examination.
Anagen hairs have
sheaths attached to their roots.
Anagen effluvium
a fall in telogen-phase hairs &
raise in number of broken hairs.
Diagnosis (contd)
2-Pull Test evaluate diffuse scalp hair loss
Gentle traction is exerted on a group of hairs (~40–60)
on 3 different areas of the scalp
If more than ten hairs are obtained, the pull test is
considered positive
3-Scalp biopsy
to diffrenciates scarring and
nonscarring forms.
Hair samples are taken from areas of inflammation, usually around the
border of the bald patch.
4-Daily hair counts
done if the pull test is -ve. It
by counting the number of hairs lost. either after combing or after
bath
<100 is normal while after shampoo <250 is normal
Prevention
If some substantial loss of hairs (i.e.>100 hairs after combing or bathing and >250 hairs after shampoo) occur without family history, attention on points should be
Eat a nutritionally balanced diet.
Avoid tight hairstyles, such as braids, buns or ponytails.
Avoid compulsively twisting, rubbing or pulling your hair.
Treat your hair gently when washing and brushing. A wide-toothed comb may help prevent pulling out hair.
Avoid combing in wet condition.
Avoid harsh treatments such as hot rollers, curling irons, hot oil treatments and permanents.
Head massage with any natural oil and proper cleaning thereafter shall be helpful
types of problems as per your concern
Type I
Hormonal changes
Type II
alopecia areata
autoimmune
scarring alopecia
•scleroderma
•lichen planus
•folliculitis decalvans
•frontal fibrosingalopecia
telogen effluvium
•Stress
•Hair styling tools:
•Frequent use of chemicals
•Junk food:
•Harsh weather conditions:
•Sleep deprivation
anagen effluvium
Medications &
treatments:
Type III
Gender
genetic causes
growing age
Treatment Androgenetic Alopecia
Topical Minoxidil (2% solution recommended
by FDA for female)
Side effects include a transient shedding
during the first 4 months of use and contact
dermatitis
Finasteride is a synthetic type-2 5α-reductase
inhibitor: 2.5 in female ^ 1 mg/day in male
efficacy is questionable It is contraindicated in
pregnancy, due to known teratogenicity.
Anti-Hormonal Therapy
Spironolactone (aldosterone antagonist)
is employed as a potassium-sparing
diuretic
should not be used in pregnancy due to its
teratogenic effects
Cyproterone acetate is an androgen receptor blocker with strong
progestational activity
decrease hair shedding, but does not seem to promote regrowth
Treatment
Alo
pe
cia
Are
ata
Treatment not mandatory;
Some therapeutic agents includes systemic, intralesional & topical steroids under occlusion and topical
immunotherapy with squaric acid dibutylester or diphencyprone
Treatment
Chemotherapy Induced Alopecia
Scalp cooling is as a method of preventing hair loss during chemotherapy
. Trichotillomania
Behavior therapy and pharmacotherapy are the most efficacious treatments for adult
other medications such as opioid blockers, atypical neuroleptics, and glutamate modulators hold promise as treatment for trichotillomania
Treatment
Telogen Effluvium
Iron Supplementation
(+)
Biotin Supplement
@5mg/day (±)+B5
Cysteine Supplement @500
mg daily)±
Authors Recommendations: types of problems as per your concern
Ty
pes
Type I: you need not to seek much attention it will usually
go by its ownHormonal changes
Type II: where your attention is valuable
alopecia areata
scarring alopecia
telogen effluvium
Type III: where even your attention will not able to make significant change & that too
up to limited extent.
genetic causes
Age
Nutritional Requirements for Hair
Proteins
ILU, LEU, LYS, MET, CYS, PHE, TYR, THR, TRP, VAL,
HIS
Fat
hydrocarbon, Squalene, wax esters,
triglycerides, Fatty Acids, Cholesterols, Cholesterols Sulfate, Ceramides, 18-MEA,
Minerals
Ca Fe, Cu, Mg, Si, Pb Zn
& Se,
Vitamins
B6, B12, C, D
Nutritional Recommendations & Constituents
Egg
Oyster
Blueberries
Sprouted Lentils
Fish
Walnuts
Green Leafy Vegetables
Yogurt CURD
Protein: Amino Acids
++++
+++
-
++++
++++
--
++
+++
Fat
Saturated, Cholesterol
Saturated, Cholesterol
-
-
+++++
ω-3, EPA
ω-3,Mono, Polyun
--
Saturated, Cholesterol
Minerals:Zn, Se, S, Fe
Zn, Se,S, Fe, K, Mg,
Zn (x500)
Fe, K, Mg,
Ca, Mg, K,
Fe, Cu
Fe, Ca
Cu, Fe
Mg, K, Fe, Ca
Mg, Fe, Ca, K
Ca, Mg, K
Vitamins
A, B6/12 C, D,
A, B6/12 C, D,
A, B6/12 C, D,
A, C
Vit E D
B6, C,
B12, 6, C, A,
B12, A
Antioxidants
-
+
++++
++
+++
+
Carotene
---
For details please visit https://iiopinion.blogspot.in/2017/01/hair-fall-scientific-way-of-treatment.html