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About Hair Loss. What causes hair loss?

During the anagen or growth phase of the normal hair cycle, scalp hairs grow at an average rate of one half to one inch per month. The hair cycle lasts for anywhere from two to six years, followed by a two to three month telogen or resting phase. During this resting period, the hair is called a 'club hair'. When the growth process resumes, the club hair falls out of the follicle and is replaced by a new, emerging hair. It is normal to lose between 50 and100 strands a day this way, with the hair usually showing up in a comb or brush or at the bottom of the bath or basin after the hair has been washed.

Contrary to some beliefs, hair loss is not related to poor blood circulation, frequent hair washing or the wearing of hats. In the usual progression of male pattern baldness (mpb), the hairline begins to recede into an "M" pattern. At the same time or later, hair loss becomes noticeable on the crown of the head. As the condition progresses, the point of the "M" continues to recede, while the bald spot at the crown widens. Eventually, the thinning crown and receding point may meet, leaving only a horseshoe-shaped fringe of hair encircling the back and sides of the head.

Individuals genetically predestined to develop male pattern baldness have normal hair follicles in the horseshoe-shaped fringe area of the scalp. However, the hair follicles in the areas destined to become bald have a genetically predetermined sensitivity to a normal body compound called dihydrotestosterone (DHT). DHT is produced from testosterone by an enzyme called 5-alpha reductase. Genetically sensitive hair follicles shrink when exposed to DHT. As these follicles become smaller, their hair-growing (anagen) cycles shorten and their resting (telogen) phases lengthen. The hairs themselves become increasingly thinner, shorter and less deeply rooted. Eventually, hair growth ceases.

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The medical term for hair loss is 'alopecia' and there are several different types of alopecia.

  1. Alopecia Androgenetica
  2. Alopecia Androgenica
  3. Alopecia Areata
  4. Diffuse Alopecia
  5. Alopecia Totalis
  6. Alopecia Universalis
  7. Cicatrical Alopecia
  8. Traction and Friction Alopecia
  9. Self-inflicted Alopecia

Alopecia Androgenetica

By far the most common type of hair loss is Alopecia Androgenetica, which affects mainly men between 20 and 50 years of age.

Alopecia Androgenetica accounts for about 95% of hair loss worldwide and is believed to be caused by a combination of three factors: age, heredity and the male hormone testosterone. The word androgenetica is made up of two words, 'androgens' meaning hormones and 'genetica' meaning genetic (hereditary).

Alopecia Androgenica

This mainly affects men and women in later years usually after the age of 50 and is caused by a combination of the hormone DHT and age.

Alopecia Areata

This type of hair loss starts with the appearance of small bald patches usually circular. The skin in these patches appears to be different from the rest of the scalp sometimes having a few scattered hairs and other times completely bald. In most cases hair is known to have grown back again but it is not uncommon for several patches to appear and to grow larger. Exact cause is not known but usually it is connected with stress and anxiety.

Diffuse Alopecia

Diffuse alopecia mainly affects women and appears as a gradual thinning of the hair all over the scalp. There are various reasons for this type of hair loss. It has been known to develop following childbirth or following an operation. Also, thyroid or poor diet or severe illness could bring about this condition.

Alopecia Totalis

As the name implies, this condition is a total loss of hair on the scalp. As with alopecia areata, little is known about the causes and remedies. In some cases hair does grow back again but re-occurrence is not uncommon.

Alopecia Universalis

This is similar to 'totalis' but it affects the whole body, scalp, pubic and armpit hair and all body hair including eyebrows and eyelashes.

Researchers headed by dermatology professor, Angela Christiano of New York's Columbia-Presbyterian Medical Center are working on a gene that could very well solve alopecia universalis. They are presently treating a Pakistani family whose members all suffer from this genetic disease.

Cicatrical Alopecia

Also known as 'scarring' alopecia. Unfortunately, since there are no hair follicles in scarred tissue, the only way to re-grow hair is by hair transplant. Scarring can be due to a number of factors such as by accidental burns (chemical or fire), road accidents, infections and also excessive exposure to the sun.

Traction and Friction Alopecia

This is a very common problem mainly caused by ponytails or plaits. People who constantly pull their hair back tightly are bound to put a strain on the follicle and cause hair loss. Tight hair bands and tight hats could break off the hair. Also, hot combs or vigorous combing could be another cause.

Self-inflicted Alopecia

Quite a common complaint is self-inflicted alopecia. Due to stress, worry or anxiety some patients tend to literally pluck their own hair out or constantly twiddle with their hair.

 
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