Hair and Scalp – The Trichology

What is hair loss [ alopecia ] ?

Hair is matter of concern for every one and that makes every one curious to know about what is normal hair loss and what amount of hair loss can lead to baldness .
Every one should know each hair follicle has its own cycle that can be influenced by age ,disease and other factors. At one point about 90 % of hair on a persons scalp is growing .
As hair follicle produce new hair cells,old cells are being pushed out through the surface of the skin at the rate of about six inch a year ; the hair you can see is actually a string of dead keratin cells .
The average adult head has about 100,000 to 150,000 hairs and loses up to 100 hair a day .
And finding few hair strands on comb is not a cause for alarm. About 50-100 hair fall per day is normal .

Hair life cycle is devided into three phases :

• Anagen – active hair growth that lasts between two to six years .
• Catagen –  transitional hair growth that lasts two to three weeks .
• Telogen – falling phase that lasts about two to three months; at the end of the resting phase the hair is shed and a new hair replaces it and the growing cycle starts again.

Types of hair loss :

1. Generalised or Diffuse hairloss or Telogen Effluvium:  Hairloss is a normal phenomenon and in some cases even losing 100 hairloss per day is normal. But in Telogen Effluvium there will be excessive amount of hairloss without sort of pattern balding over the scalp. This phenomenon happen normally after childbirth, after suffering from prolong fever like typhoid, malaria, chikungunya, dengue or with some history of prolong bed-rest. In this kind of condition more and more scalp hairs are coming into Telogen phase(normal 10-20% of scalp hairs) causing more and more of hairloss. This condition is mostly self-limiting and sometimes needs a prompt and effective treatment. Some perceptible causes for this kind of hairloss are severe stress, nutritional changes (crash dieting), chemical (dye or haircolor, after straightening, perming of hairs), hormonal changes like pregnancy, puberty, and menopause, and some disease conditions like PCOS, thyroid diseases, iron deficiency anemia are also responsible.

2. TractionAlopecia:  This is a small or localized hair loss area caused by repetitive or persistent pulling or force on hair roots. Tight braids and ponytails can pull hard enough on hairs to make them fall out.

3. Trichotillomania:  This condition is habit of voluntarily pulling at own hairs or twisting them without realizing it. Most of the time, this condition is associated with period of depression or anxiety. It causes some broken off hairs over some particular patches of the scalp.

4. TineaCapitis:  This condition is fungal infection over the scalp shows bald spots with broken-off hairs. Due to fungal infection over a particular area of the scalp the hairs are broken from the shaft.

5. Androgenic or Androgenetic alopecia (Male-pattern or Female-pattern Baldness).

This type of alopecia is often attributed to genetic predisposition and family history. Traditionally, this was originally described only in men, but we now know it is seen in both men and women. The hair loss in men is often faster, earlier onset, and more extensive.

Causes of hair loss :

1. Genes : both parents may influence persons predisposition to male or female pattern baldness.
2. Prolonged Stress ,child birth ,fungal infection can cause hair loss .
3. Chemical and cosmetic procedure : such as dyeing,purming, straightning ,bleaching can damage and break the hair .
4. Medical conditions : typhoid ,anemia, lupus ,lichen planus can cause hair loss and in some case if scarring is there than permanent hair loss can occur .
5. Diet : a low protein diet and severely calorie restricted diet .
6. Drugs : certain drugs such as chemotherapy drugs ,blood thinners ,blood pressure medicines , birth control pills can also cause hair loss.
7. Burns ,injury ,x-rays can cause temporary hair loss .
8. Hormones : abnormal level of androgens produced by both men and women .

Complications of hair loss :

Hair loss if neglected in early stages can cause permanent hair loss or complete baldness .
Hair loss in children and young generation affect quality of life can cause low self esteem ,depression,…and social withdrawal .

DO’S AND DON’TS IN HAIR LOSS :

• Avoid harsh chemicals like dyes, or gel.
• Avoid excessive use of hair dryer .
• Avoid combing in wet hair .
• Avoid the stress and stressful surroundings .
• Start meditation and practice yoga to avoid daily stress.
• Always take nutritious diet which is full of minerals and antioxidants .
• Never ignore early symptoms start the treatment earlt to get good results.

What is alopecia areata ?

Alopecia areata is an auto immune disease of hair that causes hair to fall out in small patches ….. in this disease immune system mistakenly attacks the hair follicle and damage them which can lead to hair loss .
Scalp and beard area is most commonly affected area . it affects both genders .
In most of the cases hair falls out in small and round patches in some cases hair loss is extensive and can lead to total loss of hair from scalp [alopecia totalis ] and in more sevre cases it can lead to complete hair loss from scalp,face and body [alopecia universalis ]
In few cases regrowth of hair may also occur but chances of hair fall is always possible.

Causes of alopecia areata :

• Family history : if there is family history of autoimmune disease your chances of getting alopecia areata is higher than others.
• Constant emotional stress .
• Previous illness like typhoid , tuberculosis ,malaria .
• Excessive usage of chemicals over scalp and hair like …straightening ,dying,perming can lead to damage of hair follicle.
• Any infection or disease of scalp like LPP can also lead to alopecia areata.
• Certain medication like chemotherapeutic medicines

Symptoms :

• Alopecia areata initially starts with single small patch and can spread to whole scalp in multiple patches .
• while there are new patches formation some old patches can show new hair growth.
• In advance cases alopecia areata can lead to total scalp hair loss to total body hair loss.
• Other clinical sign include ‘’ exclamation mark “in this format some short hair grow narrower at the bottom grow in and around the edges of the bald spots.

Complications:

• You may have permanent hair loss if you have family history of same condition , or any other autoimmune disease or allergy, if disease starts at young age .
• Alopecia areata can also lead to Total body hair loss .
• This disease can also lead to poor self confidence , and depression .

Dos and donts of alopecia areata :

 

• Avoid harsh chemicals like dyes, or gel.
• Avoid excessive use of hair dryer .
• Avoid the stress and stressful surroundings .
• Start meditation and practice yoga to avoid daily stress.
• Always take nutritious diet which is full of minerals and antioxidants .
• Never ignore early symptoms start the treatment earlt to get good results.

Scalp Psoriasis, – an overview:

When psoriatic lesions are confined to the scalp and its adjoining areas, we call scalp psoriasis. The most important factor for scalp psoriasis is people often confuse this disorder with dandruff and take treatment for dandruff for long time until it aggravates to very high level. It might affect the entire scalp and spread at the forehead, back of neck and behind the ears. Like other types of psoriasis it is absolutely is non-contagious. Among the entire population who is suffering from psoriasis about half of them is suffering from scalp psoriasis or the patient is having lesions over the scalp like the other parts of the body.

It is manifested by raised, reddish and scaly patches over the scalp, sometimes mixed with silvery white flakes like dandruff. There may be intense itching, burning, and dry feeling over the scalp. It might be associated with intense hair loss as well. But this is a temporary hair loss and eventually hair grows back from that particular site once the psoriasis subsides.

Seborrheic dermatitis (dandruff) and Scalp Psoriasis:

This is the most important diagnosis to make when some patients comes with complaints of long standing dandruff which is not removed by anti-dandruff shampoo having intense scaling and flaking and with intense itching, because the earlier we diagnose psoriasis, earlier we can start with the proper treatment. The most important differential diagnosis can be made when we check the lesions under UV light (Woodslamp). In case of pure psoriasis the flakes would be visible as silvery white whereas in seborrhea or dandruff the scales would be golden in colour. Apart from this Auspitz’s sign would be positive in case of psoriasis.

Sometimes a condition known as Sebo-psoriasis could be presentation where psoriatic lesions are overlapped by seborrheic dermatitis. In this case scalp would be mixed with both types of lesions. In case of Sebopsoriasis, it has been seen that psoriasis affects first and seborrhea develops afterwards. Seborrhea can also be a aftermath of the skin lesions that is being done by psoriasis or we can say that sebopsoriasis is a complication of long standing scalp psoriasis.

Homeopathic solution for Scalp psoriasis

Like the other variety of psoriasis, scalp psoriasis can also be taken care of with the help of classical homeopathy treatment, but prior to start of treatment the diagnosis has to be done properly whether it is purely psoriasis or seborrheic dermatitis or sebopsoriasis. The line of treatment would also vary from each case to other and that also vary in respect of intensity of the condition. But the proper management of skin is very important in case of Scalp Psoriasis.

Skin Management for Scalp Psoriasis:

One of the very important aspects of skin management in scalp psoriasis is removing the scalp scales. This would help the medication to effect the underlying tissue. Some amount of salicylic acid gel can be used to soften the scales and after that gently apply shampoo over the scales to remove them quickly. Once the thick scales are removed apply some amount of emollients like petroleum jelly or thick creams over the lesions. To reduce the itching, one can use wet towels or cold pack over the lesions.