What is Hair Loss?
Hair loss more than normal can be frustrating and perplexing. We normally lose an average of 100 scalp hairs per day.. Each hair follicle undergoes a cycle of growth, rest and shedding. The human hair cycle duration differs with location on the human body. For example, the growth phase on human scalp hair may take 1-5 years.
While having hair is important in mammals to keep warm, to humans, it carries a deeper meaning. Hair loss is not something most of us take lightly, as we use hair to express ourselves, and communicate our unique personalities to our friends and the opposite sex. Alopecia is a medical term used to describe hair loss, and in some of the cases, it may reflect an underlying medical condition or recent stress to the body.
You would probably have heard of mummies, who had just given birth, only to discover with horror that their hair is suddenly shedding daily a few months after. This is most likely due to the premature transition of the hair follicle into the resting phase of hair cycle, a medical condition known as Acute Telogen Effluvium. Basically, any stressful event may result in this occurrence. While childbirth is a common cause, a recent illness, major surgery, trauma, rapid weight loss and psychological stress may trigger this event. Good news is, complete hair regrowth and recovery will take place in a few months for most cases.
Does hair loss affect social impression?
It has been well documented and studied across many populations that hair loss leads to increased stress levels, anxiety and depression. It can affect one’s self image, self esteem and relationships. The ability to style your hair in the morning, or even throughout the day is something most of us would take for granted. Having a healthy head of hair gives one the perception of attractiveness, drive, confidence and vitality.
When you lose hair, it is not only how you view yourself that is important, it can also influence people’s impression of you. In studies comparing initial images of balding men to non-balding men, balding men were rated as less attractive, older, less likeable and less sexually attractive.
What is Male or Female Pattern Hair Loss?
Male and female pattern hair loss (Androgenetic Alopecia) is common, having a prevalence of about 60% in males above 17 years of age in Singapore. The gradual loss and thinning of hair over the years is due to the effects of androgen (a hormone) and genetic influence. Often, there may be someone in the family that shares the same problem. In males, it often starts after puberty, and the pattern of hair loss on the scalp involves the front, temples and vertex. In females, the condition starts later, and loss of hair in the frontal and mid regions of the scalp is the most common pattern seen. Testosterone levels in females should be checked if there are accompanying acne, facial hair and irregular menses, as it may indicate an underlying medical condition known as polycystic ovarian syndrome.
Hair Loss Myths Debunked
Poor Diet contributes to hair loss – False. There is no current evidence to support this. Male and female pattern hair loss is a polygenetic condition.
Low Testosterone levels in Men– False. Testosterone levels in men with hair loss is mostly normal. Male pattern hair loss is due to higher levels of Dihydrotestosterone (DHT), which is a breakdown product of testosterone.
Balding means Cancer – False. There is no current evidence linking pattern hair loss to cancer in both men and women.
Hair dryers damage hair follicles – False. Although too much heat can damage the hair shaft, the hair follicles remain intact.
Hair sprays, wax and gels causes balding – False. The hair follicles are not affected when using these hair products.
Balding starts only in mid age – False. The progression of hair loss is a slow process. In males, it often starts after puberty, and becomes more obvious with age. A lot of patients that we see are in their late teens to early twenties.
Classification of Alopecia
Female Pattern Hair Loss
Treatment of Hair Loss
Hair doesn’t grow overnight! Due to the relatively long growth phase of scalp hair (1-5 years), treatment takes time and your patience and continued adherence to treatment is essential. There are currently only 2 FDA approved medical treatments for Androgenetic Alopecia; topical Minoxidil and an Oral medication, but the latter is not recommended for women due to the potential effects on the foetus.
Topical Minoxidil has an interesting story. It was discovered by accident, as doctors were using the oral form to treat high blood pressure and noticed the incidental side effect of increased hair growth. Topical Minoxidil should be used for at least 6 months for maximum efficiency. It is common for hair to shed for the first 2-6 weeks when starting treatment, but treatment should be continued as it will slow progression of the hair loss and partially restore hair in some cases over time.
Oral finasteride works by reducing the amount of active androgen, dihydrotestesterone (DHT) in men. More than 90% of men on this oral medication will experience a slowing of hair loss, and up to 60% may experience hair regrowth. These results are sustained over 5 years in one study, and is generally well tolerated. Hair regrowth with treatment is more prominent over the midscalp and vertex areas.
Combination treatment with topical Minoxidil and oral medication produces better results when compared to treatments used individually, which may be due to the different modes of action of the 2 medications.
For individuals who prefer to take the drug free option, Vivsical Professional, a 100% drug free hair growth supplement that nourishes hair and promotes existing hair growth. It is recommended to both men and women of all hair types.
Hair loss is common in both men and women.
The onset is slow and gradual.
Impact on quality of life is significant.
Effective treatments for both men and women.
Treatments Slows hair loss first 3 months, Grows hair next 3 months, Shows more hair 6 months and beyond.
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- Cash, TF. Losing hair, losing points? The effects of male pattern baldness on social impression formation. J Appl Soc Psychol. 1990; 20: 154–167
- Stough D, Stenn K, Haber R, et al. Psychological effect, pathophysiology, and management of androgenetic alopecia in men. Mayo Clin Proc. 2005 Oct. 80(10):1316-22.
- Olsen EA, Dunlap FE, Funicella T, et al. A randomized clinical trial of 5% topical minoxidil versus 2% topical minoxidil and placebo in the treatment of androgenetic alopecia in men. J Am Acad Dermatol. 2002 Sep. 47(3):377-85.
- Rossi A, Cantisani C, Scarnò M, Trucchia A, Fortuna MC, Calvieri S. Finasteride, 1 mg daily administration on male androgenetic alopecia in different age groups: 10-year follow-up. Dermatol Ther. 2011 Jul. 24(4):455-61.