…..I would like to start a discussion of hair loss in women. This is a common condition for many women. By age 50, 50% of women will suffer from this problem. Another term for significant hair loss is alopecia, and affected women can suffer great anxiety and stress.
…..There are two types of alopecia: scarring and non-scarring. Scarring alopecia can be found in discoid lupus erythematosus and other conditions. The scar formation destroys the hair follicle, thus causing the hair loss. These patients should see a dermatologic specialist as soon as possible. On the other hand, in non-scarring alopecia, the hair follicles are not permanently destroyed, and so the hair loss may be reversible.
What Cycle Does Your Hair Bear Throughout Your Life?
…..Let us start with the hair growth cycle. There are three phases of this cycle: anagen (growth phase), catagen (transitional or resting phase), and telogen (testing or shedding phase).
…..In the anagen phase, the hair grows, and 80 to 90% of all hair follicles are included in this phase. This growth pattern can last for 2-3 years, and the length of time is genetically determined.
…..The catagen phase lasts only for 2-3 weeks. In this resting phase, only 1 to 3% of the scalp follicles are included.
…..The last phase is the telogen phase. This is when hair is shed usually at a normal rate of 75-100 hairs per day, and it lasts for about 3-4 months. So it is important to remember that it is natural for some hair loss every day!
- Is the loss diffuse or is it in a specific area? If it is in a specific area, it is important to delineate the location.
- Hair care techniques and the products used can provide important information. Are chemical straighteners being used?
- Are cornrows part of a new style of yours or have they been used for some time? Traction alopecia has been seen with the cornrows hairstyle.
- During a physical exam, the scalp should be carefully inspected. Is there any scaling, inflammation, or reddish areas?
…..In the areas of the hair loss, if there are hair follicles then you are dealing most likely with non-scarring alopecia. If there are no follicles then this could be scarring alopecia, and this patient should be sent to a dermatologist, who will consider a biopsy. The hair should be evaluated for its length, thickness, and fragility. Lastly, a pull test could be performed, which will help determine if active shedding is taking place.
…..At the medical exam, the scalp should be examined for redness, signs of infection, and scarring. A family history should be taken to look for a similar condition in other family members. Usually, there is not an endocrine cause for this problem, but if general hirsutism accompanies the finding, then a full hormonal investigation should be started.
…..The only FDA-approved treatment is the topically applied vasodilator called Minoxidil (Rogaine). It comes in an over-the-counter preparation of 2% and 5% foam or liquid, which are all effective. There seems to be better results with the 5%, but there may be an increased chance of local irritation. How it specifically works is uncertain but there seems to be an increased growth phase, and the hairs grow longer and stronger. Remember, the treatment is 2x per day and forever. When you stop, the hair you gained will be lost. Lastly, you may not see any results for 3-4 months, so patience is needed.
problems and make us feel terrible? As always, our mothers were right. For women, a severe illness, psychological stress, or having a baby are inciting stressful events that can cause physical effects. One of these effects is hair loss.
.…..Usually 90% of our hair is in the growth phase, with 10% in the resting phase. Keep in mind that some hairs are always shedding in the resting phase, and it is usually a small and regular amount.
…..Telogen Effluvium (TE) is a condition of diffuse hair loss that is caused by an identifiable stressful life situation; three of those situations were stated above. In TE, 70% of hairs are in the growth phase and 30% in the resting phase. This results in about 3 times as many resting phase hairs being shed daily. The hair loss is gradual and diffuse and may be similar in appearance to the loss associated with the female patterned hair loss called androgenic alopecia (AGA).
…..With TE, a woman usually is aware of shedding, but with AGA, the loss is gradual, and shedding is not usually a complaint that is presented. Also with TE, the loss may not become apparent for several months after the stressful event.
…..To treat TE, you must first identify and resolve the stress the body has been subjected to. With pregnancy or an acute illness, the hair loss is usually self-limiting with complete recovery within 6 months after having the baby or recovering from the illness. When TE is caused from psychological stress, since the treatment and recovery can take some time, the hair recovery can also involve a prolonged period.
…..Anagen Effluvium involves an acute loss of scalp and body hair when the growth phase of hair is disrupted. This occurs mostly with patients on chemotherapy. Because 80 to 90% of hair is in the growth phase, this hair loss is dramatic and diffuse. The loss usually begins 1-3 weeks after the chemotherapy is started, and the hair returns typically 3-6 months after the treatment is finished. The initial hair that returns may differ from the patient’s usual hair, but these changes are mostly temporary. Permanent hair loss from this condition is usually rare.
…..I hope this information on hair loss in women has been enlightening and helpful.