Hair is the crowning glory. 4 in 10 people are complaining of hair fall these days. Not all people have the same reason for alopecia. To reduce hair fall, the exact reason should be identified and corrected. The various causes of hair fall are:
Sudden severe hair loss is called telogen effluvium, usually after stressful events or nutritional deficiencies.
Hair usually grows in three phases:
In this type of hair fall, pathology is usually 5-10 % of hair in the telogen phase. In telogen effluvium, up to 30% of hair goes into the telogen phase leading to increased shedding and thinning of volume. It is called chronic telogen effluvium if the hair shedding is more than 6 months.
Nutritional deficiencies like vitamin D, B12, calcium, iron, and protein are common causes. Physical, work and emotional stress like loss of family members or health issues like severe fever, malaria, typhoid, CoVid, and major surgeries can cause severe hair fall.
Identifying the stressful event and correcting the deficiencies is the mainstay of Telogen Effluvium treatment. We will give you an array of lab tests to identify the deficiencies. Vitamin and other nutritional supplements, good hair care routine will be the mainstay. Peptides like procapil, capixyl, etc., will help in early recovery.
Alopecia due to androgen excess. In men, it is called male pattern alopecia, commonly known as bald head. In women, female pattern alopecia or hair loss. In men, it can start as early as their twenties and lose hair from the frontal and crown area and become bald.
Hair grows in three phases. Anagen or growing phase will be for 3-6 yrs where the hair grows, followed by the Catagen phase or transitional phase of 3-4 weeks. It is followed by the telogen phase or shedding phase, where the shrilled hair follicle falls off, and new hair grows in the next anagen phase. In Androgenic Alopecia, the Anlagen Phase reduces to few weeks. Hence, the follicle’s growth is short and fine, leading to gradual miniaturization and permanently shedding the follicle.
The cause for this type of hair loss is multifactorial. It can be genetic for people who have a family history. Androgens, i.e., male hormones, are responsible for hair thinning and shedding. Testosterone and its metabolite Dihydrotestosterone (DHT) are responsible.
In female pattern hair loss, identifying the reason for androgen excess is important. Tests to rule out PCOS, other adrenal and pituitary, and thyroid hormones are necessary whenever required and corrected accordingly. Besides topical minoxidil, oral nutritional supplements, anti-androgens like spironolactone, cyproterone acetate, and finasteride are given to treat the androgen excess. PRP, Mesotherapy, and Low-Level Laser are the mainstays.
Alopecia Areata is a common autoimmune disorder that leads to sudden and patchy hair loss. Most of the time, it would be one or few hairless patches. It may spread, causing extensive hair loss all over the scalp called alopecia totals. Sometimes there can be loss of body hair and eyebrows and eyelashes called alopecia universals, which is the most severe form of alopecia areata. Alopecia Areata usually runs in families with genetic predisposition and may be associated with other autoimmune disorders like thyroiditis.
Hair growth will be spontaneous in most patients who have few patches and for the first time. Topical steroid lotions and minoxidil are used in severe cases. Topical anthralin and immunomodulators are also used.
Intralesional steroid injections help in the regrowth of hair in resistant areas.
We may require oral steroids, cyclosporin, methotrexate, and other immunomodulators in severe and progressing cases.
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