Forbes India 15th Anniversary Special

Hair Loss: Common causes and Treatment

Dr. Dinesh Kumar Hawelia, Founder Director of Dr. Hawelia's Skin Clinic, Formerly Editorial Board Member of IJD, Organizing Secretary CUTICON-WB 2009, Hony. Secy. of IADVL-WB 2010-12

Published: Feb 7, 2022 05:42:40 PM IST
Updated: Feb 7, 2022 05:47:02 PM IST

Hair Loss: Common causes and TreatmentHair is considered an essential part of one's identity, as it represents feminity and attractiveness in women and youth and vigour in men. Hair loss can cause psychological distress and anxiety due to its effect on appearance of the individual. The entire scalp contains around 100,00 pigmented terminal hair follicles and every hair follicle undergoes an individual recurring cycle with growing and resting periods. The growing period is called anagen phase and it persists for 2-8 years, and the hair grows approximately 1 cm per month during this time. The resting period is called Telogen phase and it lasts around 3 months. During Telogen phase, the hair does not grow any longer. In a healthy scalp, 80-90% of hair follicles are in anagen phase. Most people normally shed 50 to 100 hairs a day. This usually doesn't cause noticeable thinning of scalp hair because new hair is growing in at the same time. Hair loss occurs when this cycle of hair growth and shedding is disrupted or when the hair follicle is destroyed and replaced with scar tissue.

Hair loss can be due to many reasons, including genetic predisposition, systemic illness, drugs, hormonal abnormalities, psychological distress, diet, trauma, infections, autoimmunity and structural hair defects.

Before pursuing hair loss treatment, talk with doctor about the cause of the hair loss and the best treatment options. You may be asked few questions by your physician to find out the cause of hair loss. Important questions are as follows: When did you begin losing your hair? Are you shedding a lot of hair and do you find hair all over the place, or did you notice a more gradual thinning? How many hairs are you losing per day? What percentage of your hair have you lost in what amount of time? How is your general health? Have you had any severe disease in the past? Any medicines you take? Do you have any thyroid problems? What happened in your life 3-6 months prior to the onset of your hair loss (pregnancy, high fever, any surgery, crash diets, accidents/trauma, Covid, or psychological stress)? Your dietary habits, family history of hair loss, and hair care practices are equally important. Female patients may need to inform about regularity of menstrual cycle, intake, duration and change of oral contraceptives; and/or onset of menopause. You should also inform your doctor about any treatment you tried and its effect or side-effect noticed if any.

The most common cause of hair loss in men and women is a hereditary condition called Androgenetic alopecia or pattern hair loss. Its development depends on genetic predisposition and an interaction of hormonal factors. This type of hair loss may involve both hair thinning and miniaturization.  It usually occurs gradually and in predictable patterns- a receding hairline and bald spots in men and thinning hair in women.
Some people experience smooth, coin-sized bald spots involving the scalp or any hair-bearing area of body. This type of hair loss is called alopecia areata. In some cases, your skin may become itchy or painful before the hair falls out.

Another very common cause of hair loss, especially in women, is Telogen effluvium in which abrupt shedding of hair occurs on entire scalp. It is usually triggered by fever, child birth, crash diets, thyroid dysfunction, iron deficiency, chronic illness and psychological stress. Shedding becomes obvious 3-4 months after the initiating event, as very commonly seen nowadays after Covid infection.

Some people may present with irreversible hair loss called scarring or cicatricial alopecia, where hair follicles are permanently destroyed and are replaced by fibrous tissue. This condition is very psychologically distressing to the patient. A fast and confident diagnosis as well as an aggressive treatment in case of active disease is crucial in the management of scarring alopecia.

There are a lot of treatment options available and it is a prudent idea to consult a dermatologist for any hair related problem.

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