Introduction

Hair Loss, which is medically termed as Alopecia or in plain terms baldness, is a common but distressing condition characterized by loss of hair from the scalp and in some cases even from the entire body. This usually happens when there is some problem with the hair growth cycle. In most of the cases, Hair Loss is believed to be hereditary but it can also occur as a result of a medical condition, changes in hormone levels, and at times as a side effect of certain medications. Hair Loss can occur in males, females, and children; however, it is mostly seen in males.

Under normal circumstances, an individual sheds around 100 hairs every day but this loss is not visible due to simultaneous growth of new hairs. In Hair Loss, this simultaneous growth does not occur at the required rate causing the hair to thin out at specific areas and exposing the scalp.

This is quite common in people above the age of 50-60 but as of late the younger generation is also visiting many hair care clinics with complaints of Hair Loss. This is a source of great distress to them and significantly dents their self-confidence. These individuals become socially withdrawn and in some cases even go into depression.

What Causes Hair Loss?

What exactly causes disruption of hair growth resulting in Hair Loss is not known but many physicians are of the opinion that it occurs due to the following reasons:

Hereditary Factors: This is perhaps the most common cause of Hair Loss. The process begins with recession of the hairline in males and hair thinning in females. People as young as 20 year olds start losing their hairs as a result of genetic factors. The defective gene is either inherited from the father or the mother.

Hormonal Changes: Hormonal changes, especially during pregnancy, postpartum, or when the female attains menopause also at times causes temporary hair loss. An underactive or an overactive thyroid, which controls the production of hormones in the body, is also one of the reasons for Hair Loss in females.

Medical Conditions: In addition, there are also certain medical conditions which induce Hair Loss. Alopecia Areata is one such medical conditions and a common cause for Hair Loss/. It is an autoimmune disorder in which the immune system of the body attacks the hair follicles damaging them and causing Hair Loss. The presenting feature of Alopecia Areata is the presence of bald patches on the scalp and other areas of the body where hairs are normally seen such as the chest. Other than this,

Infections: Fungal Infections affecting the scalp are also one of the common causes for Hair Loss albeit temporarily. Once the infection is treated then the hair starts growing back normally. Additionally dermatological conditions like lichen planus and even at times lupus is also believed to cause Hair Loss. Trichotillomania, commonly called as Hair Pulling, which is a behavioral disorder, is also one of the common causes for Hair Loss.

Medications: There are also certain medications that are responsible for causing Hair Loss. Among the various classes of medications, chemotherapy drugs are the most common in causing Hair Loss. Other than this, antidepressants, cardiovascular medications, antihypertensives all have a tendency to cause Hair Loss.

Other than the primary causes mentioned above of Hair Loss, there are also some secondary causes like exposure to radiation therapy for treatment of some form of cancer is one of the causes for Hair Loss. There have been cases reported where stress has played a role in an individual having hair loss. This usually occurs after a physical or an emotional shock.

Hair Loss occurring due to stress is generally temporary with the hair growing back once the trigger is removed. It has also been observed that certain hair care treatments instead of doing good have resulted in further hair loss. Even some form of hairstyles like the ponytail is well known for its tendency to cause Hair Loss.

What are the Symptoms of Hair Loss?

The presenting features of Hair Loss are different in cases of males and females, and children. However, among all three the primary symptom is that of clumps of hair coming out with combing or washing the hair. In cases of males, the symptoms of Hair Loss include loss of hair along the anterior portion of the hairline. There is also thinning of hairs around the crown area. The hair loss continues to such an extent where the scalp becomes visible with not even a strand of hair left.

In cases of females, the hair loss is more diffuse and spread across the entire scalp. There is visible widening of the hair partition, especially along the center. In cases of children, there will be patches of hair loss over the scalp for no known reason that presents abruptly. There will also be lack of hairs on the eyebrows and other parts of the body.

How is Hair Loss Diagnosed?

For a definitive diagnosis of the cause of the Hair Loss, the physician will first take a detailed history of the patient, including personal and family history. Once history taking is done then certain investigative tests will be ordered to come to the bottom of the cause of the Hair Loss. These tests include: Pull Test:, Skin Lesion KOH Test, Blood Test:, and Microscopy. A complete hair analysis test is done at Dr Rajeshwari’s Clinic - which gives detailed information of the scalp condition, hair condition, and status of hair fall and roots.

How is Hair Loss Treated ?

While some cases of Hair Loss are permanent and cannot be treated, in many instances Hair Loss is temporary and hair growth comes back to normal once the offending condition or trigger is taken care of. In people with Alopecia Areata, there is spontaneous regrowth of hairs after about a year once the condition resolves without the need for any specific treatment. In other cases, however, there are certain treatments that are required to stimulate hair growth. These treatments include medications, Laser treatments, and surgery in the form of hair transplantation.

Based on the history of the patient, the cause and extent of Hair Loss, the physician will formulate the best treatment plan for the patient. The primary aim of the treatment is to delay the progression of hair loss and stimulate new hair growth. The treatment options for Hair Loss include

Medications: If a medical condition is believed to be a cause for Hair Loss then, to begin with, a treatment for the medical condition will be done. This will require use of medications and other therapies as and when required. In case if a medication is responsible for Hair Loss then it is advisable to stop the medication and go for an alternative to prevent further loss of hair.

The medications given for treatment of hair loss include Minoxidil and Finasteride. Minoxidil comes in the form of a liquid which can be applied directly on the scalp at least twice daily to prevent further hair loss and stimulate new growth of hair. The medication usually takes about four months to completely kick in. It has a side effect profile of abnormal hair growth surrounding the area of application and scalp irritation.

Finasteride is available only on a written prescription by the physician and is taken orally. The main aim of this medication is to prevent hair loss. In some cases, people have observed growth of new hair on this medication but this need to be verified with more research.

PRP Treatment: This is one of the most effective treatments for hair loss. This process involves taking blood from the patient and separating its constituents of platelet rich plasma, platelet poor plasma, and red blood cells. The platelet rich plasma is then taken in a syringe and injected in the area of the scalp which needs hair growth. Experts believe that this form of treatment triggers natural hair growth and maintains it by improving the blood supply to the hair follicles. This treatment is either done alone or in combination with other hair loss treatments for best effectiveness.

Hair Transplant Surgery: This is perhaps the most effective treatment for Hair Loss as of now. This is recommended for people with extensive hair loss who have failed all other forms of treatment. After successful transplantation, the physician may prescribe certain medications to be used for some time till new hair grows. It normally takes up to one year for normal hairs to grow back and see the results of the surgery. However, initial improvements can be observed from the fourth month post-transplant.

Previously, only two methods of doing a hair transplant surgery were preferred, namely the FUT (Follicular Unit Transplantation) and FUE (Follicular Unit Extraction) techniques. However, as of now, the DHT and the PRP techniques have gained preference over the traditional method of hair transplantation.

DHT Treatment:This is the latest and arguably the most effective treatment for hair loss. It is completely noninvasive meaning that no nicks, incisions, or slits are required in this method. This eliminates any chances of infection, pain or discomfort.

Dr. Rajeshwari’s clinic has been doing successful hair transplantations using DHT methods for quite some time now. They have also had success in many patients with the PRP method of hair loss treatment. The clinic has the technology and the team to carry out these procedures with utmost precision for desired result.

Can Hair Loss be Prevented?

Hair Loss caused due to the normal process of aging cannot be prevented. However, steps can be taken to prevent loss and damage by avoiding chemical use in the hair like hair color and hair dyes. It is also recommended not to use hair dryers for long periods of time as it literally pulls the hair out from their shafts thereby damaging it. This makes the hair weak and brittle.

For healthy hair, it is always best to practice good hair hygiene by shampooing it regularly. Additionally, eating a diet rich in proteins, vitamin B, and iron is also quite effective in preventing hair loss. Keeping the thyroid levels under control and seeking immediate levels if diagnosed with an underactive or overactive thyroid is also recommended to prevent Hair Loss.