Why Hair Falls - Understanding Hair Growth

For a thorough why hair falls it is important to understand the types of hair fall in both men & women

Here's a quick run-through of the types & causes of hair fall.

  • On an average there are one lakh hair follicles on the scalp
  • Hair mainly consists of a protein named Keratin, which is also present in the nails
  • A single hair has a thickness of 0.02-0.04 mm, so that 20-50 hair fibres make 1 mm
  • No of hair follicles/cm2 on different body regions: Cheek-880, Forehead-770, Forearm-100, Upperarm-40
  • Each hair falls out eventually and is replaced by a new one
  • Each hair follicle goes through approximately 20 hair cycles in the life time of an individual
  • In normal hair cycle, the number of hairs in Growth (Anagen) phase is much higher than those in the shedding (Telogen) phase.
  • Certain Root Destroying Factors alters this ratio, such that the number of hairs in shedding phase increases considerably.
  • The result is far thinner and shorter hair follicles that will eventually fall out.

Roots Destroying Factors (RDF)

PERSONAL
     - Sudden severe emotional stress
     - Severe dieting

ENVIRONMENTAL
     - Pollution, Water condition, high exposure to sun etc.       

HAIR CARE RELATED
     - Hair treatments especially colouring

HORMONAL
     - Child birth
     - Pregnancy termination
     - Intake of birth control pills

HEALTH RELATED
     - Surgery
     - Thyroid gland malfunction
     - Certain diseases like diabetes
     - Some drugs like heparin, coumarin, gemfibrosil

Male Pattern Baldness (Androgenic Alopecia/ Androgenetic Alopecia)

This is one of the most common causes of hair loss in men.

Extent of male pattern hair loss
If you notice a gradual shift in your hairline from straight across the face to an M shaped contour, the indications are that you are on the early stage of male pattern baldness. Many men never grow completely bald but demonstrate thinning of the hair. When an enlarged bald spot appears on the top of the head, it is an advanced stage of male pattern baldness.

Symptoms of male hair loss
The thinning of hair may be localized to the hairline or the top of the head as in male pattern baldness or it can occur in a patchy pattern. It is a good idea to closely observe the level of your hair loss when you end up with clumps of hair in the drain after a bath or you wake up in the morning to strands of hair on your pillow.

Androgenetic Alopecia is a hereditary trait and can be inherited from either the father's or mother's side of the family. This does not imply that if either of the parents have baldness; the son will necessarily become bald. Male pattern baldness has been known to skip generations.

Alopecia Areata

Alopecia Areata is a skin condition that affects men as well as women. This condition causes sudden loss of hair on the scalp as well as on other parts of the body. The condition is normally reversible though in many cases it takes months before the hair is rejuvenated.

Anagen Effluvium

Anagen Effluvium is the excessive loss of hair that is caused due to sudden and intense disturbances at the level of the matrix cells of the hair follicles.

Instead of shedding hair, in this condition the hair strands are fractured at the scalp level. Chemotherapy and radiotherapy are the commonest causes of Anagen Effluvium.

Trichotillomania

This type of hair fall is often seen among children and is caused by intentional pulling of hair.

Scarring Alopecia

Scarring alopecia refers to a group of uncommon disorders that destroy the hair follicle and leave a scar tissue in place. This condition causes permanent hair loss

Telogen Effluvium

Telogen is the resting stage of a hair growth cycle. The condition is indicated when large amounts of hair simultaneously enter the resting phase and shed excessively over 3-6 months.

It is most common in women and is often a result of stress or trauma occurring from chemotherapy, childbirth, puberty, major surgery or chronic illness including severe dieting, diabetes and intake of certain drugs. 

If more than 4 or 5 strands of hair come out each time you pull hair, it's likely that you will be experiencing telogen effluvium. In this condition a person will shed more than 300 strands a day (over and above the normal count of 50-100 hair strands).  Telogen Effluvium can be acute or chronic.

Acute TE
If excessive hair fall continues for under six months, it is the early stage of a condition referred to as Acute Telogen Effluvium. Once the resting phase shifts to the growing phase, the hair begins to grow back. Usually when the cause of stress is addressed, the volume of hair loss will slowly and steadily decrease over time. But in cases of chemically treated hair, the shedding will continue for a longer period and it is advisable to seek medical guidance.

Chronic TE
Chronic Telogen Effluvium is indicated when excessive hair fall is sustained for over six months, sometimes lasting up to seven years. One reason for Chronic Telogen Effluvium is the prolonged impact of medication or the stress factors. Another reason could be that the hair is subjected to chemical treatments, during the acute stage. To avoid such a condition, it is necessary to consult a dermatologist and identify the cause of hair fall.

Alopecia Areata

Alopecia Areata is indicated when hair falls out in small and smooth round patches on the scalp or the body. The effected area of the skin looks smooth and normal. Alopecia Areata is caused due to an autoimmune condition due to which  the body's immune cells attack certain body parts - the hair growing tissues in this case. This condition effects men and women as well as children.    

Androgenetic Alopecia

The hair loss pattern in women suffering from Androgenetic Alopecia differs significantly from male-pattern baldness. In women, the hair becomes thinner all over the head, without any recession of the hairline. It is rare for Androgenetic alopecia to result in total baldness in women.

Traction Alopecia

Traction Alopecia is the result of excessive and severe pulling of hair. It begins as a slow and gradual process of hair fall, Traction Alopecia is most common amongst women who braid or knot their hair tightly. The major symptoms of Traction Alopecia are itchy saclp

tension headaches, hair breakage and random bald patches. It is advisable to avoid using such hairstyles frequently or for prolonged periods of time.

Anagen Effluvium

Anagen Effluvium is most often the direct result of a traumatic occurrence in the body. It is normally an issue that is related to the way in which the hair will grow over a period of time. The word Anagen refers to the growing phase of hair.

The most common of the traumatic causes is chemotherapy used to treat cancers. The chemicals used in the chemotherapy kills the cancer cells but also end up affecting other types of cells like cells that grow hair. In these cases, the patient will lose hair that will not re-grow until the medication is terminated.

Trichotillomania

Trichtillomania is a psychological condition which involves strong, overwhelming urges to pull out hair. The condition affects more women than men and most often it occurs during adolescence.

It is a type of compulsive behavior and people suffering from this condition may pull out either single strands of hair at a time from a particular spot or large handfuls of hair. This leads to the formation of a bald spot. Trichotillomania is not a condition that can be treated physically. Patients suffering from such a problem must consult a therapist who can offer practical advice on countering this compulsive habit.

Scarring Alopecia

Scarring Alopecia is the potentially permanent and non reversible destruction of hair follicles and their replacement with scar tissue.

Most forms of Scarring Alopecia first occur in small irregular patches of hair loss that may expand in time. The scarring patches normally look different from the patches formed with alopecia areata. In scarring alopecia the edges of the bald patch are jagged as compared to smooth round or oval shaped in alopecia areata.

 
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