Hair loss is an upsetting condition for everyone it affects, many patients who consult me attend with a partner or a parent who has shared the grief, upset and sometimes embarrassment that is perceived by the patient.
While we are all aware of the story of Sampson who felt his strength was in his hair and the demoralising ritual of shaving slaves heads’ in Egyptian time, for example, these no longer continue and yet profoundly the perception (however deep-rooted must). Another consideration is that the loosing of hair is a reflection of our health, this can apply but in the cases of the first condition discussed here, this does not. Patients often attend with trepidation, worried that I may diagnose or confirm their deepest fear- this obviously is so often not the case. Surely the unknown is more frightening than sharing with a friendly trichologist?! Most hair loss fits into one or more of the following categories:
This hair loss complaint is what I see most frequently in consultation, accounting for 60% of visits. Also referred to as Male Pattern Baldness or Female Pattern Baldness, this hereditary condition is not restricted to men. 1 in 4 people is affected by this condition starting as young as puberty and triggering later in menopause. It’s caused by a genetic sensitivity to hormones, which results in the affected follicles producing finer and shorter hairs. Both men and women experience the upper region of the hair to thin gradually, this does not result in patches (another condition entirely) but a miniaturisation of the predisposed hair follicles which, in men, if untreated, results in the loss of the hair in this locality. This can be treated in every case well: sometimes slowing the progression, other times maintaining it but more often improving the volume of hair resulting in better coverage of hair.
2. Telogen Effluvium/General Hair Loss
Another condition my patients attend the clinic complaining of is general hair loss. While most people lose an average of 100 hairs every day, a consistent loss of more than this each day is regarded as significant hair loss. Several circumstances may produce a shock to the system, sufficient enough to cause hair loss. Such circumstances include certain medications, poor nutrition, stress, anxiety, bereavement, and thyroid conditions. This is a temporary hair loss and in most cases can be reversed or overcome than most importantly maintained.
3. Scarring Hair Loss
Often referred to as Scarring or Cicatricial Alopecia, this relatively rare disorder is unfortunately in my last 10 years of practice is either occurring more often or people are seeking help more. For some, the hair loss is gradual, starting with small areas of hair loss that may go unnoticed for some time. For others, this condition is associated with severe itching, burning and generalised pain, and is rapidly progressive. The common theme amongst them is the loss of eyebrows, eyelashes, facial hair and then the destruction of hair follicles and their replacement with scar tissue. I am able with my team to reduce the associated inflammation of this condition without the need for steroid treatment as the first port of call. I am associated with other disciplines when required such as leading Dermatologists who are specifically experienced in this condition and the emotional upset it causes in women exclusively up until recently where men are also affected in the same way.
This is what many assume any hair loss is, in actual fact, it affects less than 1% of the population. This type of hair loss causes patches of loss and is often called Patchy Baldness. Typically, one or two bald patches appear on the head, and in most cases this condition spontaneously regrows. This condition can cause pitting or ridges to form on the fingernails, and thinning of the eyebrows, too. Other forms of Alopecia Areata can cause widespread hair loss which can lead to loss of all scalp and/or body hair. I treat this condition by considering specific blood tests, clinic treatment and a home treatment regimen and support package.
This is a category that can be of many causes. For example hair breakage caused by sun damage, over bleaching, aggressive styling, lack of care…I can gently guide you on how to minimise the damage caused and support you and the way you care for your hair while it is nurtured back to full health, a temporary condition.
Another condition is a psychological one, where patients actually pull their hair out by hand, this is often considered to be a cry for help as a form of self-harm. I can diagnose the difference between hairs damaged from the above reasons compared to the hair extracted. I see many teenagers with this who have often experienced a stressful or anxiety related period. Depending on how long this habit has been active, most cases the hair can be encouraged to return, I find mindfulness really helps.