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Hair Conditions

Healthy Hair is everyone’s desire, but many factors damages hairs along with majority being genetic makeup, where some are avoidable and can be treated successfully.
Science has grown in its length and width in the past century, and there are many techniques present now that can treat scalp and hair naturally without any side effects.
Damaged hairs are due to many factors ( pathological, physiologic, and environmental) it also impacts one’s psychology. Treatment includes reversal of those impacts resulting in healthy hair.
As life is not eternal, so does it implies on hairs too; but treatment at correct time with dedication of patient may prolong life of healthy hair.

PATHOLOGICAL HAIR CONDITIONS


Male Pattern Hair Loss

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Male pattern hair loss usually starts either with a recession to the temples or a diffuse thinning to the crown and can be followed in some cases by a gradual thinning, then a complete denuding of the top. Very rarely is the hair lost on the sides and back although men over seventy can lose hair in the neck area. Both the Hamilton and the Nor wood scales classify Androgenetic hair loss in men.
Androgenic hair loss has three causative factors: genetic predisposition, the presence of the androgen testosterone and the age of the patient.
Male pattern baldness is more commonly inherited from the maternal grandfather.
At puberty, more of the male hormone testosterone circulates around the body causing hairs that are genetically programmed (in the pattern areas) to produce finer and shorter hairs with each new cycle of hair growth. Testosterone reaches the target organ, in this case the hair follicle, where the enzyme 5α-reductase changes testosterone into the highly potent hormone di-hydro testosterone, which causes the above affects.
Many times hair transplant is not the solution for hair loss treatment or hair treatment, platelet rich plasma ( prp ), stem cell, laser technique and other methods are being used by Trichologist or hair doctor. Dandruff, itchy scalp and many other infections and diseases are obstacles to treatment and natural hair growth.

Female Pattern Hair Loss

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Female pattern hair loss presents a diffuse thinning to the front and crown area of the scalp (Ludwig pattern) and never at the sides and back from this reason alone. Partings seem wider and the scalp seems more noticeable at the front and the top of the head.
This is a slow, gradual process and rarely does it completely denude the area.
Androgenetic hair loss in women usually begins with the hormone changes after puberty, pregnancy or menopause and is fairly common in ladies over 80 years of age. Although there is normally no increased hair shedding noticed with this type of loss, there are cases of long-term excess shedding (telogen effluvium) that precede this condition. Androgenetic hair loss has three causative factors, age, inheritance and the presence of the hormone testosterone.
post-menopausal thinning is related to oestrogen reduction.

Telogen Effluvium (Symptomatic/Reflective Loss)

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By far the most common type of excess hair shedding in women is acute telogen effluvium (ATE) but when prolonged it is termed chronic telogen effluvium (CTE).

Acute Telogen Effluvium

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Acute telogen effluvium presents a sudden excess shedding of hair in a diffuse distribution throughout the scalp. A large amount of hairs will be seen in the brush and comb, particularly so when the hair has been shampooed and conditioned. On examination of the scalp many hairs will come away on minor traction. There will also be many short re-growing tapered hairs of a similar length through the scalp; the length of the hairs depends on the duration of the condition.

Chronic Telogen Effluvium

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When excess hair shedding lasts longer than nine months it is termed Chronic. Chronic telogen effluvium often starts with a sudden shedding caused by trauma, but sometimes there is a gradual onset and seemingly an unspecific cause. Hair sheds relentlessly, sometimes fluctuating in the amount of loss. There is loss of hair density, particularly to the longer lengths, and there is also a diffuse thinning to partings. Hair does not reach the length it used to and there are many re-growing tapered hairs of differing lengths throughout the head.
With chronic telogen hair loss the re-growth is still present, but at differing lengths. Mostly longer hairs will fall, but shorter ones are also noticed. Because the growing length is shortened the hair will not seem to grow.

Anagen Effluvium

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Anagen effluvium is a drastic hair shedding in the anagen growth phase soon after chemotherapy or ingestion of poisons due to the direct toxic effect on rapidly dividing cells in the hair bulbs. It causes most of the hair to fall out soon after chemotherapy, but happily most people re-grow their hair within a short period after stopping treatment.

Alopecia Areata

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Often the most drastic type of hair loss, alopecia areata presents a number of circular completely bald patches. These can sometimes merge with other patches The hair follicles are clearly visible and the earliest patch will often be re-growing fine, often white hairs from the centre of the patch.
This condition is unpredictable and can last from six months to many years depending on the causative factors. When the hair loss covers the whole scalp it is termed alopecia totalis. When the whole body is affected it is called Alopecia universalis.

Ophiasic Areata

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Ophiasic areata is a marginal presentation of alopecia areata and can affect the nape area as well as the front and sides of the scalp. This type of alopecia areata can be more persistent.

Traumatic Alopecia

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Traumatic alopecia frequently appears on the margins of the scalp and sometimes shows irregular patchy hair loss to the crown area. There will be breakage to these area and also short re-growing hairs. It is caused by excessive chemical, thermal or physical trauma as well as scratching the scalp. Traumatic alopecia is frequently seen on Afro-type hair when subjected to any or all of the above hairstyling methods over long periods.

Traumatic Hair Loss Or Breakage

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Trichotillomania is a form of self-inflicted physical trauma and is a variant of obsessive-compulsive disorder. It is very common in children and they usually grow out of the habit. It is however a much more difficult habit to break in adults.

Scarring Alopecia

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Scarring alopecia often presents itself as an irregular area of shiny bald skin, which can be a darker or lighter colour than that surrounding it. No hair follicles are present and the skin can be atrophied, or even raised and thickened (Keloid). A scar is formed when a wound heals itself after deep tissue damage. The structure of scar tissue differs from normal skin and does not support normal hair growth. There are three main causes of scarring: chemical, infection and autoimmune disease.

PATHOLOGICAL SCALP CONDITIONS


Seborrhoeic Eczema

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Seborrhoeic eczema is a chronic relapsing inflammatory scalp condition occurring in seborrhoeic areas (areas with more sebaceous glands). It spite of the name it is not necessarily an oily condition. It presents differing signs, varying between mild pruritic scaling and erythema, to excessive scaling and crusting formed from dried exudation over a red and moist scalp.
The whole of the scalp can be affected, particularly the margins and retro auricular area behind the ears.
Seborrhoeic eczema can be highly pruritic, which leads to excoriation and secondary infection with pustulation.
Seborrhoeic eczema occurs in infancy as cradle cap and is rarely seen throughout childhood. It returns at puberty or later and lasts throughout life. Infantile and adolescent forms are likely to be two distinct conditions.

Irritant Dermatitis (Contact Dermatitis)

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Irritant dermatitis is caused by a substance which can create cell damage when applied for the first time in strong concentrations i.e. bleach, relaxer (sodium hydroxide). It can also occur when weak concentrations of successive applications i.e. shampoo are used. That substance is called the primary irritant. The reaction caused may be inflammatory but it is not an allergic reaction.
Primary irritants that may cause non-allergic reactions include shampoos, hair cosmetics such as conditioners, setting lotions, or perm lotions, para-dyes and relaxers on black hair. Plants and metals can also create similar problems.

Allergic dermatitis

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Allergic dermatitis is a potentially life-threatening reaction to a substance previously used on the skin. The reaction takes place sometime later. The allergic reaction creates an intensely irritable reaction, which happens after a substance has been applied to the skin.
A few hours or even days after the application of the substance, the affected skin may become swollen, red and blistered or dry and crusted. Mostly the area in contact with the substance is affected but when the scalp is affected, the reaction can spread to the eyes and face and sometimes there can be swollen lymph nodes and secondary infection. There can be anaphylactic shock with subsequent restriction of the windpipe. Allergic dermatitis causes intense itching and burning.

Psoriasis

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Psoriasis often begins on scalp or elbows with circular areas of uniform darker/ redder skin clearly differing in colour from adjacent normal coloured skin.
These areas are covered with dry white, adherent silvery scales, which can sometimes be quite dense. These scales are not easily removed but when they are, then coarse lined skin with bleeding points can be seen underneath them.
Other areas that can be affected are the knees, elbows and shins. The fingernails and toenails can be affected with thimble pitting. Stiff and painful joints can accompany psoriasis.
The cause of psoriasis is unknown, but there would seem to be a familial trait. Two per cent of Caucasians suffer from the condition, which more commonly appears between the ages of ten and thirty.
The condition is triggered by stress, skin damage, illness and bacterial infection. Itching to an adjacent area often denotes an extension of the condition.

Pityriasis Amiantacea

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Psoriasis often begins on scalp or elbows with circular areas of uniform darker/ redder skin clearly differing in colour from adjacent normal coloured skin.
These areas are covered with dry white, adherent silvery scales, which can sometimes be quite dense. These scales are not easily removed but when they are, then coarse lined skin with bleeding points can be seen underneath them.
Other areas that can be affected are the knees, elbows and shins. The fingernails and toenails can be affected with thimble pitting. Stiff and painful joints can accompany psoriasis.
The cause of psoriasis is unknown, but there would seem to be a familial trait. Two per cent of Caucasians suffer from the condition, which more commonly appears between the ages of ten and thirty.
The condition is triggered by stress, skin damage, illness and bacterial infection. Itching to an adjacent area often denotes an extension of the condition.

Folliculitis

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Folliculitis is inflammation and infection of the hair follicle, mostly affecting young black men. The signs of folliculitis are pustules and follicular inflammation throughout the scalp, but mostly affecting the nuchael to occipital area where raised nodules and keloidal scarring can exist.
There are pustules, weeping, bleeding, erythema, crusting, and hair breakage in particular to the neck area. The condition can extend upwards towards the vertex.
Symptoms include prolonged intense itching and it can occur on any hairy position.

Acne Necrotica Miliaris

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Acne necrotica miliaris presents a few minute yellow pustules that are extremely itchy. They are situated at the opening of the hair follicles. The pustules have a cone-shaped crust over a moist base and are of pinhead size. Four or five of these tiny lesions can be found scattered across the scalp. They are prone to affect the top of the scalp and when healed they form tiny scars which can occur with male pattern loss making the scarring difficult to see.

Ringworm

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Ringworm is not caused by a worm but is a superficial fungal infection of the scalp affecting mostly children.
It is a non-scarring, patchy hair loss showing brittle hairs and broken stumps of hair with grey coloured scale and erythema. The patch or patches are circular and show dry, dull broken hairs very unlike the surrounding uninfected hairs. The hairs tend to lie at different angles to one another.

PHYSIOLOGICAL HAIR CONDITION


These are the conditions that are otherwise normal functioning of overall body, but impacts hair growth or induce hair fall. Usually no advanced treatment is needed hear but the need to take medical advice remains the same. Also, there are some conditions that are related to other field of medicine but still impact hairs. Hear consultation with both specialists is needed.

Few physiological conditions are mentioned below.


PSYCHOLOGICAL IMPACTS


Baldness can have devastating psychological impacts on individuals silently. People may not recognize it but it effects.

Some effects are mentioned below.


  • Indifference in general
  • Lower self-confidence
  • Lower self-esteem
  • Shyness
  • Depression
  • Introvert
  • Stress
  • Consciousness
  • Anxiety issues
  • Emotional suffering with personal, social and work related problems
  • Disfigurement of person’s self and identity
  • Hysterical behavior
  • Anger, aggression and violence
  • Image and identity issues
  • Envious and jealousy
  • Dependence on caps
  • Loss of personal attractiveness
  • Marital problems (40%)
  • Career related problem (63%)
  • Front Desk jobs are impacted most
  • People dealing with public relationship, i.e. front desk jobs, air hostess, receptions
  • Psychiatric problems are more in people with alopecia than in general population suggesting higher risk of developing a serious depressive episodes with anxiety disorder paranoid disorder and social phobia.
  • Psychological impacts are worse in children and women
  • Usually psychological impacts are silent killers and sometimes patient is unaware of it.
  • We at Elite Trichology give a lot of importance to psychological impacts of hair loss as our approach to treatment is physical, mental and social well-being of our patients.

ENVIRONMENTAL FACTORS THAT EFFECTS HAIRS

Pollution in this century is on its peak in this century whether it air, water, sound and many more. Along with adulteration of food and junk food, environment has a great impact on one’s health leading hair loss, these toxins and allergens damages hair roots.

  • Life style also plays a major role.
  • Some bad toxins and bad habits are mentioned below.
  • Drinking less water daily
  • Use of soft water
  • Instead of drinking mineral water, increase in drinking soft water that is free from essential minerals
  • Increase in use of packaged water and water purifiers
  • Hard water is also not good for health, one should use optimal balanced water to drink and for other purposes including bathing
  • Non exposure to sunlight
  • Poor nutritive food products
  • Vitamin D is essential
  • Pollution
  • Smoking
  • Chemicals and chemical hair products
  • Hygiene
  • People may not recognize it but environment impact silently and sometimes patients are unaware of it.
  • We at Elite Trichology educate patients of all environmental factors causing most damage to their hairs.