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You are here: Pandora’s Box - Health - Hair Loss |
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Hair loss Introduction Alopecia is baldness or loss of hair. The commonest form is male-pattern baldness (also known as androgenic alopecia), but both women and men can get hair loss. Alopecia areata is another type of hair loss, involving patches of baldness that may come and go. It affects about 1 in 100 people, mostly teenagers and young adults. In some cases, hair loss is a side effect of having cancer treatment drugs, but in many cases the hair grows back. Hair loss can lead to problems with confidence and self-esteem. Symptoms Male-pattern baldness is hereditary which means it runs in families. It usually starts to happen around the late twenties and thirties although this can vary. By the age of 60, most men have some degree of hair loss. Male-pattern baldness is so called because it tends to follow a set pattern. |
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The first stage is usually a receding hairline, followed by thinning of the hair on the crown and temples. When these two areas meet in the middle, you have a horseshoe shape of hair around the back and sides of your head. Eventually you may be completely bald. Alopecia areata causes patches of baldness that are about the size of a large coin. They usually appear on the scalp but can occur anywhere on the body, including the beard, eyebrows and eyelashes. There are usually no other symptoms. Causes The average human head has 100,000 hairs. Hair is made in hair follicles (the root of the hair). Each hair grows for about 3 years then it drops out and a new one grows - we lose 40-120 hairs a day. Male-pattern baldness is caused by over-sensitive hair follicles. This is linked to dihydrotestosterone (DHT) that is produced by the male hormone testosterone. If there is too much DHT, the follicles shrink, so the hair becomes thinner and grows for less time than normal. The balding process is gradual because different follicles are affected at different times. Alopecia areata is linked to a problem with the immune system. The hair follicles are not permanently damaged and in many of these cases the hair grows back in a few months. In 1 in 5 cases it runs in the family. Some conditions such as anaemia (disorder of the blood), illness, stress (including bereavement), fungal infections and thyroid problems can make you lose some of your hair, as well as drug treatment for cancer. Women who are pregnant or have recently given birth may also experience some hair loss. Hair loss is not caused by a lack of any vitamins in the diet. Diagnosis Male-pattern baldness is usually easy to identify because of the pattern it follows. It usually begins with a receding hairline in the late twenties or thirties, but can start earlier. At first, you may notice that your hair is starting to get thinner. If your hair loss does not follow the typical pattern as above you should see your GP to find out what is causing it. It could be linked to an illness such as anaemia or a fungal scalp infection. Your GP may refer you for more tests or suggest that you see a dermatologist. With alopecia areata, there are no obvious symptoms other than patches of baldness, so your partner or hairdresser may notice it before you do. Treatment If hair loss is caused by an infection or a condition such as anaemia, treating the infection or condition may prevent further hair loss. In some cases, including after cancer treatment, your hair may start to grow again. Finasteride works by preventing the hormone testosterone being converted to the hormone dihydrotestosterone (DHT). DHT causes the hair follicles to shrink, so blocking its production allows the hair follicles to regain their normal size. Although more research is needed, studies suggest that in two-thirds of men who take finasteride there is some hair re-growth. In the remaining third there is no hair re-growth, but most do not experience any further hair loss. It normally takes at least 4 months of using finasteride before any effect is seen, and the balding process will normally resume if treatment is stopped. Finasteride is not available on the NHS, but is available on private prescription from your GP. It comes as a tablet that you take every day. Side effects are uncommon, although about 2 in 100 men, who use it, experience a loss of sex drive. Minoxidil is available as a lotion that you rub on your scalp every day. It is available from pharmacies without prescription. It is not clear how minoxidil works, but studies suggest that the balding process will slow in about half of those men who use it, and that about 15% of those who use it will experience hair re-growth. However, about a third of men who use minoxidil will not see any change to their hair loss. Like finasteride, minoxidil normally needs at least 4 months of use before any effect is seen, and the balding process will normally resume if treatment is stopped. Any new hair that does re-grow falls out two months after treatment is stopped. Side effects are uncommon. Other treatments for hair loss include wigs, hair transplants (taking hair from the sides and back of the head) and plastic surgery (such as scalp reduction where the bald area is removed and the bit with hair on is stretched forward). There is no really effective treatment for alopecia areata. Some treatments can encourage hair to grow, such as steroid injections or creams, or minoxidil lotion see your GP for more information. In 60-80% of cases the hair grows back after about a year without any treatment. Complications A person with alopecia areata is more likely to have or to develop other autoimmune conditions such as thyroid disease, diabetes and vitiligo (a condition that produces white patches on the skin). These are all linked to problems with the immune system. Prevention If you have inherited the genes responsible for male-pattern baldness there is not a lot you can do to prevent it happening. The treatment suggestions may slow down the loss but are not an actual cure. It is important to remember that hair loss happens to a lot of people as they get older and there is no need to be embarrassed or depressed about it. If hair loss is making you worried or unhappy you can see your GP or ask to see a dermatologist. Your local pharmacist may have some useful advice for you as well. Your hairdresser may be able to suggest a flattering haircut for you. |
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