By Dr. Vivian

A full head of hair usually has a total of 100,000 to 150,000 strands and it is normal to lose some hair everyday (about 150 to 200 strands). Baldness refers to excessive hair loss from your scalp and can be the result of heredity, certain medications or an underlying medical condition. Men, women and children can experience hair loss.

The medical term for hair loss is Alopecia. The most common type is male pattern baldness also known as Androgenic Alopecia which accounts for 95% of cases of hair loss from the scalp. This form of alopecia is characteristically permanent and can be attributed to heredity. In this condition, the hair follicles are genetically predisposed to being sensitive to a metabolite of testosterone know as DHT (dihydrotestosterone).

These follicles shrink when exposed to DHT and eventually become incapable of producing hair. Alopecia Areata is a form of alopecia that may be temporary and could involve hair on the scalp as well as the body. This form of hair loss usually occurs in small, round and smooth patches and is an auto-immune disorder.

To better understand hair loss it is helpful to understand the biology of hair. There are 3 stages of hair development namely: Growth, Resting and Shedding. Not all hairs are in the same stage at the same time. About 90% of hair is in the growth phase while the other 10% is in the resting phase after which it is shed. When the rate of shedding exceeds the rate of regrowth the result is baldness.

The Growth or Anagen phase can last between 2 and 6 years and the hair shaft is at its thickest. Caucasian hair grows about one-half to one inch a month while Black African hair grows much slower. The Resting or Catagen phase lasts 2 to 3 months and the Shedding or Telogen phase lasts five to six weeks and with this process, new hair begins to grow to replace shed telogen hair which is very fine.
Individuals with Androgenic hair loss typically start losing hair in their teenage years.

It is common in men but may also affect women. Heredity determines the age at which loss starts and the developmental speed, pattern and extent of loss. In men, the loss usually begins at the temples and the crown and the end result may be complete or partial baldness. In women with androgenic hair loss, the hair loss is usually limited to the front, side or crown and it is rare to see complete baldness in women.

Alopecia Areata is classified as an autoimmune disease and the cause is unknown. Patients with this condition are usually in good health and there may also be a hereditary factor. Unlike androgenic alopecia, the hair usually grows back but the loss may occur several times.
Other causes of temporary hair loss include :
• Poor Nutrition when protein, zinc, biotin and iron are deficient
• Diseases like syphilis, diabetes, thyroid disorders, amyloidosis and lupus
• Certain Medications used for the treatment of arthritis, gout, depression, heart disease and hypertension.
• Oral contraceptives may lead to hair loss in some women
• Chemotherapy and Radiation Therapy
• After stressful events such as Childbirth, Illness and Surgery
• Infants often lose hair during the first several months of life
• Scalp Infections such as ringworm and Hair Treatments done incorrectly such as dying, tinting, perming and bleaching
• Some hairstyles pull the hair too tightly leading to hair loss known as traction alopecia.
Treatment
You should start by seeing a Doctor to help determine the cause of your hair loss and to prescribe treatment. Investigations including blood tests and biopsies may be carried out to help reach a diagnosis.
Baldness cannot be cured but there are treatments available to help promote growth and cover up hair loss. Spontaneous hair growth without any form of treatment may be seen in some forms of alopecia. The effectiveness of medications used to treat alopecia depends on the cause of hair loss, the extent of loss and individual response. Treatment is generally less effective in extensive cases of loss.
Drugs used for the treatment of alopecia include:
• Minoxidil (Rogaine) a topical preparation rubbed into the scalp which is used for the treatment of androgenic alopecia and alopecia areata
• Finasteride (Propecia, Proscar) a tablet taken daily to treat male pattern alopecia
• Corticosteroids injections into the scalp used to treat alopecia areata
• Steroid creams may also be used but are not as effective as the injectables
• Anthralin (Drithocreme) a tarry substance applied to the scalp and washed off daily

Surgical Procedures such as hair transplants are available to treat androgenic alopecia. During transplantation, a cosmetic surgeon or dermatologist takes tiny plugs of skin from the nape or side of the scalp containing one to several hair follicles and transplants them in the balding areas. Several sessions may be needed since hereditary loss progresses.
Scalp reduction is another surgical procedure where the bald scalp is surgically removed and hair covered scalp is stretched and sutured to cover the area. Alternatively, a flap of scalp containing hair may be folded over an area of bald skin.
Wigs and hairpieces are alternatives to painful expensive surgery.

There are other options available when fighting hair loss:
• Nizoral Shampoo has been helpful in cases of androgenic alopecia
• FNS (Follicle Nutrient Serum) contains natural ingredients that stimulate hair growth
• Flutamide a prescription medication blocks the effect of androgenic hormones like DHT (Dihydrotestosterone It is used to treat excessive facial hair growth in women with PCOS (Polycystic Ovarian Syndrome) and female pattern baldness
• GHK Copper Peptides inhibit the enzyme 5 alpha-reductase necessary for the formation of DHT
• Minimize Physical and Chemical Trauma to the hair due to processes such as perming, flat ironing, dyeing and heat styling.