Alopecia, better known as hair loss has been a trending clinical topic due to the events that happened at this year’s Academy Awards ceremony. At the Oscars, Chris Rock joked about about Jada Pinkett Smith’s hair loss. This is when Will Smith came on stage and slapped Mr. Rock. Pinkett Smith has alopecia areata, an immune disorder that causes hair loss and can be very distressing for the person affected.
There are many types of hair loss. The following is a short explanation of the most common forms.
Alopecia Areata:
Alopecia Areata (AA) is a disease that causes the body’s immune system to attack the hair follicles, (responsible for hair growth), causing hair to fall out. Hair can be lost from anywhere on the body such as scalp, nose ears, eye lashes and brows.
In some cases, hair regrows on its own, but if it doesn’t, some treatments can help stimulate the growth.
Hereditary Hair Loss or Androgenic Alopecia:
Most common cause of hair loss in the world. It is often called male pattern hair loss or lesser known women pattern hair loss. This hereditary hair loss caused the hair follicles to shrink and eventually stop producing hair. This can begin as early as the teen years but it usually starts later in life.
In women, what we see is an overall thinning or spacing of the hair shafts. Men on the other hand, get a receding hairline or bald spot at the top of the head.
Hair Loss from Cancer Treatment:
Chemotherapy or radiation treatments to the head or neck will cause hair loss within a few weeks of treatment initiation.
In this case, hair will start to regrow within months of treatment completion. There is medication that can be taken to help hair regrow more quickly. Sometimes the hair will regrow differently, like with curls when originally, it was strait.
Sometimes wearing a cooling cap before, during and after chemotherapy session can help prevent some of that hair loss.
Childbirth, Illness or Other Stressors:
Major life stressors like childbirth, divorce or the death of a loved one can cause temporary hair loss. In such cases, when the stressor goes away the hair stops falling and regrows again going back to normal within 6-9 months.
Chemical Hair Loss:
Coloring, getting permanents or relaxing your hair can be damaging and cause hair loss over time. To prevent this type of hair loss, you need to change how you care for your hair. Once the hair follicle is damaged hair can no longer grow out of it. Many damaged hair follicles are the source of permanent bald spots.
Traction Alopecia:
Hair loss can happen when the hair is tightly pulled back. The constant traction can cause permanent hair loss. This type of hair loss is easy enough to prevent. That is correct, just relax your hair styles.
Hormonal Imbalance:
Polycystic Ovarian Syndrome (PCOS) is a hormonal imbalance that causes cysts to form on a woman’s ovaries. This is accompanied by a group of symptoms such as hair growth in areas not typically seen on women such as on the chest, back or face (hirsutism), irregular periods, weight gain around the abdomen, acne or oily skin, infertility and male-pattern baldness or thinning hair. Seeing your care provider for treatment and monitoring can help your hair regrow where you want it and prevent the growth where you don’t want hair.
Scalp Infection:
Tinea capitis or ring worm (fungal infection of the scalp) causes the hair to break off the surface of the scalp and the scalp to become flaky and scaly. This infectious process will grow and spread if not treated. You can also get ringworm through contact with contaminated items such as combs, unwashed clothing, shower or pool surfaces. It can also be passed from one person to the next by direct skin-to-skin contact. Specific anti-fungal medications can be prescribed to treat this condition. Once the scalp is treated the hair should grow back.
Piedra:
Piedra, also known as trichomycosis nodularis is a hair fiber fungus. The infected hair fibers from trichomycosis nodularis have visible nodules on them. These nodules are very hard, thus the name piedra which means stone in Spanish. These fungal bodies also called ascostroma release fungal spores and spread to other hair fibers.
There are two types of piedra. Black piedra, which is mostly found in tropical countries, and white piedra which is found mostly in Europe and Southern parts of the United States.
This infection can affect hairs on the scalp, body and genital areas. When the infection is severe, it can cause the hair fiber to become weak and break off, leaving patchy, diffuse hair loss. Treatment for this is comprised shaving off the affected areas and the use of anti-fungal medications.
Folliculitis:
Folliculitis means inflammation or infection in the hair follicles. It looks like little red circles around the hair shaft. It can be caused by oils or lotion that is applied to the skin that end up blocking the hair follicles and making it easy for bacteria to overgrow. Staphylococcus aureus is a bacterium we all have on the surface of our skin. It’s harmless until it has a chance to overdevelop in a moist and warm environment. Folliculitis that develops after going in the hot tub is caused by a different bacterium called Pseudomonas aeruginosa that grows in water that is not adequately chlorinated. Left untreated, folliculitis can become severe and cause hair loss, leaving bald patches.
Over the counter topical antibiotic like bacitracin, mycitracin or neomycin can be used to treat early localized infection. However, if the folliculitis is widespread and severe, an oral prescription antibiotic must be used.
Demodex Folliculorum:
Demodex is a little worm-like creature that live on skin and in hair follicles where it feeds on dead skin and oils.
These are harmless but repulsive little creatures that are spread through contact with others during childhood. For the most part, we don’t know they are there except when they cause irritation, usually in the eyelashes. If you have itchy eyelashes, this may be the cause. Contrary to popular belief, Demodex does not cause hair loss.
Seborrheic Dermatitis:
This is a skin condition that can cause temporary hair loss if it is located on the scalp or areas of the skin where there is visible hair. This dermatitis is and inflammatory process that makes the skin scaly, itchy, oily and sometimes painful to touch.
The cause of this condition is not well understood, but we know there is a genetic component and that Caucasians of Celtic descent are most susceptible. We also know that it is triggered by androgen steroids.
Newborns develop this condition (cradle cap), from excess androgens that are passed from the mother in the womb. Hormonal fluctuations such as in puberty can also activate the development. Conditions such as Parkinson’s, head injuries or stroke can be associated with it and stress and fatigue can make it worse.
Seborrheic dermatitis develops when the sebaceous glands that are attached to the hair follicles overproduce sebum that triggers an excess of bacteria on the skin. Add a yeast overgrowth to the mix and you increase the intensity of the dermatitis.
The area can become very itchy, red or inflamed and have flaking.
Seborrhea is simple enough to treat with the use of over the counter medicated anti-dandruff shampoos or some that contain sulfur, selenium sulfide, zinc pyrithione, tar, salicylic acid or oil of cade that have been around for many years. Prescribed medication can be used if the condition is too advanced.
Psoriasis:
Psoriasis is similar to seborrheic dermatitis as both cause red, scaly, inflamed patches on the skin. The difference is that psoriasis starts out as rough, red, scaly skin and grows into thick, silver colored scales usually on the scalp but can also be on other parts of the body like torso, arms, legs, hands and feet. These thick scaly patches could crack, itch and burn.
Seborrheic dermatitis is more likely to be whitish yellow, red or brown and tend to feel oily and is more likely to be found on the scalp, or where the face produces more oils (corners of the nares, ears or eyebrows), upper chest and back.
Both Seborrhea and Psoriasis can be treated or managed with proper medications and both can flare up when a person is triggered or stressed. Neither of these are contagious. They are autoimmune conditions that are passed down in the genepool or they’re triggered by things in the environment such as infections, injury to the skin, smoking, drinking or stress.
Scarring Alopecia:
Scarring alopecia or cicatricial alopecia develops when inflammation, caused by a multitude of conditions, destroys hair follicles and causes hair to thin or bald patches.
Sexually Transmitted Infection (STI)
Certain STIs such as Syphilis if left untreated, can lead to hair loss. In these instances, we would see patchy hair loss on the scalp, eyebrows, beard and genital area. Once the STI is treated the hair usually grows back.
Thyroid Disease:
What is commonly called low thyroid can also cause thinning hair that sometimes comes out in clumps when brushed. Once the hypothyroidism is treated and normalized the hair will grow back.
Poor nutrition:
Eating too little biotin, iron, protein or zinc can cause hair loss. This is also an easy fix if you remedy the cause. Hair will grow back once the person’s diet is adjusted.
Hair Pulling:
Some people develop a habit of pulling their hair when stressed, trichotillomania, which causes bald spots. Hair will regrow if the habit stops before the hair follicles are destroyed.
Frictional Alopecia:
Hair loss can develop when the skin continuously rubs against something like clothing, boots, socks. The hair tends to regrow when the frictions stops.
Poisons:
Slow poisoning by arsenic, thallium, mercury and lithium will cause hair to fall out. Mega doses of Vitamin A, Selenium or warfarin, a rat poison will also cause hair loss. Once the poison is removed or treated, the hair will regrow.
Most causes of hair loss can be treated successfully with the proper treatment and conditions. The key is to identify the cause otherwise the treatment will not be effective. Sometimes, a combination of approaches can be beneficial as well.
Platelet Rich Plasma (PRP) is a procedure that can be added as an adjunct to treating hair loss. Studies have shown that patients treated with PRP had significantly increased hair regrowth by increasing the thickness of the epidermis and increasing the size of the hair follicle. PRP is also associated with an increase in capillaries around the hair follicles ensuring they are well oxygenated and nourished for optimal function.
The Many Causes of Hair Loss
Alopecia, better known as hair loss has been a trending clinical topic due to the events that happened at this year’s Academy Awards ceremony. At the Oscars, Chris Rock joked about about Jada Pinkett Smith’s hair loss. This is when Will Smith came on stage and slapped Mr. Rock. Pinkett Smith has alopecia areata, an immune disorder that causes hair loss and can be very distressing for the person affected.
There are many types of hair loss. The following is a short explanation of the most common forms.
Alopecia Areata:
Alopecia Areata (AA) is a disease that causes the body’s immune system to attack the hair follicles, (responsible for hair growth), causing hair to fall out. Hair can be lost from anywhere on the body such as scalp, nose ears, eye lashes and brows.
In some cases, hair regrows on its own, but if it doesn’t, some treatments can help stimulate the growth.
Hereditary Hair Loss or Androgenic Alopecia:
Most common cause of hair loss in the world. It is often called male pattern hair loss or lesser known women pattern hair loss. This hereditary hair loss caused the hair follicles to shrink and eventually stop producing hair. This can begin as early as the teen years but it usually starts later in life.
In women, what we see is an overall thinning or spacing of the hair shafts. Men on the other hand, get a receding hairline or bald spot at the top of the head.
Hair Loss from Cancer Treatment:
Chemotherapy or radiation treatments to the head or neck will cause hair loss within a few weeks of treatment initiation.
In this case, hair will start to regrow within months of treatment completion. There is medication that can be taken to help hair regrow more quickly. Sometimes the hair will regrow differently, like with curls when originally, it was strait.
Sometimes wearing a cooling cap before, during and after chemotherapy session can help prevent some of that hair loss.
Childbirth, Illness or Other Stressors:
Major life stressors like childbirth, divorce or the death of a loved one can cause temporary hair loss. In such cases, when the stressor goes away the hair stops falling and regrows again going back to normal within 6-9 months.
Chemical Hair Loss:
Coloring, getting permanents or relaxing your hair can be damaging and cause hair loss over time. To prevent this type of hair loss, you need to change how you care for your hair. Once the hair follicle is damaged hair can no longer grow out of it. Many damaged hair follicles are the source of permanent bald spots.
Traction Alopecia:
Hair loss can happen when the hair is tightly pulled back. The constant traction can cause permanent hair loss. This type of hair loss is easy enough to prevent. That is correct, just relax your hair styles.
Hormonal Imbalance:
Polycystic Ovarian Syndrome (PCOS) is a hormonal imbalance that causes cysts to form on a woman’s ovaries. This is accompanied by a group of symptoms such as hair growth in areas not typically seen on women such as on the chest, back or face (hirsutism), irregular periods, weight gain around the abdomen, acne or oily skin, infertility and male-pattern baldness or thinning hair. Seeing your care provider for treatment and monitoring can help your hair regrow where you want it and prevent the growth where you don’t want hair.
Scalp Infection:
Tinea capitis or ring worm (fungal infection of the scalp) causes the hair to break off the surface of the scalp and the scalp to become flaky and scaly. This infectious process will grow and spread if not treated. You can also get ringworm through contact with contaminated items such as combs, unwashed clothing, shower or pool surfaces. It can also be passed from one person to the next by direct skin-to-skin contact. Specific anti-fungal medications can be prescribed to treat this condition. Once the scalp is treated the hair should grow back.
Piedra:
Piedra, also known as trichomycosis nodularis is a hair fiber fungus. The infected hair fibers from trichomycosis nodularis have visible nodules on them. These nodules are very hard, thus the name piedra which means stone in Spanish. These fungal bodies also called ascostroma release fungal spores and spread to other hair fibers.
There are two types of piedra. Black piedra, which is mostly found in tropical countries, and white piedra which is found mostly in Europe and Southern parts of the United States.
This infection can affect hairs on the scalp, body and genital areas. When the infection is severe, it can cause the hair fiber to become weak and break off, leaving patchy, diffuse hair loss. Treatment for this is comprised shaving off the affected areas and the use of anti-fungal medications.
Folliculitis:
Folliculitis means inflammation or infection in the hair follicles. It looks like little red circles around the hair shaft. It can be caused by oils or lotion that is applied to the skin that end up blocking the hair follicles and making it easy for bacteria to overgrow. Staphylococcus aureus is a bacterium we all have on the surface of our skin. It’s harmless until it has a chance to overdevelop in a moist and warm environment. Folliculitis that develops after going in the hot tub is caused by a different bacterium called Pseudomonas aeruginosa that grows in water that is not adequately chlorinated. Left untreated, folliculitis can become severe and cause hair loss, leaving bald patches.
Over the counter topical antibiotic like bacitracin, mycitracin or neomycin can be used to treat early localized infection. However, if the folliculitis is widespread and severe, an oral prescription antibiotic must be used.
Demodex folliculorum:
Demodex is a little worm-like creature that live on skin and in hair follicles where it feeds on dead skin and oils.
These are harmless but repulsive little creatures that are spread through contact with others during childhood. For the most part, we don’t know they are there except when they cause irritation, usually in the eyelashes. If you have itchy eyelashes, this may be the cause. Contrary to popular belief, Demodex does not cause hair loss.
Seborrheic Dermatitis:
This is a skin condition that can cause temporary hair loss if it is located on the scalp or areas of the skin where there is visible hair. This dermatitis is and inflammatory process that makes the skin scaly, itchy, oily and sometimes painful to touch.
The cause of this condition is not well understood, but we know there is a genetic component and that Caucasians of Celtic descent are most susceptible. We also know that it is triggered by androgen steroids.
Newborns develop this condition (cradle cap), from excess androgens that are passed from the mother in the womb. Hormonal fluctuations such as in puberty can also activate the development. Conditions such as Parkinson’s, head injuries or stroke can be associated with it and stress and fatigue can make it worse.
Seborrheic dermatitis develops when the sebaceous glands that are attached to the hair follicles overproduce sebum that triggers an excess of bacteria on the skin. Add a yeast overgrowth to the mix and you increase the intensity of the dermatitis.
The area can become very itchy, red or inflamed and have flaking.
Seborrhea is simple enough to treat with the use of over the counter medicated anti-dandruff shampoos or some that contain sulfur, selenium sulfide, zinc pyrithione, tar, salicylic acid or oil of cade that have been around for many years. Prescribed medication can be used if the condition is too advanced.
Psoriasis:
Psoriasis is similar to seborrheic dermatitis as both cause red, scaly, inflamed patches on the skin. The difference is that psoriasis starts out as rough, red, scaly skin and grows into thick, silver colored scales usually on the scalp but can also be on other parts of the body like torso, arms, legs, hands and feet. These thick scaly patches could crack, itch and burn.
Seborrheic dermatitis is more likely to be whitish yellow, red or brown and tend to feel oily and is more likely to be found on the scalp, or where the face produces more oils (corners of the nares, ears or eyebrows), upper chest and back.
Both Seborrhea and Psoriasis can be treated or managed with proper medications and both can flare up when a person is triggered or stressed. Neither of these are contagious. They are autoimmune conditions that are passed down in the genepool or they’re triggered by things in the environment such as infections, injury to the skin, smoking, drinking or stress.
Scarring Alopecia:
Scarring alopecia or cicatricial alopecia develops when inflammation, caused by a multitude of conditions, destroys hair follicles and causes hair to thin or bald patches.
Sexually Transmitted Infection (STI)
Certain STIs such as Syphilis if left untreated, can lead to hair loss. In these instances, we would see patchy hair loss on the scalp, eyebrows, beard and genital area. Once the STI is treated the hair usually grows back.
Thyroid Disease:
What is commonly called low thyroid can also cause thinning hair that sometimes comes out in clumps when brushed. Once the hypothyroidism is treated and normalized the hair will grow back.
Poor nutrition:
Eating too little biotin, iron, protein or zinc can cause hair loss. This is also an easy fix if you remedy the cause. Hair will grow back once the person’s diet is adjusted.
Hair Pulling:
Some people develop a habit of pulling their hair when stressed, trichotillomania, which causes bald spots. Hair will regrow if the habit stops before the hair follicles are destroyed.
Frictional Alopecia:
Hair loss can develop when the skin continuously rubs against something like clothing, boots, socks. The hair tends to regrow when the frictions stops.
Poisons:
Slow poisoning by arsenic, thallium, mercury and lithium will cause hair to fall out. Mega doses of Vitamin A, Selenium or warfarin, a rat poison will also cause hair loss. Once the poison is removed or treated, the hair will regrow.
Most causes of hair loss can be treated successfully with the proper treatment and conditions. The key is to identify the cause otherwise the treatment will not be effective. Sometimes, a combination of approaches can be beneficial as well.
Platelet Rich Plasma (PRP) is a procedure that can be added as an adjunct to treating hair loss. Studies have shown that patients treated with PRP had significantly increased hair regrowth by increasing the thickness of the epidermis and increasing the size of the hair follicle. PRP is also associated with an increase in capillaries around the hair follicles ensuring they are well oxygenated and nourished for optimal function.
To find out more about how you can treat hair loss and how PRP can help your hair regrow contact this writer, Linda Lafrance MScN, NP, Chi Medical Aesthetics, for a consultation. 613 558 0080
Sources for this blog:
- American Academy of Dermatology Association
- Web MD
- PMC PubMed Central
The Effect of Platelet-Rich Plasma in Hair Regrowth: A Randomized Placebo-Controlled Trial published in the Stem Cells Transl Med. 2015 Nov 4(11): 1317-1323. Published online 2015 Sep 23. Doi: 10.5966/sctm
Chi Medical Aesthetics 