Hair loss: causes and solutions

Every day we lose 30 to 60 hairs. This is normal. But more than 100, no! Hair loss can be explained and good news, we can even fix it! Discover the causes and solutions to hair loss. The main causes: fatigue, stress, hormonal disorder, pregnancy or psychological trauma. Your hair is it healthy? Not easy to have lost hair on the brush in the shower or on the pillow. But in case of sudden drop, you will notice it. Women tend to lose their hair on the top of the skull and patchy, sometimes delaying the detection of a problem of alopecia. Your hair grows in cycles and fall well established. The life of a hair female is about six years. Then he falls and is replaced by another. A hair follicle can give birth to twenty hairs in a lifetime. And when it's over, it's over. Moreover, according to your hair color, you will have a more or less dense hair.


Hair Fall:
Your hair took to their heels? Do not panic. It may be a drop in "season" so called because they occur at the entrance of the fall or summer. In reality these falls have generally been very tired or under great stress. You did not notice anything? This is normal. The origin of evil is to be sought in the past. It is three months earlier than decides the fate of our hair. Between fatigue and accumulated before the summer holidays boosted by the hair and the sun (and which will therefore also more likely to fall), the equation is solved. You can experience a sudden drop of hair at any time of year. Remains is to discover what event served to trigger three months earlier.

Hormones to tame:
Our hair is quite sensitive to hormones. The hormonal disorders are the leading cause of alopecia in women. This is the situation facing many young mothers who sported a mane after stunning during pregnancy, are many hair loss after childbirth or after the end of breastfeeding. The hair is sensitive to estrogen, present in large quantities during pregnancy, they fall after delivery (or menopause) and carry with your hair. Hair loss can also be significant traces of a hormonal problem. Thyroid, pituitary, androgens or prolactin may explain abnormal hair loss. This type of hormonal disorder is more common among women from the Mediterranean basin. A blood test will check the rates of these various hormones.

Solutions for a hair of your dreams

A. If you are used to lack iron like many women, it may be necessary to take a dietary supplement. There are also dietary supplements designed to improve the health of your hair. 2. Avoid stress and recover if you were particularly tired. Your dermatologist will prescribe a lotion that is applied to the hairline and increases their growth rate. 3. Like many hair falls in shampoos, women prone to hair loss often avoid too important to wash your hair . But beware, an excess of sebum on the scalp will stop hair growth. It is therefore important to have a healthy hair. 4. Improve micro-circulation to your scalp by asking your boyfriend to massage your scalp. Finally, a good excuse to be pampered. 5. Many special treatments available on the market. Kérastase offers, for example, while an anti-fall. Densifying shampoo, lotion bulbs for slowing down, densifying care and food supplements are available to fight counter hair loss.

Acne Miliaris Necrotica

Acne Necrotica Miliaris is a superficial, non-scarring inflammatory disorder of the hair follicles. It is one of two syndromes that falls under the broader clinical term Acne Miliaris Necrotica (AN), the other being the deeper, scarring Acne Necrotica Varioliformis. Since first being described in 1851, AN has proven to be a rare condition, prevalent among adult males, with chronic symptoms that wax and wane over time.

Both Acne Necrotica Miliaris and Acne Necrotica Varioliformis are characterized by pruritic follicular papule that are often triggered by stress.¹ Patients tend to be men aged 30 to 50, although the lesions have been reported in women and patients younger than 30 who have passed puberty.

Acne Necrotica Miliaris is characterized by minute, intensely itchy pustules on the scalp that may become sore and crusted due to constant scratching.² The lesions may concentrate around the frontal hairline (acne frontalis), but can appear anywhere on the scalp. They also vary in number from just a few to numerous pustules covering the scalp. Additional lesions may be found on the face, neck, chest, or back.³

Acne Necrotica Miliaris affects only the superficial portion of the hair follicle, allowing for hair regrowth following successful treatment, which can include oral antibiotics, topical corticosteroids, and oral isotretinoin, which has shown a rapid reduction of the pruritic lesions.⁴

Acne Necrotica Varioliformis is characterized by erythematous follicular papules that undergo necrosis (or cell death). These deeper lesions may progress to crusting, dry, dark scabs that leave smallpox-like scars (varioliformis) in their wake. Permanent hair loss may occur where the scalp has

been scarred (cicatricial alopecia).

Histological studies of an early lesion show lymphocytes (white blood cells) and plasma cells centered around a central hair follicle. The lymphocytes then fuse into the external root sheath. The keratinocytes within the external root sheath and surrounding epidermis show extensive cell necrosis.⁵

The true etiology, or cause, of AN is unknown, however, it has been postulated that the initial lesions are inflamed hair follicles with Propionibacterium acnes. (Propionibacterium acnes are slow growing anaerobic bacterium which are linked to the skin condition acne.⁶ They are gram positive, which means they stain dark blue or violet with gram staining. Gram positive bacteria generally have a single lipid bilayer called monoderms.)

The lesions may also be caused by an abnormal reaction to the Staphylococcal Aureus Bacteria and the Streptococcal Bacteria, which live on the skin at all times but can cause infection when they enter the body through a cut or other injury. Gram-negative bacteria, which usually originates in the nose following antibiotic treatment for acne, may also be to blame, as is Tinea Capitis (ringworm of the scalp), caused by a fungus that invades the hair shaft. In at least one case, use of the drug phenylbutazone was believed to have caused the syndrome.⁷ In still others, extreme mechanical manipulation of the scalp due to scratching or rubbing patches of underlying folliculitis may be to blame, as are the tiny parasitic mites, demodex folliculorum. However, the most common pathogens found in pustules remain Staphylococcus aureus and Propionibacterium acnes.⁸

Examining the scalp and forehead for past umbilicated scars with a “punched-out” appearance is helpful to the trichologist working toward a diagnosis of AN. In addition, the presence of Staphylococcus aureus and Propionibacterium acnes should be determined in erupting pustules. In the case of Propionibacterium acnes, Isotretinoin should be tried, while in the case of Staphylococcus aureus, anti staph agents and oral tetracyclines may prove successful.⁹

Sources

Dawber, Rodney, Ed., Diseases of the Hair and Scalp, Third Edition, Blackwell Science, Malden, MA, 1997.

DermNetNZ.org

HairScientists.org

Olsen, Elisa A.,Ed., Disorders of Hair Growth, Second Edition, McGraw-Hill, New York, 2003.

Wikipedia.org

1 Dawber, Rodney, Diseases of the Hair and Scalp, p. 511.

2 DermnetNZ, Scalp Folliculitis, http://dermnetnz.org/acne/scalp-folliculitis.html

3 Olsen, Elisa A., Disorders of Hair Growth, p. 111.

4 Olsen, Elisa A., Disorders of Hair Growth, p. 383.

5 Olsen, Elise A., Disorders of Hair Growth, p. 112.

6 Wikipedia.org, Propionbacterium Acnes, http://en.wikipedia.org/wiki/Propionibacterium_acnes

7 Zemite, Inga, http://www.hairscientists.org/acne-miliaris.htm

8 Zemite, Inga, http://www.hairscientists.org/acne-miliaris.htm

9 Zemite, Inga, http://www.hairscientists.org/acne-miliaris.htm

Hair Loss May No Longer Be A Certain Side-Effect of Chemo

Excellent news for chemotherapy patients! A new device called the DigniCap is helping women keep their hair even when undergoing chemo, which often leads to hair loss. The device cools the scalp, reducing blood flow to the hair follicles and minimizing damage from the toxic chemicals. In a Japanese study, more than 82 percent of 255 breast cancer patients kept most of their hair thanks to the cap.

Oncologist and medical professor Hope Rugo at the University of California, San Francisco, has launched a U.S. study of the DigniCap. She says FDA approval and wider availability could come in the near future.

Email info@dignitana.com for more information.

Another cooling option is the Penguin cold cap. Unlike the DigniCap, which has its own cooling unit, the Penguin cold cap must be cooled in a special freezer and replaced every 20 minutes throughout the chemotherapy session. The caps can be rented for around $500 a month.

Acquired Progressive Kinking of the Hair (APKH)

Acquired Progressive Kinking of the Hair (APKH), is a rare disorder characterized by dull, frizzy, extremely curly scalp hair. The syndrome was first described in 1932 and since that time, only a couple dozen cases have been reported and even fewer have been thoroughly studied.[1]

What we do know is that the syndrome is acquired around adolescence, which is one of the factors that distinguishes it from conditions such as pili torti and woolly hair naevus, which occur at birth or infancy. The earliest documented case of APKH was in an 8-year old girl and the latest onset was in a 23-year old man.[2]  The frizzy, kinky hair appears in the frontal, temporal, and vertex regions (frontal, parietal, occipital) of the scalp.

An electron microscopic examination of at least one case of affected hairs showed partial twisting of the hair along its longitudinal axis along with longitudinal grooves in the hair shaft (pili canaliculi)[3]. In addition to the severe kinking of the hair, the follicles may turn lighter (hypopigmented), darker (hyperpigmented) or remain the same color. Hair growth may or may not be affected by the kinking.

A proposed criteria for diagnosis of APKH published in the Journal of Pediatric Dermatology (Vol 21, No. 3 265–268, 2004) includes:

An acquired circumscribed area of dull, woolly, hair in the frontal,

temporal, or parietal regions in the absence of previous trauma.

Irregular, twisted, and tortuous hair with the first twist appearing

at 3–4 cm from the emergence of the hair.

On optical microscopy, a periodic reduction in the hair shaft diameter

with broadened sections alternating with flattened ones.

On scanning electron microscopy, partial twisting of the hair on its

longitudinal axis with a 180-degree rotation, variable pili canaliculi

(or longitudinal grooves), spindle-shaped broadening with

occasional fractures, and increased numbers of cuticular cells per

diameter in the twisted sections.[4]

            Some scientists suggest that the onset of APKH may be a type of androgenic alopecia, the most common form of hair loss that results from a genetic predisposition making follicles sensitive to the effects of dihydrotestosterone (DHT). Androgenetic alopecia is often termed “male pattern baldness,” but women can suffer from it, too. In men, the hair loss usually begins above the temples and thins at the crown. In women, the hair loss usually occurs along the hair part. The hair loss occurs as a genetic condition related to the presence of androgens in the blood. Androgens are hormones responsible for normal male sexual development as well as regulating hair growth and sex drive in both men and women.[5]

In one study published in the Archives of Dermatology, the patients (7 males), all had a strong family history of androgenic alopecia. In addition “the pathological features of the affected scalp were consistent with the diagnosis of the early stages of androgenetic alopecia.” [6] All cases eventually evolved into androgenetic alopecia within a two to nine-year period, and 5% Minoxidil was ineffective in preventing the eventual hair loss. The effects of finesterinde (Propecia) have not been recorded in cases of APKH.

APKH appears to share several characteristics of androgenic alopecia[7]:

• APKH occurs at the onset of puberty when hormones are at their most active.
• There is an increased concentration of DHT on the scalp.

DHT stands for dihydrotestosterone, a potent androgenic hormone synthesized in the prostate gland, hair follicles, testes and adrenal glands by 5-alpha reductase, an enzyme involved in steroid metabolism. If hair follicles are genetically sensitive to DHT, hair follicles can shrink and growth can slow or stop altogether.

• The affected hairs appear similar to pubic hair.
• The distribution of affected hair is similar to pattern baldness.
• In some patients, APKH developed into androgenic alopecia.
• There is a decreased anagen to telogen ratio.

Another cause of APKH may be the use of retinoids such as Isotretinoin (Accutane), used for severe acne, and Etretinate, prescribed for psoriosis.[8] Both drugs have shown to produce kinking of hair in some people, which may reverse itself with the cessation of the drug treatment.

APKH is very similar to “Whisker Hair,” a condition where scalp hair develops into short, curly, dark hair similar to beard hair.[9] Some scientists even believe that “Whisker Hair” and APKH are variants of the same disorder because both can lead to excessive hair loss.[10]

      Still other experts believe APKH may be an autoimmune problem.[11] To lend further to the lack of solid conclusions, some APKH patients have reported  progression of symptoms over time, while still others report regression, as in the case of at least one woman whose symptoms disappeared with the onset of pregnancy.[12] Researchers at the University of Bologna who published a study in the Archives of Dermatology (Vol. 135, No. 10, Oct. 1999) even concluded that APKH was not its own syndrome, but rather the term Acquired Progressive Kinking of the Hair “encompasses a number of conditions characterized by acquired curling of the scalp hair.”[13]

Clearly, more cases of APKH need to be recorded and studied in order to learn whether it has specific common symptoms and how it can be treated.

Notes

[1] Pediatric Dermatology, Acquired Progressive Kinking of the Hair, http://onlinelibrary.wiley.com/doi/10.1111/j.0736-8046.2004.21317.x/pdf, p. 265

[2] Pediatric Dermatology, Acquired Progressive Kinking of the Hair, http://onlinelibrary.wiley.com/doi/10.1111/j.0736-8046.2004.21317.x/pdf, p. 266

[3] Pediatric Dermatology, Acquired Progressive Kinking of the Hair, http://onlinelibrary.wiley.com/doi/10.1111/j.0736-8046.2004.21317.x/pdf, p. 265

[4] Pediatric Dermatology, Acquired Progressive Kinking of the Hair, http://onlinelibrary.wiley.com/doi/10.1111/j.0736-8046.2004.21317.x/pdf, p. 267

[5] Wikipedia.org, Androgenic Alopecia, http://en.wikipedia.org/wiki/Androgenic_alopecia

[6] Archives of Dermatology, Acquired Progressive Kinking of the Hair, http://archderm.ama-assn.org/cgi/content/abstract/135/10/1223

[7] Pediatric Dermatology, Acquired Progressive Kinking of the Hair, http://onlinelibrary.wiley.com/doi/10.1111/j.0736-8046.2004.21317.x/pdf, p. 266

[8] The Trichological Society, http://www.hairscientists.org/kinking.htm

[9] PubMed.gov, Whisker Hair, http://www.ncbi.nlm.nih.gov/pubmed/7238115

[10] Pediatric Dermatology, Acquired Progressive Kinking of the Hair, http://onlinelibrary.wiley.com/doi/10.1111/j.0736-8046.2004.21317.x/pdf, p. 267

[11] The International Association of Trichologists, Hair Shaft Problems, p. 95.

[12] Dawber, Diseases of the Hair and Scalp, p. 292.

[13] Archives of Dermatology, Acquired Progressive Kinking of the Hair, http://archderm.ama-assn.org/cgi/content/abstract/135/10/1223

Sources

Archives of Dermatology, Vol. 135, No. 10, Oct. 1999, Acquired Progressive Kinking of the Hair, http://archderm.ama-assn.org/cgi/content/abstract/135/10/1223

Dawber, Rodney, Ed., Diseases of the Hair and Scalp, Third Edition, 1997.

Pediatric Dermatology, Acquired Progressive Kinking of the Hair, Vol. 21, Issue 3, May 2004, http://onlinelibrary.wiley.com/doi/10.1111/j.0736-8046.2004.21317.x/abstract

The International Association of Trichologists, Hair Shaft Problems, 1999.

The Trichological Society, http://www.hairscientists.org/.

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