Hair fall is a common concern that for almost everyone in the region! But when do you know if you need to start worrying? And when do you know it’s Alopecia!  This article is an attempt to explain this rare occurrence and what causes it to better equip yourself to deal with it should the need arise

Hair fall is normal

The human body has around five million individual hairs. And a hundred thousand of those are on the head.

A hair follicle is the sac from which the strand of hair grows. It anchors each strand to the skin. Cells within hair follicles divide and multiply creating fresh cells and pushing out the older dead cells to form the hair shaft.

The phase when the strand grows is the active or anagen phase. It then enters the catagen phase when it neither grows nor falls off, and the finally into the telogen phase when it rests and then falls off. The growth phases vary for hair on different parts of the body.

For head hair, the anagen phase lasts around three years; the catagen around three weeks; and telogen, around three months. Normally, 85% of the hair is in the anagen phase, 0.5%-1% in catagen; and 15% in telogen – shedding around 25 to 100 strands per day. This is a normal amount of hairfall

When Hair loss can become a problem

When hair fall exceeds the normal daily amount of hair loss by a visible difference it is – called Alopecia in medical terminology. It is important to understand that there are several types of alopecia, each with its own causes and patterns.

Types of alopecia

  • Telogen Effluvium: Post-pregnancy hair loss is a common example of this. Broadly, Telogen Effluvium occurs when the hair thins out due to stress, illness or hormonal changes. In this condition, many strands of hair may in shed prematurely, 3-4 months after stress exposure, resulting in increased hair loss.This is a temporary condition and hair starts growing back within six months.
  • Anagen Effluvium: This is widespread hair loss due to chemotherapy and other cancer treatments. It can affect the scalp, face and body but is also temporary in nature.
  • Androgenetic alopecia: also known as male and female-pattern baldness, is typified by a receding hairline which is followed by thinning of hair on the crown and temples in males. This leaves a horseshoe-shaped patch of hair on the back and sides of the head. Female pattern baldness, on the other hand, shows up as uniform thinning across the scalp.Genetic factors control this type of hair loss and it is a factor in hair loss among elderly individuals.
  • Alopecia Areata: Classified as an autoimmune disorder, it occurs when the immune system mistakenly attacks the hair follicles, making them shrink and slow down or stop hair production. The condition causes hair to fall out in clumps, leaving round, hairless patches on the scalp or any other part of the body. In many cases, the hair grows back over time. Sometimes, however, it turns more severe and develops into alopecia totalis, with total loss of scalp hair, or alopecia universalis, which is loss of scalp and body hair.Family history and stress can be precipitating factors in this type of hair loss.
  • Cicatricial alopecia: also known as scarring alopecia, is caused when the hair follicle is completely destroyed. The hair will not grow back. It is generally a result of complications arising out of other conditions such as congenital defects, physical injury, infections or tumors and certain collagen diseases
  • Metabolic or nutritional disorders: conditions like anemia or zinc deficiency may also lead to hair thinning and increased hair loss. This form of alopecia is quite common. However what distinguishes it is the fact that hair loss is diffused – it is not localised, but takes place more or less uniformly all over the head.

How hair loss can be treated

Evaluation, diagnosis and appropriate laboratory investigations are important to define which type of hair loss has occurred. Dermatologists usually carry out visual inspection, a hair pull test and trichoscopy. Although the specific course of treatment would be determined through several factors, let’s comb through the general spectrum of solutions:

  • Oral multivitamins, vitamin B, vitamin C and iron to encourage healthy hair regrowth.
  • Topical minoxidil for alopecia areata
  • If the root cause is hormonal in nature, the alopecia may be treated with oral 5 α reductase inhibitors which inhibit the conversion of testosterone to DHT.
  • Androgenetic alopecia may be treated with oral 5 α reductase inhibitors too, if the dermatologist assesses it as a viable option. However, since this is an irreversible form of alopecia, hair transplant is often recommended as a more effective and sustainable solution.
  • Mesotherapy, PRP (platelet rich plasma) and carboxy therapies deliver positive outcomes across all types of alopecia as they serve to strengthen hair. Let’s take a closer look at how they work.

Mesotherapy is a technique where microscopic quantities of pharmaceuticals, vitamins and minerals are injected into the scalp to help it rejuvenate and repair itself. Biotin, folic acid, vitamin B and zinc stimulate circulation and nourish the hair follicles. The strands of hair that regrow out of these follicles are now thicker, stronger and healthier. Hair shedding, hair loss and even hair breakage lessens.

Platelet rich plasma (PRP) is a rejuvenation therapy which uses the innate healing and regenerative powers of your own blood. Here’s how it works. Your blood platelets, rich in growth factors, are injected into targeted areas of your scalp to stimulate and accelerate cell regeneration. This stimulates hair growth, making hair appear thicker and more conditioned. PRP is done in monthly sessions, alternating with mesotherapy between ​​sessions.

Carboxy Therapy: which works by stimulating the hair follicles with more oxygenation, better blood circulation and increased supply of nutrients. These hair follicles get rejuvenated and in turn, stimulate hair growth.

Lose the sense of loss. Help is at hand.

Alopecia is often accompanied by emotional issues. Hair loss can severely affect self-confidence, and coming to terms with it is not easy. In a holistic sense, the optimal way forward is to adopt the right combination of acceptance and action. Accept that conditions such as alopecia are normal and nothing to be embarrassed about. Act positively, seeking professional intervention so that hair loss can be minimised, slowed down… or reversed. There’s a lot that science can do… and will.

By Dr. Mohamed Gharib

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