4.outer root sheath
Hair loss can have many causes and can be seen in both men and women. Hair loss which is more common in men effects %25 of men up to age of 25, %40 up to age of 40 and %50 up to age of 50.
More than 95% of hair thinning in men is male pattern hair loss (also known as male pattern baldness). Male pattern hair loss is characterized by hair receding from the lateral sides of the forehead (known as a “receding hairline”) and/or a thinning crown (balding to the area known as the ‘vertex’). Both become more pronounced until they eventually meet, leaving a horseshoe-shaped ring of hair around the back of the head.
A specialist physician before treatment should examine the type of hair loss. Many diseases, hormonal and metabolic disorders and nutritional effects can cause the hair loss. The treatment cannot be successful before such causes are fully eliminated. Cosmetics for hair loss must be used with attention. Using natural soaps and shampoos (from olive, bay or almond…) for hair care helps to prevent hair loss.
Hair loss can have many causes. These are as follow with decreasing frequency;
• Male Pattern Hair Loss: Please look .. link to erkeklerde saç dökülmesi
• Diffuse Alopecia: Diffuse hair loss can affect both sexes at any age. Anything that interrupts the normal hair cycle can trigger diffuse hair loss. Triggers include a wide variety of physiologic or emotional stresses, nutritional deficiencies, and endocrine imbalances. Loss of telogen-phase hairs is the most common. Hair loss during the anagen phase is usually caused by chemotherapy or radiation therapy. Finding the cause, or trigger, of the hair loss requires a thorough history and examination and will enable appropriate treatment. Patient education is key in the management of diffuse hair loss.
• Alopecia areata – Alopecia areata (AA) is a condition in which hair is lost from some or all areas of the body, usually from the scalp. Because it causes bald spots on the scalp, especially in the first stages, it is sometimes called spot baldness. In 1–2% of cases, the condition can spread to the entire scalp (alopecia totalis) or to the entire epidermis. Conditions resembling AA, and having a similar cause, occur also in other species.
• Cicatricial Alopecia – Cicatricial alopecias are classified as primary or secondary. This discussion is confined to the primary cicatricial alopecias in which the hair follicle is the target of the destructive inflammatory process. In secondary cicatricial alopecias, destruction of the hair follicle is incidental to a non-follicle-directed process or external injury, such as severe infections, burns, radiation, tumors, or traction.
Primary cicatricial alopecias are further classified by the type of inflammatory cells that destroy the hair follicle during the active stage of the disease. The inflammation may predominantly involve lymphocytes or neutrophils. Cicatricial alopecias that predominantly involve lymphocytic inflammation include lichen planopilaris, frontal fibrosing alopecia, central centrifugal alopecia, and pseudopelade (Brocq). Cicatricial alopecias that are due to predominantly neutrophilic inflammation include folliculitis decalvans, tufted folliculitis, and Dissecting cellulitis of the scalp. Sometimes the inflammation shifts from a predominantly neutrophilic process to a lymphocytic process. A cicatricial alopecia with a mixed inflammatory infiltrate is folliculitis keloidalis.
• Traumatic Alopecia – Traumatic alopecia is a cutaneous condition that results from the forceful pulling out of the scalp hair.
• Infections – Various microorganisms can cause directly or indirectly the deterioration of hair shaft or hair follicles. The causative agent determines the type of hair loss.
• Hair shaft abnormalities – Structural abnormalities of the hair shaft is examined in four groups; fractures, irregularities, spiral structure and foreign objects that affects the hair shaft.
• Other – Various chronic skin diseases such as psoriasis can also affect the scalp.
Other types of hair loss are usually temporary and can be caused by various factors. For example; stress, thyroid disorders, surgery with general anaesthesia, diabetes, an overdose of vitamin A, chemotherapy, various drugs.
Male pattern hair loss is usually genetic and is a source of real concern for many men. If you are genetically programmed to lose your hair your chance to protect your hair is very small in long term.
DHT: Dihidrotestosteron; a potent endogenous androgenic hormone, derived from testosterone.
DHT is important early stages of a man’s life for development but it starts to become the cause of hair loss as man get older. DHT scales down the hair follicle and it cannot produces hair any more.
DHT has an important role in male pattern hair loss;
Hair follows a cycle of growth – loss – regrowth. But increased levels of DHT causes shorten the required time of growth and loss. Then hair starts to be attenuated.
Low-level hair loss (Type 1 ve Type 2)
Mid-level hair loss (Type 3, Type 4 ve Type 5).
High-level hair loss (Type 6 ve Type 7).
About one-third of women experience hair loss (alopecia) at some time in their lives; among postmenopausal women, as many as two-thirds suffer hair thinning or bald spots. Hair loss often has a greater impact on women than on men, because it’s less socially acceptable for them. Alopecia can severely affect a woman’s emotional well being and quality of life.
The most common type of hair loss seen in women is androgenetic alopecia, also known as female pattern alopecia or baldness. This is seen as hair thinning predominantly over the top and sides of the head. It affects approximately one-third of all susceptible women, but is most commonly seen after menopause, although it may begin as early as puberty. Normal hair fall is approximately 100-125 hairs per day. Fortunately, these hairs are replaced. True hair loss occurs when lost hairs are not regrown or when the daily hair shed exceeds 125 hairs. Genetically, hair loss can come from either parent’s side of the family.
There are two different types of hair loss, medically known as anagen effluvium and Telogen effluvium. Anagen effluvium is generally due to internally administered medications, such as chemotherapy agents, that poison the growing hair follicle. Telogen effluvium is due to an increased number of hair follicles entering the resting stage.
The most common causes of Telogen Effluvium are:
Physical stress: surgery, illness, anemia, rapid weight change.
Emotional stress: mental illness, death of a family member.
Medications: High doses of Vitamin A, Blood pressure and Gout medications.
Hormonal causes: pregnancy, birth control pills and menopause.
When the above causes of telogen effluvium are reversed or altered you should see the return of normal hair growth.
Hair loss may also occur due to dieting. Franchised diet programs, which are designed or administered under the direction of a physician with prescribed meals, dietary supplements and vitamin ingestion, have become popular. Sometimes the client is told that vitamins are a necessary part of the program to prevent hair loss associated with dieting. From a dermatologists’s standpoint, however, the vitamins cannot prevent hair loss associated with rapid, significant weight loss. Furthermore, many of these supplements are high in vitamin A that can magnify the hair loss.
Physical and Emotional Stress
Surgeries, severe illnesses and emotional stress can cause hair loss. The body simply shuts down production of hair during periods of stress since it is not necessary for survival and instead devotes its energies toward repairing vital body structures. In many cases there is a three-month delay between the actual event and the onset of hair loss. Furthermore, there may be another three-month delay prior to the return of noticeable hair regrowth. This then means that the total hair loss and regrowth cycle can last 6 months or possibly longer when induced by physical or emotional stress. There are some health conditions which may go undetected that can contribute to hair loss. These include anemia or low blood count and thyroid abnormalities. Both of these conditions can be detected by a simple, inexpensive blood test.
Hormonal changes are a common cause of female hair loss. Many women do not realize that hair loss can occur after pregnancy or following discontinuation of birth control pills. It is important to remember that the hair loss may be delayed by three months following the hormonal change and another three months will be required for new growth to be fully achieved.
Treatment Options for Female Pattern Hair Loss
Accepting and learning to live with hair loss. Professional counseling may be of help.
Perms, color and other cosmetic options to give a fuller appearance to hair.
Medical therapy– Rogaine (topical minoxidil).
Hair Replacement Surgery. Modern surgical techniques have made transplantation for females a viable treatment option providing they are qualified candidates and have realistic expectations.
Hair Additions. Modern forms of hair additions have also made recent improvements in simulating a natural appearance. A consultation with a skilled specialist to discuss your options is advised.