Have you ever wondered why your hair is falling out?
Human hair is composed of a protein called keratin produced in hair follicles in the outer layer of skin. As a part of the hair growth cycle, while new hair cells are produced by a hair follicle, old cells are pushed out through the surface of the scalp skin. The result of this process is our hair, which in fact is a string of dead keratin cells. Although the number of hairs an individual has on his or her scalp varies by color, an average adult person has 100.000 hair follicles and sheds approximately 30-150 hairs a day. It emerges as a distressing problem that shatters their confidence and self-esteem when individuals experience excessive shedding as they begin to lose fistfuls of hair. Therefore, it bears crucial importance to determine the root causes of the alopecia (hair loss) to decide where it is temporary or progressive before one seeks medical treatment.
Are you experiencing a sudden, temporary hair loss?
The temporary hair loss also called telogen effluvium is a condition experienced as a result of an external factor disturbing the growth cycle of hair. While approximately 10% of the scalp hair is in the telogen phase (resting phase), in telogen effluvium, this rate increases to 30% or more, as an environmental trigger shocks the hair follicles into a dormant state, and hair falls out approximately three months later. Let’s take a look at the hair growth cycle to understand this phenomenon.
Anagen
| Catagen
| Telogen
|
Medications or Hormones
Contraceptive pills, beta-adrenergic blockers used to control blood pressure, anticoagulants (blood thinners), and chemotherapy drugs used in cancer treatments may cause telogen effluvium within approximately 12 weeks of medication.
Telogen effluvium also may occur when the thyroid glands do not function well. Thyroid disorders such as hypothyroidism (underactivity of thyroid glands) and hyperthyroidism (overactivity of thyroid glands) may lead to hair loss as thyroid hormones are directly involved in the overall thinning of scalp hair.
Major Weight Loss or Extreme Dieting
An exceedingly strict protein-poor or calorie-deficit diets may deprive hair of nutrients necessary for a healthy hair growth, which include proteins, iron, B-vitamins, and zinc.
Childbirth or Menopause
Fluctuating estrogen levels during menopause could lead to telogen effluvium in women. Similarly, as pregnancy and childbirth lead to hormonal changes, a diffuse hair shedding may occur in women after giving birth, which is also known as postpartum telogen effluvium.
Stressful or Major Life Event
Incidents causing significant emotional stress may trigger the premature termination of the anagen phase and cause temporary hair loss.
A study conducted on healthy young female university students under major exam stress demonstrated that stress activated neuroendocrine-immune circuits which terminated the hair growth in these young women with no other clinically-noticeable health disturbance.
Trauma or Illnesses
The outbreak of an illness or a disease or experiencing a trauma that haphazard the wellbeing of an individual triggers telogen effluvium.
A recent study conducted on individuals who were diagnosed with COVID-19 to determine the side effects of the virus suggested that COVID-19 may be a significant trigger leading to telogen effluvium, as infected patients were under ‘immense psychosocial and physiologic stress.
Distinguishing Telogen Effluvium from Other Hair Loss Types
Physician Examination:
When determining the type of hair loss, your dermatologist will examine the appearance of your hair, along with the history of your hair shedding as the diameter and the length of the shed hair are important indicators in this aspect. In telogen effluvium, while individuals experience an excessive hair shedding across their scalp, the texture and integrity of their hair is not compromised; permanent hair loss may lead to
patchy hair loss while the hair texture becomes thin and wispy. Your dermatologist may also require blood tests to see whether your hair loss is caused by iron or nutrient deficiency or thyroid diseases.
Hair Pull Test:
Hair Pull Test is carried out by gently pulling 40 to 60 hairs from the scalp, and if more than 10% of these hairs fall out, the test is considered ‘positive’, indicating that you are experiencing hair loss. However, for the accuracy of the results, this method requires you not to wash your hair within 48 hours beforehand.
The Wash Test:
The wash test is carried out by washing the hairs in a basin after having avoided shampooing for 5 days. The number of shed hairs collected from the basin floor is counted and separated into groups depending on their length to determine the severity of hair loss. In telogen effluvium, this number usually turns out to be higher than 100, and the length of shed hair allows dermatologists to distinguish telogen effluvium from
androgenetic alopecia.
Understanding Progressive Hair Loss
Progressive hair loss occurs when expected hair regrowth does not follow the telogen phase anymore. This indicates that hair growth is terminated, and bald spots begin to appear in areas where hair follicles have fallen out. Progressive hair loss is quite frustrating for both men and women as it alters their appearance permanently, crumbling down their self-esteem and confidence.
The ground-breaking technological and scientific advancements paved the path for the development of treatments which slow down the progressive hair loss, encourage the growth of new hairs and even strengthen the hair roots and follicles. These treatments can be categorized in relation to their method of application, such as non-surgical methods, drug treatments and hair transplant. Below are the most popular non-surgical treatments applied to treat the progressive hair loss.
Mesotherapy: a technique which delivers the medical mixture consisting of natural plant extractions, vitamins, enzymes, amino acids, and medicines into the scalp to stimulate hair shafts and decrease the excess of DHT (an androgen associated with causes of hair loss in androgenetic alopecia).
PRP (Platelet-Rich Plasma): a technique involving the injection of the concentration of platelets obtained from a person’s blood into the scalp to accelerate the cell proliferation and stimulate the growth in the relevant area.
LLT (Low-Laser Treatment): a technique which triggers the stimulation of the hair cells and hair follicles, and prolongs the anagen phase of the hair growth, while preventing the immature transition to the catagen phase by irradiating photons into scalp through a red laser.
The drug treatments for progressive hair loss, such as the use of Finasteride and Minoxidil aim to slow further hair loss, while their success depends on various factors such as the bodily factors and the severity of hair loss. However, frequently encountered serious adverse effects of these drugs, such as decreased libido, and ejaculatory disorders resulting from the use of Finasteride, and hirsutism (unwanted abnormal hair growth), increased heartbeat, and inflammation around the hair roots lead many people to choose hair transplant as a method to restore their hair permanently.
