Hair Loss Treatments
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A hair goes through various phases of its life cycle during which it first grows first inside and then outside the scalp. Once it has grown out of the follicle, it grows on the scalp for a certain period of time (few months to years). This period varies in different individuals and determines the ultimate length a person’s hair can achieve. After this period hair goes into a resting phase and finally falls off, leaving the hair follicle empty from where a new hair will grow.
A normal person loses about 50-100 hair per day but the change goes unnoticed as new hair keep growing regularly. Any loss above this range is considered not normal. But for any person, any number of hair loss which is above his routine hair fall should be taken into account seriously.
Some hair is regularly shed off from the scalp and they grow back. Examples of physiological hair loss includes hair fall experienced by pregnant women about 3 month after the delivery and hair loss in neonates few weeks after birth.
Non-scarring hair loss: It is the kind of hair loss in which the hair follicles have suffered some damage, making them loose hair but it is not permanent. The follicles still have their growth potential and hair can be grown back from them with the help of medical treatment.
Scarring hair loss: In scarring hair loss the follicles have suffered permanent damage and donot have much growth potential left. Medicines can hardly grow hair in such type of hair loss.
NON-SCARRING HAIR LOSS
Patterned hair loss/ Androgenetic alopecia
Both men and women can suffer from patterned hair loss. However, it is more commonly noticed in males, due to the short hair length. It is characterized by slow and progressive reduction in hair density, diameter as well as hair length. Hair tends to become shorter, thinner and less dense with every hair cycle. In males it leads to a gradual recession anterior of hair line with reduction of volume from the top of the head. In females, the anterior hair line is usually preserved and they experience a gradual widening of the hair parting along with a diffuse thinning of hair over scalp.
The gradual loss remains unnoticeable for a long time and becomes appreciable only after a certain volume is lost. People may commonly attribute it to some starting factor like a recent illness, pregnancy.
If left alone Patterned hair loss is progressive with end result being a bald scalp with hair left only in the behind area of the scalp. Therefore, an early treatment is a must to halt the hairfall as well as to restore the thinning hair.
Treatment needs to be started as soon as possible and needs to be continued for a very long time preferably life-long.
Lotions which need to be applied on the scalp regularly once or twice daily as per the physician recommendation.
Oral medications also may be required and needs to be taken for specified duration of time.
Platelet Rich Plasma (PRP) Therapy: includes the injection into the scalp of a platelet rich concentrate which is harvested from the patient’s own blood. The procedure may need multiple sessions.
Other less commonly recommended treatment modalities include stem cell therapy, mesotherapy, energy based devices.
Hair transplantation is the most definitive treatment for the bald areas. It can be done in both males and females above 25 years of age. Other factors need to be considered before a transplant is the area that requires to be transplanted, existing hair density and diameter and also the donor area.
Scalp micropigmentation is an option in those males who wish to wear their short. A permanent tattooing of the scalp is done with the help of a professional machine.
It is non-scarring type of hair loss in which body’s immunity starts working against one’s own self. It can affect both males and females and people of any age group may be affected. It may have a rapid progression and is characterized by one or more peripherally spreading, smooth patches of baldness. In severe form of the disease it may affect the hair of eyebrow, eyelashes and body hair
If left untreated, milder form of the disease may resolve spontaneously in one year or so. However, few patients may progress to more severe forms of the disease affecting the whole of the scalp and even body hair. Multiple treatment modalities that are available include oral or potent topical corticosteroids, intralesional corticosteroids, immunotherapy and phototherapy.
Telogen effluvium is a type of temporary hair loss in which a large number of hair shift from the growing phase to the shedding phase. An increased hair shedding above the normal for a patient is seen , more commonly after washing of hair or combing them. It leads to a generalized decrese in the hair volume and in severe cases scalp may be visible. It can be further divided into acute form when preent for less than 6 months and chronic form when present for more than 6 months. It usually starts around 10-12 weeks after a precipitating factor like stress, recent illness, delivery, excessive dieting or significant weight loss.
Telogen effluvium requires no treatment as such. The hair that are shed starts to regrow after a period of about 3-6 months, once the patient has recovered from the precipitating stress. In case of any nutritional deficiency a supplement of that particular nutrient helps in gaining back the lost volume of hair.
Anagen effluvium refers to the hair loss that arises during the growth phase of the hair cycle. At any point of time about 90% of total scalp hair are in anagen phase. Any sudden insult to the hair follicle during this phase leads to very rapid hair loss. It is most commonly seen in patients on chemotherapy and radiotherapy. It may start soon after the initiation of the therapy any lead to a completely bald scalp within weeks. The hair loss is temporary and the patient starts to regain their hair after the discontinuation of therapy.
Unfortunately, no treatment is proven to prevent the hair from shedding of hair during the chemotherapy. Also, little help is achieved with medicines post chemotherapy. The main aim of treatment is to reduce the duration of hairless period for the patient. It can be achieved by camouflaging techniques technique like hair patches and wigs.
SCARRING HAIR LOSS
These are a group of scarring alopecia in which the root of the hair is damaged to such an extent that it has failed to grow any hair from it. It can be classified into primary and secondary cicatricial alopecias. The primary ones include the disorders that directly affect the hair like Lichen Planopilaris and DLE. The secondary cicatricial alopecia occurs as a result of some insult to hair due to some systemic illness like SLE and Systemic sclerosis. A detailed clinical evaluation and battery of tests including a skin biopsy is required to make a confirmatory diagnosis. An early diagnosis and treatment is essential in patients with cicatricial alopecia as the main aim of treatment is target as correcting the underlying disorder.
Main treatment includes both lotions and creams to be applied. Severe and widespread disease may require oral drugs also.
However the scarred areas have little potential to regrow hair and the hair loss is more of permanent type. Camouflaging techniques including wigs and hair patches can be used. Surgically the bald areas can be treated with the help of hair transplant.