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What is hair loss?

Hair loss is a common problem affecting men and women worldwide. There has been an increase in the number or people losing hair at a relatively younger age which has led to pioneering research in the hair industry to develop treatments which can offer to slow, stop and replace the area of hair loss using advanced surgical procedures.

Types of hair loss:

There are approximately 5 million hair follicles covering the body, of these around 100,000 to 150,000 are on the scalp.  Before exploring hair loss further, we need to know a little about the hair growth cycle.

Hair growth occurs in 3 stages:

ANAGEN: Active growth can last up to 2-6 years, this is perfectly normal. At any given time there are 90% of hairs in Anagen phase on every healthy person’s body.

CATAGEN: Transitional stage is where the hair growth stops; this is a shortest phase which cans last 2 to 3 months.

TELOGEN: Resting phase where 5-8% of all hair at this stage can last up to 3 months followed by shedding. Shedding of hair is different in every individual. Social and personal preference for styling hair using chemicals or emotional wellbeing is all triggers that contribute to shedding.

Here is a simple image showing the three phases of hair growth;

Normally we have 5-8% of our hairs in Telogen and around 90% in Anagen phase. This ratio may become distorted in Telogen effluvium, when the percentage of hairs fall  can increase to 20%.

Approximately 100 hairs are shed every day. Sometime people can suffer from increase hair loss which  can be caused by a number of factors, such as; stress, shock, illness or traumatic event, this temporary  hair loss phase is  called Telogen effluvium – recovery from this can take 2 to 4 months.

The success of any treatment can be impacted by the Physician or Surgeon you are seeing, it is therefore crucial that the person you see is knowledgeable, experienced and specialised in hair Loss conditions to be able to determine an accurate history of your condition and carries out a bespoke examination to reach the right diagnosis and offer a suitable treatment plan.

Common Types of Hair Loss

Alopecia aerate (AA): At any point in a healthy person’s lifetime they are at 1.7% risk of developing AA, this is usually easily diagnosed. There is a strong association with psoriasis, vitiligo and thyroid disease. Vitamin D levels are often deficient in patients with AA. It is certainly worth checking vitamin D levels in patients with AA and taking corrective action if needed.

Patches of AA in the beard area are a relatively common occurrence, and similar patches can appear on the scalp too.

This is an image of what AA looks like;

Androgenetic Alopecia (Male pattern hair loss)

This is a very common type of hair loss affecting men and women, which is often inherited from parents. It is the most common form of hair loss in men, with a lifetime risk of 50-70%.

Male pattern hair loss is due to hormone receptors in the hair roots. These receptors are stimulated by the male hormone dihydrotestosterone (DHT) and results in hair loss. Usually men never lose hair on the side and back of the scalp, this is because hair on the back of head parts do not have those receptors.

Clinical appearance

The Norwood Scale can be used to classify male pattern baldness, which is usually easy to diagnose for a skilled practitioner. Mostly the male pattern hair loss starts from the frontal sides and can spread to the top of the head.

Female Pattern Hair Loss (FPHL)

Women who develop balding patterns often have a family history of baldness in male or female members. Frontal hairline usually stays normal; instead loss of hair becomes obvious at the front one to two-thirds of the scalp.  In over 85% of women with excess circulating androgens can be due to Polycystic Ovarian Syndrome.

The start of hair loss is often a widening of the part width, which is followed by the so-called ‘Christmas Tree’ pattern over the top of the head.

The Ludwig scale below shows this over the stages of hair loss.