Hair we go!

We shed up to a hundred hairs a day – this is normal. Every time we shower or brush our hair, there will be a few hairs that are shed.  So, what happens when its more than a hundred, a thousand and a whole patch? Do we panic? YES! We panic and ring our dermatologist because time is hair follicles.

Alopecia is a broad blanket term that means hair loss. It’s largely divided into non-reversible (scarring) and reversible (non-scarring) hair loss. It’s always worth getting assessed by a health care provider so that this distinction can be made as it impacts on your treatment options.

Reversible hair loss is commonly due to:

Traction – High tension pulling hairstyles like braids, sleek tight bun updo, extensions, ponytails, tightly styled dreadlocks and head wraps like doeks, inhloko and hijabs. This causes reversible hair loss from the hairline and if repeatedly done can cause permanent hair loss

Sudden illness or stressors: this can result in the shedding of hair in its resting phase. Post-pregnancy, hair dye and fever can also result in hair loss.

Drugs like chemotherapy can cause loss of hair in its active growth phase.

Systemic illness like nutritional deficiency, iron deficiency and thyroid disease could manifest as hair loss and the hair usually grows back when these conditions are treated.

Female pattern hair loss occurs when hair follicles are genetically more sensitive to male hormones causing the growth phase to be shorter causing the hair to be shorter, thinner and easily shed.  The hair starts thinning and the central hair line path starts widening.

Alopecia areata: the one Chris Rock made a fool of himself over, yes that’s the one! One gets sudden smooth patches of hair loss that may involve the scalp, eyebrows, eyelashes and any body hair.  hair is lost because it is affected by inflammation, the cause of the inflammation is unknown but it is thought that the immune system may attack the growing hairs. There’s a genetic predisposition to alopecia areata, 20% of people with it have a family history.  It’s usually treated with corticosteroids, minoxidil or immunotherapy.

Before you start with that gel, hair food, placenta or magic lotion determine what the underlying cause is and address it.  For the most part the cause of your hair loss can be determined by simple examination of your scalp, trichoscopy and a simple hair pull test where they gently run fingers through your hair and evaluate those removed. Occasionally it will also be a few blood tests and if there’s still no luck, a biopsy will be done. This is rarely needed with the use of small devices called dermatoscopes that your dermatologist can examine your hair with. It’s similar to a magnifying glass but fancier.

Another distressing but common menace is dandruff. This is the shedding of excessive amounts of dead skin cells at a faster rate than normal.  These ingredients may be helpful in managing it –

Salicylic acid: it loosens the attachment between the dead skin cells and allows them to get washed off.

Selenium sulfide: controls dandruff by attacking the yeast related to it.

Zinc pyrithione: it heals the scalp by controlling sebum production.

My top picks for medicated shampoos to deal with dandruff are Selsun 2,5% shampoo, Bioderma Node DS+ Intense shampoo, Vichy Dercos anti-dandruff shampoo.

If the symptoms continue after using a dandruff shampoo, then consult a dermatologist because it could be another medical condition such as fungal infections, psoriasis, seborrheic eczema or allergic eczema.

Remember – time is hair follicles. Getting a diagnosis and treating the cause early could prevent permanent hair loss.