Why Am I Losing Hair?
Date: 24 May 2018
“Why am I losing hair?”
Is your hairline receding? Have you experienced thinning of your once thick voluminous hair? Noticed a bald spot on your loved one’s head? Is a big bunch of hair accumulating around the floor trap of your shower area?
People that answer “yes” will usually want to know the reason behind hair loss. Before explaining why you might be losing hair, it would be helpful to understand the normal hair cycle.
The Human Hair Cycle
The normal hair cycle consists of a growth phase (anagen), a transitional phase (catagen) and a resting phase (telogen).
A normal hair follicle would have an anagen phase which lasts between 2-6 years, where the hair shaft continuously lengthens.
Catagen, the transitional phase, then occurs and the hair shaft stops growing longer, and eventually detaches from the base of the hair follicle (the dermal papilla).
In the telogen phase (which lasts few weeks), the hair follicle is at rest and under normal circumstances will be followed by a new anagen phase. The new lengthening hair shaft will push the detached hair out, resulting in a shed hair.
About 10-15% of hair follicles are in telogen phase at any one time. As such, it is normal to shed 50-100 hairs daily.
Disruptions to the normal hair cycle
A hair loss condition, medically known as alopecia, results from a disruption of the normal hair cycle.
There are conditions that only affect the hair follicles, conditions that affect the skin which hosts these hair follicles, or conditions that affect internal organs (hormonal conditions, for example) that can disrupt the normal hair cycle.
Any hair loss condition could be caused by a combination of:
- senescence (or aging process)
- blood vessel changes
- anatomical or structural changes
- nutritional deficiency
- metabolic abnormalities
- hormonal changes
- changes in communication between the different cells that make up the hair follicle (cell signalling) and the list goes on.
Disrupting the normal hair cycle can result in hairs not being able to grow longer or thicker, or could involve more hair follicles being in the resting (telogen) phase at once, causing more hair to be shed per day.
How would I know what kind of hair loss I am suffering from?
It is important to ascertain why you are losing hair, as it will determine what treatment should be prescribed and the prognosis of the condition. It can be a fairly straight forward diagnosis or might involve some further investigations.
The consulting doctor will first take a thorough history of your concerns pertaining to hair loss, followed by a detailed examination of your scalp, including a magnified view of the scalp and hair. In certain circumstances, laboratory investigations may be ordered to diagnose the cause of hair loss. These could be in the form of blood tests or a scalp biopsy.
The most common type of hair loss affecting men and women is ‘patterned hair loss’ or androgenetic alopecia. Other common types of hair loss include post-pregnancy hair loss, medication related hair loss, hair loss due to physical or emotional stress.
As many factors can contribute to hair loss, getting a professional opinion will be a crucial first step in combatting the problem. At the consultation, the diagnosis and treatment plan will be discussed in detail.