Hair Loss in Men
Hair is made of protein called 'Keratin'. Hair has 2 parts, hair shaft (which is visible on the scalp) & root (which is underneath the scalp) which is responsible for the growth of hair. The hair follicle bulb manufactures cells continuously, pushing the older cells towards the surface. The cells are converted into a scleroprotein called keratin, which is then compacted to form the hair. The continuous activity of the hair follicle bulb is responsible for the growth of hair.
The hair cycle is composed of 3 stages.
Anagen (growth phase) - 3-10 yrs (follicle actively grows hair).
Catagen (involution phase) - 2-3 weeks (follicle is almost entirely degraded).
Telogen (resting phase) – 3-4 months (the follicle rests prior to re-initiation of the anagen phase)
Exogen – few weeks to months.
On any given day, human beings lose about 50-100 scalp hairs due to exogen. These are the hairs we find in the comb and after a shower. Shedding in excess of this may be due to an increase in the follicles of scalp hair in the telogen stage and should be addressed to contain hair loss. At any given time, approximately 90% of the hair are in the growing phase and about 10% in the telogen phase.
CAUSES OF HAIR LOSS
Many MYTHS abound regarding hair loss; hair loss is NOT caused by wearing of helmets and tight hats or washing hair frequently. A minor factor in hair loss is stress, which is thought to accelerate already genetically programmed hair loss.
Common pattern baldness or Androgenetic alopecia. Physical Trauma e.g. burns or x-ray overdose (normally seen).
Some infectious diseases like TB, leprosy, viral diseases like herpes, etc.
Chemical injury like acid burns.
Skin diseases like DLE, lichen planus, skin cancers, etc.
Telogen effluvium (Diffuse hair loss).
Alopecia areata ( Patchy hair loss).
Infections: Bacterial, viral or fungal.
Intake of medicines /chemicals e.g. Anticancer drugs, high doses of vitamin-A.
Self induced physical trauma (Trichotillomania) - seen in depression.
Compulsive scratching of scalp.
Hormonal disturbances - Diabetes, Thyroid disorders, menstrual disturbances.
Physical agents- Overuse of parlour procedures- Blow drying , Straightening.
Tight pulling of hair as in tight buns or knots.
PATTERN HAIR LOSS
It is the most common type of hair loss affecting men and women, characterized by a process of progressive hair miniaturization. This leads to pigmented, large terminal hairs to be replaced by colourless, fine vellus hairs. Genetic predisposition and androgens play a key role in the process of miniaturization, hence both male pattern hair loss (MPHL) and female pattern hair loss (FPHL) are collectively referred to as Androgenetic Alopecia. The tendency for male and female pattern hair loss is genetically inherited from either side of the family, and begins to develop after puberty. Baldness becomes noticeable when 50% of the hair is lost.
Grade I: Thinning hair on the central scalp (top of the head).
Grade II: Thinning hair and patches of greater scalp hair loss.
Grade III: Male-pattern alopecia with hair loss at the front of the scalp to mid-scalp. However, it is very rare to see complete male-pattern "cue-ball" baldness in a woman.
EVALUATION OF HAIR LOSS
For an accurate treatment, it is very important that the causes and situations of hair loss should be evaluated very minutely. To begin with, it is imperative to assess the degree of hair loss correctly.
A detailed history
The frequency of hair loss.
Diet, level of stress, hormonal disturbances.
Evaluation of hair loss with hair analysis device. Assessment of hair loss also includes some tests like of Haemogram, Serum Iron Level, Thyroid and Prolactin levels but these tests vary from patient to patient.
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