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Hair loss: Why does it happen?

Hair is found everywhere on the human skin, except on the palms of our hands, the soles of our feet and our lips. Hair is a tiny shaft of protein called keratin that is produced in hair follicles in the outer layer of the skin. As follicles produce new hair cells, old cells are being pushed out through the surface of the skin at the rate of approximately six inches a year. A scalp typically contains about 100,000 to 150,000 hairs and it is a normal condition to lose between 50 to 200 of them a day.

Hair is in a constant cycle of growth, rest and renewal. Each follicle’s life cycle can be affected by factors such as age, disease, etc. This life cycle is divided into three phases: the Anagen, Catagen and Telogen phase.

The Anagen phase sees active hair growth that lasts between two to six years.

The Catagen phase sees a transitional hair growth that lasts two to three weeks.

The Telogen phase is the resting phase that lasts about two to three months. At the end of the resting phase, hair is shed, new hair replaces it and the growing cycle starts again.

As we age, some form of hair loss occurs when some follicles stop producing hair, resulting in thinning or baldness.

Hair loss, also known as alopecia, falls into several different categories. They are:

  • Involutional alopecia - This is the stage where hair gradually thins with age. It is a natural condition whereby more hair follicles go into the resting phase, resulting in the remaining hair becoming shorter and less in number.
  • Androgenic alopecia - This is a genetic condition that can affect both men and women. For men, it is commonly known as male pattern baldness and hair loss begins as early as during teenage years or early twenties. People with this condition experience a receding hairline and a gradual disappearance of hair from the crown and frontal scalp. For women, it is commonly known as female pattern baldness. Women with this condition first experience a receding hairline. This is then followed by a gradual disappearance of hair from the crown and frontal scalp.
  • Alopecia areata – This is an autoimmune disease that attacks hair follicles. This condition, also known as spot baldness, is common in children. Hair loss often starts in small bald patches. In some cases, the hair regrows and the condition does not reoccur, but in more serious cases, complete baldness may occur.
  • Alopecia universalis - This is an advanced form of alopecia areata where there is complete loss of hair on the scalp and body.
  • Trichotillomania - This is a type of psychological disorder whereby there is an irresistible urge for people to pull out their hair, usually from their scalp, eyelashes, and eyebrows.
  • Telogen effluvium – This is the thinning or shedding of hair resulting from the early entry of hair into the telogen phase.
  • Scarring alopecias – This is a condition where hair loss is accompanied by scarring. This happens when inflammation destroys the hair follicles and they are replaced with scar tissues. Once the hair follicles are destroyed, hair growth is no longer possible.

Common causes of hair loss

When people think of hair loss, the first thing that comes to mind is genetic factors, like male pattern baldness. However, several other factors may also influence hair loss:

  • Hormones and hormonal imbalance are also responsible for hair loss. For example, women who have excess testosterone can develop male pattern baldness.
  • Genetics. Genetic hair loss is the most common cause of hair loss. It can be inherited from either the maternal or paternal side of the family.
  • Stress caused by illness, surgery or even mental stress can trigger temporary hair loss by pushing hair follicles into the resting phase. Hair stops growing and begins to fall out. By reducing stress, hair loss can be reversed.
  • Salon treatments such as perming, bleaching and dyeing hair can weaken the hair, causing it to become weak and brittle. Similarly, shampooing too often, tight braiding, using rollers or hot curlers, and running hair picks through tight curls can also damage and break hair. Although these procedures don't cause baldness, severe damage to the hair or scalp sometimes can still happen which leads to follicle damage, causing permanent bald patches.
  • Medical conditions such asthyroid disease, alopeciaareata and scalp infections like ringworm can trigger hair loss. Permanent hair loss caused by scarring can also be caused by diseases such as certain types of lupus and lichen planus.
  • Medications thatcan cause temporary hair loss include chemotherapy drugs, blood thinners, beta-adrenergic blockers used to control blood pressure and birth control pills.
  • Vitamin deficiency. A balanced diet is important for healthy hair growth. Incorrect dieting, especially a low-protein diet or severely calorie-restricted diet, can lead to vitamin deficiency which leads to hair loss.

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Hair Loss / Thinning Hair / Itchy Scalp / Dry Scalp

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