Sunday, Nov 23, 2014
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The 'what' and 'why' of women's hair loss


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Women with thinning hair or areas of balding can find themselves wondering why and what can be done about this embarrassing problem.

"If a client has thinning hair or starts to notice it and asks me what to do, I do tell them to ask their doctor while trying different shampoos that help thinning," said Stephanie Sapp, co-owner of Starz Salon in Sebring.

She said that depending on the type of hair loss and where it occurs, there are a variety of treatments readily available from companies such as Bosley, Nioxin and Rogaine that might help, but it is always important to get an accurate understanding of why the hair is falling out by seeing a doctor.

"There are hair losses that are caused by illness, by medication, by diet, by autoimmune diseases," said dermatologist Darrin A. Rotman of the American Institute of Dermatology in Sebring.

"But the number one cause is hereditary," said Rotman. "Generally hair loss is defined as losing more than 100 hairs per day.

"If it is something that is gradually getting worse year by year, that is hereditary."

Rotman stressed that while there are many effective over-the-counter products for hair loss that is caused by genetics, it is important to be properly diagnosed.

A thorough exam and a medical history will help your dermatologist understand if surgeries, hormonal influences, thyroid disease, stress, anemia, even deficiencies of iron or vitamin B could be a factor.

"Some surgeries and illnesses can cause hair loss three to six months later," said Rotman.

A common hair loss disease that affects more than 6.5 million people in the United States is alopecia areata, or AA.

"Alopecia areata is generally thought to be an autoimmune disease where the immune system attacks part of the hair follicle and causes rather rapid hair loss," said Rotman.

While this disease can cause hair to fall out anywhere on the body, the follicles remain alive and can go through cycles of growing back and falling out again.

Of the three types of this disease, AA is the least severe and causes round, smooth patches of hair loss.

It has been known to respond well to cortisone injections, often with new growth visible in four weeks.

Alopecia areata totalis causes total loss of hair on the scalp and may be treated with cortisone pills or a 5 percent solution of topical Minoxidil twice daily.

Complete loss of body hair occurs in the most severe form, alopecia areata universalis.

Anthialin cream or ointment, a tar-like substance used to treat psoriasis, is another product prescribed by doctors for the treatment of alopecia, but it should not be used around the eyes and could cause brownish skin discoloration.

The best documented treatment for severe and refractory AA is topical immunotherapy, a purposeful irritation of the affected area by the use of contact allergens like diphencyprone (DPCP).

While this method of treatment causes itching and mild irritation, DPCP has had a response rate of 60 percent in severe AA patients and up to a 100 percent in patients with only patchy hair loss.

"Topical immunotherapy increases inflammation so the specificity of the attack is compromised," Rotman said of the treatment that confuses the immune system, disrupting the attack on the hair follicles. "It can take a good month or two to see results."

According to the National Alopecia Areata Foundation, current treatments work by stimulating the follicle to produce hair again.

They stress that treatments need to continue until "the disease turns itself off."

Wigs can help women feel more comfortable about their appearance while managing their alopecia and may be worn with double-sided tape to help keep them in place.

According to Wendy Roberts, a California dermatologist quoted on WebMD.com, hair growth is like a garden, with the normal growth cycles being disrupted by a variety of illnesses, medications, infections or chemical treatments.

Extreme stress, physical traumas such as surgery, taking too much vitamin A, dramatic weight loss and even the overuse of flat irons or bad brushes are other reasons Roberts cites for hair loss.

Roberts said, "It's a very dynamic place and anything that can get the cycle off can cause hair loss."

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