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Diffuse Hair Shedding

Temporary Hair Loss

By far the most prevalent form of hair loss; indicated by an increased shedding that is noticeable by seeing more hairs in the basin after shampooing and in the brush or comb. Hair can be shed in this way for many reasons and the most well known is after having a baby. It does not happen to all and it does not happen to the same person after each pregnancy. Hairs throughout the pregnancy are held in the anagen phase of the hair growth cycle and the hairs that would have been shed throughout, plus those due to be shed naturally, all fall together within the first few months after the baby has been born. The situation takes time to get back to normal and if there is more excess shedding after six to nine months then it is wise to see the General Practitioner and have both thyroid and ferritin levels checked.

Telogen effluvium is the term used to describe large numbers of hairs going into the telogen phase and shedding two to four months later in a diffuse manner. TE is referred to as a reflective loss of hair and can be caused by thyroid disorder, low iron, diabetes, medications, and protein deficiency. This is not a definitive list as there are other causes, not least the effects of the sympathetic nervous system described generally as ‘stress’, to do with emotional upset.

Alopecia Areata (Non-scarring Alopecia)

This is a typical case showing a patch of alopecia areata.

The hair falls in the area from the centre outwards and in an active patch (hairs still falling) exclamation mark hairs can be seen around the edge of the patch. These are small broken hairs that come away easily. Sometimes they look like small black dots. The hair will start to grow back from the centre of the patch, as in the picture, fine hairs, often white, to start with. The colour and texture progress to normal over the months. This particular lady had three small patches develop at the age of 39yrs which fell in March 2000, and replaced by June of that year. Another two patches developed (one inch in diameter) four years later 2004, in May, hair grew back to normal again by the end of that year. No more losses of hair have been experienced since that time. I will keep you updated.

My Advice to Sufferers

There are no cures. However, please request a blood test with your doctor for thyroid function as I have found that an early diagnosis of a thyroid disorder, followed by treatment, can be very beneficial for those suffering thinning and/or patchy loss of hair.

If the skin of the scalp in the area of the loss is spotty or red, or itches at all, then ensure you wash your hands and apply an antiseptic cream to the area twice a day, the trichologist will make up and supply suitable preparations (be sure they are licensed with the MHRA to do so) or ask your pharmacist. Always ask you doctor to look at the area as he/she can prescribe steroid preparations, if necessary, or refer you on to a dermatologist.

In most cases of alopecia areata the small patches grow back without any treatment. Use of a medicated or menthol shampoo alternated with a clear or liquid shampoo daily can help from a cosmetic point of view. Do remember; no more hair will fall out because of shampooing, best to keep the area clean. For some the need to apply a preparation to refresh and stimulate the area; I suggest the use of a menthol swab/drops twice daily.

Ultra violet light may be advised by the trichologist if there are signs of growth. This would only be used in very strict accordance with instructions. Controlled exposure to sun light can also be helpful. A holiday in the sun would be very beneficial. Covering the area is not the best thing to do, as fresh air and sun light are indicated if possible, or a loose hat.

A final thought…

Being that our body systems are so responsive to disturbing situations and events, with the consequence of adrenalin and cortisol rising to protect us, try to relax and be calm because the hair growth mechanisms respond to hormonal change and allow this disorder.

Scarring Alopecia

Permanent Patchy Loss of Scalp Hair

Hair loss will happen in very small patches that grow very slowly, are hardly noticeable at their onset, but go through periods of time when they progress a little more, and in some cases stop altogether to leave small bald areas that grow no further than the size of a thumb nail. The causes are of unknown origin, although bacterial infection and auto-immune factors have been looked at during research into such cases. The follicles are replaced by scar tissue and different to all of the above conditions. In some cases hair can be transplanted and great success is achieved by scalp reduction for areas of scar tissue.