Diffuse Hair Loss
- Diffuse hair loss is a self-perceived loss of more than 25% of scalp hair.
- The decrease in hair density is more apparent on the central and the diffuse hair loss front portion of the scalp.
- This condition is called as 'telogen effluvium' in medical parlance and is different from 'androgenetic alopecia' which is patterned loss of hair.
- Each hair grows at a rate of approximately 1 centimeter per week.
- The hair cycle as shown in illustration has three phases (anagen, catagen and telogen). It lasts for 2-6 years and in longer in females than in males.
- Approximately, 90% of the hairs on scalp are in the growing phase also called as the anagen phase. The remaining hair are either in the resting phase (telogen phase) or about to fall off
- On an average it is normal to lose up to 50-100 hairs each day. Some people may experience more hair fall than others.
- Telogen effluvium is due to a sudden increase in the number of 'telogen' hair. Effluvium means 'discharfe or shedding off'. The effluvium of these increased telogen hair is perceived as abnormal hair loss and is called as telogen effluvium.
- Telogen effluvium can be caused due to multiple reasons:
- Nutritional deficiency, specifically iron deficiency, protein deficiency and zinc deficiency.
- Auto immune illness such as diabetes and thyroid disorders.
- Sudden emotional stress or physical stress such as that seen after child birth, major surgery or loss of a loved one.
- Acute severe illness such as typhoid, malaria and dengue.
- Intake of certain medicines can also cause this kind of diffuse hair loss.
- Shampoos with an alkaline pH can increase hair damage.
- Using hair prosthesis such as wigs, use of hair curlers, wearing tight braids and weaving of hair can lead to hair damage and hair loss.
- Similarly using hair cosmetics such as bleeching, coloring and straightening can also cause hair damage and hair loss.
- Psychological stress, air pollution and tabacco smoking can lead to increased hair loss.
- Recent studies have shown that excessive sun exposure increases the rate of hair fall in women.
- However there is no evidence of role of hardness of water, used during hair wash, causing hair loss.
- It is important to consult a dermatologist when one has a history of excessive hair loss.
- Dermatologist are trained to treat hair related problems. They can help in diagnosing the cause of hair loss and suggest appropriate therapy.
- Assessing the hair loss in patient is usually done clinically. A dermatologist will examine the scalp skin and hair and conduct a few bedside tests such as a hair pull test and dermatoscopy to make a clinical diagnosis.
- Laboratory tests such as a complete blood count, thyroidscreen, estimation of vitamin D levels, Serum ferritin (iron) evels and vitamin B12 levels may be advised. In select female patients, tests for hormonal dysfunction may be required on the basis of clinical suspicion.
- In many cases the hair loss tends to correct by itself by a positive change in the lifestyle or by improvement in the nutritional status.
- Treatment of allied disorders such as thyroid disorders, vitamin D deficiency and anemia also helps in correcting hair loss.
- Nutritional supplements and topical medications may be needed to help in hair growth. It takes 3-6 months to see a positive result.
- In case if the hair re-growth is not entirely satisfactory, you may consider to use hair prosthesis such as a hair piece, or wig. However an improper prosthesis may cause further hair damage and hair loss.
- Hair loss due to increased telogen shedding is not treated with surgery, hair restoration surgery is primarily indicated for androgenetic alopecia. Also hair loss due to burns or other trauma can be treated with surgery.
- In certain cases where the cause of hair loss is unknown or where the cause cannot be corrected, hair loss may recur after discontinuation of therapy.
- In these cases the doctor may advise you to consider wearing hair prosthesis. Custom made wigs can help in restoring the positive self-image in a patient who is disturbed by hair loss.
- Certain myths are associated with the phenomena of hair loss. It is important to know that:
- Daily shampooing does not cause hair loss.
- Avoidance of combing does not prevent hair loss.
- Shaving of scalp does not cause hair to grow back thicker
- Dandruff does not cause permanent hair loss.
- Over the counter hair products do not help in thicker and faster hair growth.
- Coconut oil is effective as a conditioner and does not aid hair growth. Oils don't penetrate the hair shaft and don't help in growth.
