Each day the scalp hair grows approximately 0.35 mm (6 inches per year), while the scalp sheds approximately 100 hairs per day, and more with shampooing.1 Because each follicle passes independently through the three stages of growth, the normal process of hair loss usually is unnoticeable. At any one time, approximately 85 to 90 percent of scalp follicles are in the anagen phase of hair growth. Follicles remain in this phase for an average of three years (range, two to six years).1 The transitional, or catagen, phase of follicular regression follows, usually affecting 2 to 3 percent of hair follicles. Finally, the telogen phase occurs, during which 10 to 15 percent of hair follicles undergo a rest period for about three months. At the conclusion of this phase, the inactive or dead hair is ejected from the skin, leaving a solid, hard, white nodule at its proximal shaft.2 The cycle is then repeated.
*Photograph used with permission of the Journal of the American Academy of Dermatology. This photograph was published in the Journal of the American Academy of Dermatology, Vol. # 60, Gathers RC, Jankowski M, Eide M, et al. “Hair grooming practices and central centrifugal cicatricial alopecia,” 660-8. Copyright Elsevier (2009). Journal of the American Academy of Dermatology.
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Family history will often tell the doctor what type of alopecia a person has. Occasionally, a punch biopsy may be necessary to determine the type of hair loss. Looking at plucked hairs under a microscope can help to tell the difference between alopecia areata and androgenic alopecia. Other tests might be done to check for autoimmune diseases like lupus that can accompany alopecia.
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The topical sensitizers, diphencyprone or squaric acid dibutylester, have been used in those suffering from recalcitrant alopecia areata or those with more than 50% hair loss. The goal of treatment is to create an allergic contact dermatitis of the scalp. This alteration in the immune response occasionally is accompanied by hair regrowth. The efficacy of the topical sensitizers has been demonstrated in both young children and adults, but it probably works less than half the time. Recent success using oral janus kinase inhibitors, including tofacitinib, ruxolitinib, and baricitinib, have been shown to be efficacious in severe, extensive alopecia areata in adults, but long-term therapy has potential side effects. The durability of response to these medications is variable, and most patients experience recurrence of hair loss after discontinuation. Perhaps topical therapy with these types of drugs may be available in the near future.
There can be several factors behind hair loss such as environmental effects, aging, too much stress, excessive smoking, nutritional deficiencies, hormonal imbalance, genetic factors, scalp infections, use of wrong or chemically enriched hair products, certain medicines and medical conditions like thyroid disorder, autoimmune diseases, polycystic ovary syndrome (PCOS), iron-deficiency anemia, and chronic illnesses.
Even though modern folklore, and even some limited scientific studies, have suggested that the mother's side of the family is largely responsible for a genetic predisposition toward baldness, the truth is balding is not all our mothers' fault. In fact, doctors now say baldness patterns are inherited from a combination of many genes on both sides of the family. There are some environmental factors that come into play, too.
I was searching the internet and came across this wonderful site. I really appreciate you posting this article. I have always had a small bald patch on one side of my head. My mom told me it had always been there so I didn’t worry about it. Recently it has been getting larger and the hair around it is getting lighter. On the other side my hair is thinning and the color and texture is changing. It also seems to be falling out. I have excessive hair loss on a regular basis. I am only 24 years old and I can’t stand that my hair is falling out. I went to the dermatologist and he gave my injections but they didn’t work. He said I have alopecia areata and that the other side was a normal receding hairline. (He barely even looked at it) He then told me after the injections weren’t working to try Rogaine. I think it might be helpful to see an endrocrinologist as I have also been having problems with anemia. Again, thank you so much for the information you have provided.
I’m going to see an endocrinologist, a trichologist, a hematologist and a gastroenterologist and maybe this Dr. Redmond. I’m done with ‘hair loss experts’ pushing cosmetic surgery and trying the all around approach. My insurance is crap, but….Anyway, thanks all for your stories and knowing I’m not alone in hair loss and the fight against disinterested medical establishment. xxx
You ARE the same inside, but you are also different… you’ve been through a lot and it is so difficult to to stay strong through this experience. I won’t even go into the hair stuff, because it sounds to me that this is not what your post is about. You need to get some really solid support and find something other than your hair to focus on. You need an awesome hair system…and support system. From there, I hope and pray for you, that you will be able to find happiness and balance in your life again. You are a glorious human…don’t doubt that for a moment!
While you won’t find a miracle shampoo on the market, nioxin and some other products can help keep your scalp in tip-top shape to improve the look of any hairs you do have left on your head. In fact, feeding your hair with the proper nutrients both inside and out can make it appear healthier, so you might consider using products with natural herbs, such as rosemary and mint.
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