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Understanding Hair Loss: the Basics
WebMD Medical News
What Is Hair Loss?
Hair grows everywhere on the human body except
on the palms of our hands and the soles of our
feet, but many hairs are so fine they're
virtually invisible.
Hair is made up of a protein called keratin (the
same protein in nails) produced in hair
follicles in the outer layer of skin; as
follicles produce new hair cells, old cells are
being pushed out through the surface of the skin
at the rate of about six inches a year. The hair
you can see is actually a string of dead keratin
cells.
The average adult head has about 100,000 to
150,000 hairs and loses up to 100 of them a day;
so finding a few stray hairs on your hairbrush
is not necessarily cause for alarm.
At any one time, about 90% of the hair on a
person's scalp is growing. Each follicle has its
own life cycle that can be influenced by age,
disease, and a wide variety of other factors.
This life cycle is divided into three phases:
-
Anagen -- active hair growth.
Lasts between two to six years.
-
Catagen -- transitional.
Lasts two to three weeks.
-
Telogen -- resting phase. At
the end of the resting phase (two to three
months) the hair is shed and a new hair
replaces it and the growing cycle starts
again.
As people age, their rate of hair growth slows.
There are many types of hair loss, also called
alopecia.
Gradual thinning of hair with age is a natural
condition known as involutional alopecia. More
and more hair follicles go into a telogen, or
resting, phase, and the remaining hairs become
shorter and fewer in number.
Androgenic alopecia is another form of hair
loss. It's a genetically predisposed condition
that can affect both men and women. Men with
this condition can begin suffering hair loss as
early as their teens or early 20s, while most
women don't experience noticeable thinning until
their 40s or later.
In men, the condition is also called male
pattern baldness. It's characterized by a
receding hairline and gradual disappearance of
hair from the crown. In women, androgenic
alopecia is referred to as female pattern
baldness. Women with the condition experience a
general thinning over the entire scalp, with the
most extensive hair loss at the crown.
Patchy hair loss in children and young adults,
often sudden in onset, is known as alopecia
areata. This condition may result in complete
baldness, but in about 90% of cases the hair
returns, usually within a few years.
With alopecia universalis, all body hair falls
out.
Tearing out one's own hair, a psychological
disorder known as trichotillomania, is seen most
frequently in children.
Telogen effluvium is hair thinning over the
scalp or other parts of the body that occurs
because of changes in the growth cycle of hair.
A large number of hairs enter the resting phase
at the same time, causing shedding and
subsequent thinning.
What Causes It?
Doctors do not know why certain hair follicles
are programmed to have a shorter growth period
than others.
Although a person's level of androgens -- male
hormones normally produced by both men and women
-- is believed to be a factor, hair loss has
nothing to do with virility. For that matter,
the presence or absence of dandruff has no
effect on balding either. An individual's genes,
however -- from both male and female parents --
unquestionably influence that person's
predisposition to male or female pattern
baldness.
Telogen effluvium is temporary hair loss that
can occur within a few months after a high
fever, a severe illness, thyroid diseases, iron
deficiency, medications, hormonal imbalance, or
extreme stress, and in women following
childbirth.
Drugs that can cause temporary hair loss include
chemotherapeutic agents used in cancer
treatment, anticoagulants, retinoids used to
treat acne and skin problems, beta-adrenergic
blockers used to control blood pressure, and
oral contraceptives.
Hair loss can also be caused by burns, X-rays,
and scalp injuries. Ringworm can also cause hair
loss.
The causes of alopecia areata, a disease that
often strikes children or teenagers, remain
unexplained. It is thought to be an autoimmune
disease, meaning that the immune system revs up
for unknown reasons and destroys the hair
follicles. In most cases the hair grows back,
although it may be very fine and possibly a
different color before normal coloration and
thickness return.
Although too-frequent washing, permanent waves,
bleaching, and dyeing hair do not cause
baldness, they can contribute to overall
thinning by making hair weak and brittle. Tight
braiding and using rollers or hot curlers can
damage and break hair, and running hair picks
through tight curls can scar hair follicles. In
most instances hair grows back normally if the
source of stress is removed, but severe damage
to the hair or scalp sometimes causes permanent
bald patches.
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The average adult head has about
100,000 to 150,000 hairs and loses up to 100 of
them a day; so finding a few stray hairs on your
hairbrush is not necessarily cause for alarm.
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