Hair follicle regenerates all the time, has numerous functions but the most prominent ones are protection and sensation. For people of all nations hair is one of the crucial psychological and sexual characteristics.
Hair grows in cycles: anagen 2 – 6 years, telogen 2 – 3 months, catagen (phase of hair falling out). About 80 – 90% of the hair roots should be in the anagen phase, or the growth phase, and around 1% in the catagen cycle or the falling out period. It is normal to loose around 60 – 100 hairs a day, whose root is already recovered and ready to create new hair.
Hair disease is roughly divided to hair loss disease (alopecia) and excessive hair growth (hypertrichosis). We can differentiate between:
Androgynous alopecia is genetically predisposed oversensitivity of the hair root to the normal level of sexual hormones. Hair root atrophy and hair loss is characteristic in the middle frontal part of the head and at the nape. Unlike men, the frontal hair line is usually retained in women and the central part is thinned almost to full disappearance of hair. Minoxidil lotion 2% and 5% and Finasterid 1% are used in therapy. If there is androgynous activity in women contraceptives with Spironolactone are used. Characteristic periods for women are after pregnancy and in menopause when there is a lack of estrogen in the organism.
Alopecia areata is spotted baldness; it belongs to the group of autoimmune diseases of yet unknown origin. It is not caused by fungus or bacteria and is considered to be an autoimmune disease. The cause is unknown to date, and it frequently appears together with changes in nails and thyroid gland. Alopecia areata usually passes within the first year of appearing.
Telogen effluvium is an increase of hair percentage in the telogen phase from 10 to 20 and more percent, and also the diffuse hair thinning. It is usually caused by great stress, lack of iron, disorder of the thyroid gland, existence of internal organ diseases or high fevers. Diffuse hair loss is characteristic for this disease and the trigger should be looked for, two to four months after the symptoms appear.
Anagen effluvium is one of the consequences of the cytostatic therapy or radiation therapy. The disease is characterized by uniform hair loss over the whole scalp. It can also be a consequence of strict diets.
Scarring alopecia appears as a consequence of the hair follicle damage caused by fungi, bacteria or certain immune processes.
Trichotillomania is unconscious pulling of hair from the root. It is most common in puberty and belongs to impulse control disorders.
Fungal infections can cause very dramatic hair loss with scalp scaling and scaring baldness.
Hirsutism is the appearance of terminal, strong hair in women, in a male distribution pattern. It is caused by hormonal factors at the level of adrenal gland or ovaries. If the hormone level is within referential values, it is a genetic predisposition.
Spec. Dr. Svetlana Djurisic, dermatologist
Dermatological clinic DERMATIM, Belgrade – Serbia