Hair Fall

This is the most common problem that I encounter in my practice as a Hair Transplant Surgeon. I find it increasingly common among the working women class. It starts in as young as teenagers who are more stressed initially about their education and later their career.

The normal hair follicle goes through a cycle of Growth (Anagen phase), Transition (Catagen Phase) and Resting (Telogen phase). Eventually, every hair follicle sheds off. The whole cycle lasts about two till six years.

A diseased or unhealthy scalp can lead to excess hair fall. This is so true as we all know that a good crop needs a good soil to grow on. There are many scalp conditions that are associated with hair fall.

Hair fall in men and women can be a direct result of sensitivity of the hair follicle to Dihydrotestosterone (DHT). This tendency is determined genetically at birth. The gene could be inherited from either of the parents. On top of this, this tendency can skip a generation within families. It can affect siblings variably in the same family. This is labeled as either Male Pattern or Female Pattern Hair Loss depending on the person’s gender.

It is common for women to loose hair during and for a small period after delivery. The hairs lost in this period tend to be the ones in Telogen phase. Similarly, a prolonged and/ or a severe illness can result in Hair Fall for a few months afterwards. Again, this affects telogen hair to fall off. With a return to good health and nutrition, hair regrowth occurs gradually.

A very common reason for hair loss in my clinic tends to be the presence of dandruff. This is caused by a fungus Pityrosporum orbiculare (Malssezia species) that takes the opportunity to manifest in a low immune condition. The fungus is present in most individuals scalp but the manifestation of the disease is only in a few that have low immune status. Normal healthy adults tend to show dandruff in times of stress.

Alopecia (= hair loss) can be patchy and non scarring from scalp and other parts of the body. This is called as Alopecia areata. It is thought to be due to an inflammation that selectively affects the hair follicle. It is treatable with medications resulting in good regrowth in majority of the individuals.

A scarring form of Alopecia seen along with Lichen Planus or Lupus Erythematosus leaves behind a shiny, smooth scalp surface. Unfortunately, the hair follicle gets permanently damaged resulting in no regrowth.