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Hair: Your crowning glory

By Gio Dimayuga, M.D.

12/24/2005

Your “crowning glory” serves a significant function in your well-being. It protects your scalp from the scorching heat of the sun, and in colder climates it helps control heat loss. Society has placed a great deal of social and cultural importance on hair and hairstyles. Unfortunately, many conditions, diseases, and improper hair care result in excessive hair loss. People who notice their hair shedding in large amounts after coming or brushing, or whose hair becomes thinner or falls out, should consult a dermatologist. With correct diagnosis, many people with hair loss can be helped.

Dermatologists, physicians who specialize in treating diseases of the hair and skin, will evaluate a patient’s hair problem by asking questions about diet, medications including vitamins and health food taken in the last six months, family of hair loss, recent illness and hair care habits. Hormonal effects may be evaluated in women, by asking menstrual cycles, pregnancy and menopause. After examining the scalp and hair, the dermatologist may pluck a few hairs and examine them under the microscope. Sometimes various blood tests and scalp biopsy may be performed for an accurate diagnosis. It’s important to find the cause and whether the problem will respond to medical treatment.

Normal hair growth

About 90 percent of the hair on a person’s scalp is growing at any one time. The growth phase lasts between two to six years. Ten percent of the hair is in resting phase that lasts two-three months. At the end of its resting stage, the hair is shed. When a hair is shed, a new hair from the same follicle replaces it and the growth cycle starts again. Scalp hair grows about one-half inch a month. As people age, their rate of their growth slows. More hair shedding is due to the normal hair cycle, and losing 50 to 100 hairs per day is no cause for alarm. But, if you are concerned about excessive hair loss or dramatic thinning, consult your dermatologist.

Causes of excessive hair loss

Improper hair cosmetic use/improper hair care – Many men and women use chemical treatments on their hair, including dyes, tints, bleaches, straighteners and permanent waves. These treatment rarely damage hair if they are done correctly. However, the hair can become weak and break if any of these chemicals are used too often. Hair can also break if the solution is left on too long, if two procedures are done on the same day, or if bleach is applied to previously bleached hair. If hair becomes brittle from chemicals treatments, it’s best to stop until the hair has grown out.

Hairstyles that pull on the hair, like ponytails and braids should not be pulled tightly and should be alternated with looser hairstyles. The constant pull causes some hair loss, especially on the sides of the scalp (called traction alopecia).

Shampooing, combing and brushing too often may also damage hair, causing it to break. When hair is wet, it is more fragile, so vigorous rubbing with a towel, and rough combing and brushing should be avoided. Don’t follow the old rule of 100 brush strokes a day – that damages hair. Instead use a wide-toothed combs. A cream rinse after shampooing helps detangle hair.

Hereditary thinning or balding (Androgenetic Alopecia) – Hereditary balding or thinning is the most common cause of hair loss. The tendency can be inherited either from the mother’s or father’s side of the family. Women with this trait develop thinning hair, but do not become completely bald. The condition is called androgenetic alopecia or male-pattern baldness. It can start in the teens, 20s or 30s. There is no cure, although medical treatment has recently been available that may help some people. One treatment involves applying a solution, minoxidil, to the scalp twice a day. Another treatment for men is a daily pill containing finasteride, a drug that blocks the formation of active male hormone in the hair follicle. When confronted with thinning hair or baldness, men and some women consider hair transplantation, which is a permanent form of hair replacement. Anyone who has suffered permanent hair loss may be a candidate for hair transplantation. The procedure of hair transplantation involves moving some hair from hair-bearing portions (donor sites) of the head to bald or thinning portions (recipient sites) and/or removing bald skin. Because the procedures involve surgery as well as time and money, they should not be undertaken lightly.

Your dermatologist will help decide which method or combination of methods is right for you.

Dr. Dimayuga is a Fellow of the Philippine Dermatological Society (PDS), the only recognized affiliate society for dermatology of the Philippine Medical Association and the Philippine College of Physicians. The Society is committed to maintaining the highest ethical professional standards in the practice of dermatology through its mission-vision: To be a highly recognized society, locally and globally, striving toward excellence in the attainment of healthy skin for all, through humane service, information dissemination, training and research.

The PDS Secretariat is at Room 1015, Front Tower, Cathedral Heights Building Complex, St. Luke’s Medical Center, E. Rodriguez Avenue, QC; with tel. 727-7309. For information on diseases of the skin, hair or nails and their treatments, visit the PDS Web site at www.pds.org.ph.