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Explaining Hair Loss by a Singapore Dermatologist

January 19, 2018
Hair loss (alopecia) can be a major source of distress and is a common problem.
 
Is my hair loss normal?
 
We may experience changes to our hair such as hair loss or thinning as we age, so be sure to distinguish the difference between normal changes and alopecia. 100-150 hair strands lost in a day is normal and they usually show up when you brush your comb through or after washing your hair.
 
Bald patches on your scalp or more than 150 strands a day can be classified as abnormal hair loss.
 
The hair cycle
 
Normal hair grows through a hair cycle that has three stages. The growth phase, or the anagen phase, is the longest phase of the hair cycle, with 80 to 90% of the hair on our scalp in this phase. In the next stage called the catagen phase, the hair bulb detaches from the blood supply and is pushed from the scalp. In the last stage, the telogen phase, shedding occurs as the hair is released, leaving behind an empty follicle.
 
Each hair follicle is independent, going through the cycle at different stages as the other hairs. Hair problems occur when there is a disruption in the hair cycle.
 
How do I diagnose alopecia?
 
According to Dr Teo Wan Lin, accredited dermatologist at TWL Specialist Skin and Laser Centre, she says: “There are two major forms of hair loss – scarring or non-scarring alopecia. If follicular orifices are absent on the scalp, and the underlying scalp has a shiny white color, the hair loss is scarring. Follicular orifice is the opening of a hair follicle on the surface of the skin. If follicular orifices are present, it is a form of non-scarring alopecia.”
 
Non-scarring hair loss is the loss of hair without any presence of scarring in the scalp. Scarring alopecia leaves scar tissues on the scalp and may show signs of inflammation, redness or swelling.
 
Another common type of hair fall problem is androgenetic alopecia, or female/male pattern hair loss. Patients with androgenetic alopecia have high levels of androgen, a type of steroid hormone. Effects of androgen include miniaturisation of hair follicles by increasing the rate of cell division, shortening the hair cycle and increasing the duration of the telogen phase.
 
How can I treat my hair fall problem?
 
A multifaceted approach is recommended, as there are likely to be multiple factors that cause your hair condition.
 
For topical agents, either a minoxidil solution or ketoconazole shampoo can counter female/male pattern hair loss. Oral ketoconazole has anti-androgen effects, while topical ketoconazole can suppress androgen activity. Minoxidil shortens the telogen phase, and increases the duration of growth phase.
 
Low-level light treatments, in combination with active ingredients such as minoxidil and copper peptide can encourage hair growth by triggering inactive follicles or increasing blood flow to follicles.
 
Any tips on hair loss problems?
 
Avoid combing your hair when it is wet, as wet hair is most subject to trauma. Hair should only be combed when mostly dried with a wide-toothed comb. Also, the less that is done to thinning hair, the better. Stay away from bleaching, rebonding or perming your hair to reduce damage done.
 
Dermatologists also specialize in treating scalp and hair problems, so head to your dermatologist if your hair condition deteriorates.
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