By Dr. Teo Wan Lin, Consultant Dermatologist at TWL Specialist Skin & Laser Centre
One of my patients who came to my clinic for hair loss treatments once remarked that “Why is it that everyone thinks of seeing hair loss treatment centres, hair spas and their hair salons offering anti hair loss treatments before consulting a dermatologist for their hair and scalp problems?” Hence in part 2 of my article, I will be using this as a case-study in point in my discussion on hair loss.
However, before that, I would like to qualify what exactly counts as hair loss. It’s normal to lose about 60–100 strands of hair a day, however, anything more than what you are used to losing should be monitored carefully. Here are some symptoms: more hair in your shower drain, on the floor, your combs and pillow, having a wider parting and thinner ponytail for girls. If you have a family member with hair loss, also be alert to early symptoms of hair loss.
1. Who do you see for hair loss treatments?
My patient spoke from experience, having gone a merry-go-round with numerous hair and scalp treatments promising to treat hair loss for over two decades, emerged none-the-better nor wiser until a good friend of hers recommended her to see a dermatologist instead. She had, at that time already resigned to her fate of having a troubled scalp and also lost 40 to 50% of her natural hair at the age of 35, blaming it on bad genetics and oily scalp.
She wasn’t even aware that dermatologists are the specialists in treating scalp and hair problems, including hair loss. Do a google search of “hair loss treatments Singapore” and one is instantly inundated with a multitude of trichologist, herbal remedies, centres specialising in anti hair loss treatments, salon listings, aesthetic centres run by general practitioners and with that a few listings of dermatologists which seems buried under all the other ads. So, if you have a true hair loss problem, stop self-medicating or visiting spas or salons and instead find an accredited dermatologist here.
2.What causes hair loss?
In my dermatological practice, almost all patients suffering from hair loss had also done their due research online about possible causes of hair loss before seeing me. The real problem though, medical websites are not written for the layperson and the lists of diagnoses of conditions that lead to hair loss simply leave the hair loss sufferer worried and fearful. Those that do their research on forums and beauty websites are none the wiser, as they suggest many non-evidenced backed methods of hair growth or causes of hair loss which is simply unscientific and wrong information.
There are many different causes of hair loss, which can occur at the same time or individually, and dermatologists need to conduct a thorough history taking, medical evaluation/examination and may recommend some blood tests and microscopic tests before diagnosing the cause of hair loss. For some rare causes of hair loss, especially of what is termed scarring alopecia, a scalp biopsy, which is where samples of the scalp are taken for microscopic examination may be required.
3. Do hair loss treatments actually work?
The good news is, my patient’s hair loss did get better, she turned out to be suffering from a combination of telogen effluvium, scalp inflammation from seborrheic dermatitis as well as underlying genetic hair loss, known as female pattern hair loss. The bad news? Her treatment took a while, while her hair loss was controlled, a lot of her hair follicles had become miniaturised (think the shiny glossy scalp that you’ve seen in older men with androgenetic alopecia, which is hair loss influenced by genetics and the male hormone testosterone).
What this means is that it is a more advanced stage of hair loss which could mean a slower or less optimised outcome with treatment. The take home point is, while there are multiple evidence-based methods of encouraging hair growth (for cosmetic reasons in age or genetics influenced hair loss i.e. androgenetic alopecia) such as light treatments, in combination with active ingredients such as minoxidil and more recently, copper peptides which I prescribe in my practice.
The real issue is that more severe underlying medical conditions like lupus (an autoimmune disease), chronic undiagnosed illnesses, thyroid disease, anemia — these have serious underlying health implications which need to be treated on top of the hair loss problem. In addition, a trained dermatologist can pick up causes of both non-scarring and scarring alopecia. The latter is irreversible hair loss that can be promptly diagnosed and requires medical hair loss treatments.
© 2017 Dr. Teo Wan Lin. All rights reserved.
Meet with Dr. Teo Wan Lin, founder and Specialist Consultant Dermatologist of TWL Specialist Skin & Laser Centre, an accredited dermatologist specialising in medical and aesthetic dermatology. She integrates her artistic sensibility with her research background and specialist dermatologist training, by means of customised, evidence-based aesthetic treatments using state-of the-art machines, injectables (fillers and toxins) which work synergistically with her proprietary line of specialist dermatologist grade cosmeceuticals Dr.TWL Dermaceuticals.