Tag Archive: Hair

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.

A Dermatologist’s Best Guide to Hair Loss Treatments for Your Sensitive Scalp

October 5, 2017

By Dr. Teo Wan Lin, Consultant Dermatologist at TWL Specialist Skin & Laser Centre

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In the third installment of my series on dealing with hair loss in Singapore as a dermatologist, I’m going to discuss dandruff and scalp sensitivity. This is one of the commonest scalp complaints that my patients have in conjunction with hair loss symptoms and leaves many of them wondering if it is the cause of their hair loss problem.

1. What is dandruff and what causes it?

Flaking on the scalp and white scales found on one’s clothes are one of the first symptoms of dandruff, which is lay speak for any form of scalp inflammation that causes the cell turnover rate on the scalp to increase abnormally. There are several medical conditions that can result in this, the commonest being the following: scalp psoriasis, seborrheic dermatitis and scalp eczema.

2. Do I have a sensitive scalp or is it a symptom of another condition?

Do you have itch, redness or pain on your scalp? You may have an undiagnosed inflammatory scalp disease. Scalp “sensitivity” without any underlying scalp condition is a very rare condition attributed to abnormal nerve sensations known as scalp dysaesthesia.

It is far more common to have an underlying cause such as seborrheic dermatitis, which is due to proliferation of a yeast known as malessezia furfur in an individual with excess production of oil. It is also commoner in tropical and humid climates such as Singapore, as it encourages this yeast to grow. Otherwise, malessezia is an inhabitant of one’s skin and scalp. Under normal conditions, it does not cause any issues, however under humid and sweaty environments, this yeast can proliferate to cause scalp inflammation and flaking. If you have scalp flaking which does not respond to over the counter anti-dandruff shampoos, which usually contain zinc pyrithone which is anti-fungal, promptly seek the care of an accredited dermatologist rather than self medicate or DIY.

Other causes of scalp inflammation would be scalp eczema, which is due to an excessively dry scalp/skin condition, scalp psoriasis, which may be the case especially if one has a family history of psoriasis or rashes on one’s body. If you have been in contact with a ringworm infected cat or dog, also do have your scalp and skin checked by a dermatologist as these infections are contagious and could also cause a form of scalp inflammation presenting as a red, scaly and itchy patch with hair loss.

3. Is my sensitive scalp causing hair loss?

Most cases of scalp inflammation due to eczema, seborrheic dermatitis, scalp folliculitis or psoriasis should not cause hair loss. However severe inflammation can push the hair growth cycle into a stage of telogen effluvium which is when hair reaches the end of its cycle and falls out, similar to hair loss that occurs after a major illness or post-pregnancy. In addition, if one picks and peels off crusted areas over the scalp this can also cause damage to the hair root and lead to hair loss. There are other causes of hair loss such as alopecia areata, which is an autoimmune disorder causing one’s immune system to attack hair follicles, leading to hair loss. This usually has no symptoms other than the appearance of round patches of hair loss over one’s scalp. Scarring causes of hair loss include folliculitis decalvans, which is the end-stage of a type of scalp folliculitis, whereby the hair follicles themselves are constantly inflammed and infected. Children may be more susceptible to tinea capitis, which is a fungal scalp infection that can lead to scarring hair loss if untreated.

© 2017 Dr. Teo Wan Lin. All rights reserved. 

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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.

To book an appointment with Dr. Teo, call us at +65 6355 0522, or email appt@twlskin.com. Alternatively, you may fill up our contact form here.

Top 3 Tips on Hair Loss Treatments Reviewed by a Dermatologist

October 4, 2017

By Dr. Teo Wan Lin, Consultant Dermatologist at TWL Specialist Skin & Laser Centre

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One of my patients who came to my clinic for hair loss treatment 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 and scalp problems?

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, anti-hair loss treatment centres, 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. Can hair loss be treated?

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 treatment.

© 2017 Dr. Teo Wan Lin. All rights reserved. 

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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.

To book an appointment with Dr. Teo, call us at +65 6355 0522, or email appt@twlskin.com. Alternatively, you may fill up our contact form here.