Tag Archive: scalp inflammation

Dermatologist’s Best Guide to Hair Fall

December 11, 2017
Dermatologist Hair Fall Guide

What is hair loss?

Hair loss, or excessive hair fall, is also known medically as alopecia can be defined by shedding of hair, leading to an overall thinning that causes the scalp to be visible, or “balding”. Some people may also experience hair problems such as a change in the quality of hair or breakage of the hair shaft, which also results in an overall altered appearance of hair. Excessive hair fall can happen to anyone and everyone under the sun. Everyone, male or female, elderly, middle aged-adults or children is considered susceptible when it comes to hair fall although at each age group, there are different underlying causes that results in the loss of one’s crowning glory.

What causes excessive hair fall?

Excessive hair fall can be caused either by an isolated problem or a combination of factors such as genetics, chronic medical diseases such as a thyroid problem or underlying anemia (low blood count), poor nutrition, etc. Chemical treatments performed in hair salons, such as hair dyes, bleaching, perming and rebonding hair, can cause a form of hair fall from breakage of the hair shaft.  In the hospital setting, patients undergoing chemotherapy usually suffer from a form of temporary hair loss, caused by the hair follicles entering into the resting phase whereby they are shed.

Namely, as a our hair growth cycle goes through 3 main phases — active growth caused by anagen, transitional growth caused by catagen and inactive growth and shedding caused by telogen — an impact in any of these stages caused by the abovementioned factors can lead to loss in hair density due to less hair on the scalp present in the growth or anagen phase. Here is a comprehensive list of some of the commonest causes of hair loss:

  • Hormones, abnormally high levels of male hormones in females
  • Genes, from both parents in male or female pattern baldness
  • Childbirth, emotional stress, illness, and are causes of temporary/reversible hair fall known as telogen effluvium
  • Fungal infections such as Ringworm, Tinea capitis caused by dermatophyte infections i.e. microsporum canis and trichophyton rubrum.
  • Medications such as chemotherapy medications in cancer treatment, birth control pills
  • An underlying autoimmune disease which attacks the hair follicles, known as alopecia areata. This is genetically influenced and those with a family history of such a condition will have a high risk of getting this condition. It is also linked to conditions such as Graves Disease and Hashimoto’s thyroiditis.
  • A form of scarring alopecia from traumatic injuries, burns, X-rays.
  • Chemical procedures such as perms, bleaching, and dyeing hair can cause hair breakage.
  • Trichotillomania,a psychological disorder affecting children, teenagers and young adult females, a condition in which the affected  person compulsively pulls out his own hair.
  • Telogen effluvium is a temporary, reversible reaction to stressors such as an acute severe illness or to pregnancy or emotional/psychological trauma. This is due to changes in the growth cycle of hair. A proportionately increased number of hairs enter the resting phase known as telogen at the same time, as opposed to normal hair which forms  90% of  scalp hair in the active growth phase, causing increased hair shedding and subsequent thinning.
  • Tight hairstyles and using instruments like rollers or hot curlers. Tightly braided hair and hot combs  can also result in permanent hair loss by trauma.
  • Anemia,thyroid illnesses, autoimmune diseases such as lupus, diabetes,iron deficiency,eating disorders can lead to hair fall.
  • Poor Diet. An or extreme severely calorie-restricted diet or a low-protein diet can also cause temporary hair fall.
  • Involutional alopecia is a natural degenerative condition whereby  hair thins with age. Proportionately increased hair follicles go into a resting phase, and existing hairs become shorter and fewer in number.
  • Androgenetic alopecia is a genetically influenced condition that affects both men and women. For males with androgenetic alopecia, they can even begin suffering hair fall from their teens or early 20s. Some signs of this condition are a receding hairline and thinning of  hair from the crown and frontal scalp. Women generally experience this later in life. With a general thinning over the entire scalp, often with the worst hair loss at the crown.
  • Alopecia areata is a rare condition which may start suddenly and lead to patchy hair fall in children and young adults. Although rare, this may progress to complete baldness (alopecia totalis), whereby a person loses 100% of scalp hair. Hair regrows within a few years in about 90% of people with the condition. The most severe form of this condition is known as Alopecia universalis, which causes all body hair to fall out, including the eyebrows, eyelashes, and pubic hair.
  • Scarring hair loss can be picked up by a trained dermatologist as the hair follicles have been permanently damaged and it may be impossible for the hair to regrow over the same areas again. This is comparatively rare but medical conditions such as  scalp cellulitis, dissecting cellulitis, folliculitis, folliculitis decalvans, if left untreated, can lead to severe scarring alopecia. Some forms of lupus, such as discoid lupus erythematosus on the scalp, results in discolored bald patches on the scalp. Lichen planus is another inflammatory scalp condition that can destroy the follicle leaving hair unable to grow again.

Can hair fall be prevented?

Excessive hair fall is scary and traumatic. The most important thing to know is that you are not alone and that there are specific causes to any type of hair fall which should be diagnosed early and treated appropriately by a trained dermatologist. See an accredited dermatologist as soon as you pick up any signs of hair loss to identify and treat any underlying disease. If you have a family history of hair loss, you may wish to consult a dermatologist to discuss treatment options for prevention.

Treatments such as red and yellow light, together with active ingredients in certain medications like minoxidil and copper peptide can increase hair growth. However, if you have active inflammation on the scalp or an underlying more serious health condition you will need medical treatment to stop hair fall before treatments to cause hair re-growth. If you don’t have hair loss, do take good care of your hair by avoiding chemical treatments such as hair colouring, bleaching and perming processes. Sleek high ponytails or bun might look chic in the short term, but for healthier hair in the long run opt for loose hairstyles to avoid traction injury resulting in hair fall along the hairline.

© 2017 TWL Specialist Skin and Laser Centre. All rights reserved.

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Meet with Dr. Teo Wan Lin, accredited dermatologist at TWL Specialist Skin & Laser Centre, for a thorough consultation to determine the most suitable treatment for your skin.

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.

A Dermatologist’s Best Guide to Dandruff and Sensitive Scalp – 3 explanations for Your Hair Loss

October 5, 2017

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

In the third instalment 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. This is lay speak for any form of scalp inflammation that causes the cell turnover rate on the scalp to increase abnormally. Dead skin cells, which are rapidly shed from the cell turnover, in turn constitute the white scales observed as the primary symptom of dandruff. 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.

Sensitive Scalp Inflammation Dandruff Dermatologist Singapore

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. Dandruff is observed as a result. If you have scalp flaking which does not respond to over the counter anti-dandruff shampoos, such as those containing 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. For example, scalp psoriasis, which may be the case especially if one has a family history of psoriasis or rashes on the 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 and dandruff 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). These work synergistically with her proprietary line of specialist dermatologist grade cosmeceuticals, Dr.TWL Dermaceuticals, which include sensitive scalp and hair loss treatments.

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.