Lifestyle & Retirement

Quest for Hair

Share This Post

MARY PITRE FIRST noticed that her hair was thinning when she turned 50. This was disturbing, to say the least. "You don’t want to talk about hair loss," says Pitre. "It’s embarrassing, and you will try anything to fix it. You truly feel like less of a woman." For quite some time, Pitre’s hairdresser attempted to battle the problem. At first, he teased her hair to make it appear thicker and to camouflage the thinning areas. Then, as the problem progressed, her beautician applied a color fix to make the scalp appear less prominent, plus spray-on concealer to beef up thin strands and hide see-through spots, then hair extensions, and eventually glued-on hair pieces. All of this proved not only costly, but made Pitre feel even more self-conscious. "I got to the point where I just said enough is enough," she says. She bought some wigs and hats and, for a time, gave up her quest for hair.

When one thinks about alopecia (al-oh-PEA-she-uh), the medical term for excessive or abnormal hair loss, usually the first thing that comes to mind is male baldness. But women suffer from the problem in substantial numbers, about 30 million women in the United States alone, according to Dr. John Wolf, chairman of the Department of Dermatology at Baylor College of Medicine. Where balding in men is typically associated with heredity and advancing age, in women the problem is frequently linked to an underlying medical condition- thyroid disease, hormone imbalances, or other potential culprits such as lupus, anemia, diabetes, celiac disease, and other chronic nutritional disorders that can be diagnosed with special laboratory tests.

Complicating the problem for women is the social stigma. "Thinning hair is more acceptable among males," says Zoe Draelos, M.D., vice president of the American Academy of Dermatology and consulting professor of dermatology at Duke University School of Medicine. "Men can even shave their heads to camouflage balding, but hair loss on women is associated with lack of femininity."

"A thick, shiny, full head of hair is an essential part of female beauty in our culture," adds Dr. Patricia Farris, a dermatologie surgeon and clinical assistant professor at Tulane University. "We spend so much time grooming, coloring, and styling our hair that it is a very personal expression of our own beauty. For this reason, women with hair loss are usually quite distraught."

A certain amount of hair loss is occurring on the healthiest of heads every day. A full head of hair has about 100,000 strands. Fach one has a life cycle a growing phase followed by a transitional phase, then a short resting phase, and finally the old hair falls out. You lose about 100 hairs each day by this process. It’s not until significantly more than 100 hairs per day start falling out that you have clinical hair loss. The process is gradual and quite difficult to spot for quite some time. In fact, by the time you actually observe that your hair is thinning, you may have lost more than half of your individual hairs.

Because female alopecia is often associated with a medical condition, the doctor’s office, not the hairdresser’s, should be your first stop. And it’s vital that one health professional remains "captain of the ship," coordinating the workup with urgency and speed. In fart, a visit to a boardcertified dermatologist early in the game may well save you lots of money and time, says Dr. Farris. "We work with skin pathologists, experts at evaluating scalp biopsies and determining the type of hair loss. If blood work suggests a hormonal problem like thyroid disease, we send the patient to an endocrinologist for further workup and treatment."

Once you’ve had a workup, your diagnosis will most likely fall into one of the following most common categories:

1. Androgenetic Alopecia (Female Pattern Hair Loss). The most common form of hair loss results from a progressive shrinking of hair follicles. The cause is believed to be a genetic predisposition to effects of a byproduct of testosterone on the hair follicles. This kind of hair loss is usually inherited.

2. Telogen Effluvium. In the second most common form of hair loss in women, an increased number of hairs enter the resting phase of the hair’s life cycle. Additional shedding usually occurs in response to stresses such as emotional trauma, illness, major surgery, and certain medications.

3. Alopecia Areata. With this condition, the body mistakenly attacks some hair follicles, causing a sudden appearance of oval or round patches of hair loss. Affecting about 2 percent of Americans, it is believed to be a result of a combination of immunologic, environmental, and genetic triggers.

4. Scarring Alopecia. Fiere, the patient experiences patchy hair loss with an obvious sign of scalp inflammation. The condition tan result in permanent, distressing hair loss. A scalp biopsy is needed to confirm the diagnosis.

Upon identifying the cause, you can take action. "Significant advances in treating alopecia have emerged in the past decade," says Dr. Ted Daly, medical director of Garden City Dermatology on Long Island, a group that specializes in female alopecia. He describes a range of options, from oral medications that stimulate hair growth, to topical lotions to apply directly to the scalp, to hair transplants.

When blood work reveals no underlying medical problem, a hair transplant may be a great option, says Dr. Nicole Rogers, a board- certified dermatologist and a fellow of the International Society of Hair Restoration Surgery. "The procedure takes advantage of the fact that hair retains its donor characteristics, even when moved to another part of the scalp. Thus, it will grow as long as it was genetically programmed to grow, even where surrounding hair may be thinning or lost," she says. "In my practice, exactly half of our transplant surgeries are on women."

Mary Pitre contacted Dr. Rogers after watching a television segment featuring the dermatologist. "She came across as someone who cared and clearly explained what women go through," says Pitre. "So I made an appointment, and we began working as a team."

After thorough blood analysis, Pitre was deemed a good candidate for transplantation. She began fhe process in October 2009. "I was so excited to have hair growing in the front of my scalp," says Pitre. "Though my hair is still thin on top, I now have hair in the front, back, and sides, so I can wear a hat, and no one knows the difference."

Medications can be very helpful in stabilizing hair loss, either in conjunction with transplantation or used alone. Rogaine (minoxidil) is currently the only FDA-approved medication for female hair loss, and has extensive data supporting its use. The mechanism is unclear, but may be related to vasodilation of surrounding blood vessels. It has been shown to increase the caliber (width) of hairs as well as the length of the anagen (growing) phase. Some physicians use anti-androgen therapies such as Aldactone (spirolactone) or Propecia (finasteride) as well. Minoxidil is applied topically, where the two other medications are taken orally. There is some risk involved with the latter two: "Women of childbearing age should not use either, because there is a risk of birth defects in male fetuses," says Dr. Rogers. "Furthermore, preliminary data do not support using Propecia in women at this 1 mg dose required to counter hair loss. Some doctors will use higher doses of 2.5 mg or 5 mg in women who cannot get pregnant, but patients must understand that this is an off-label indication, and not yet well investigated."

Consumers are also hearing about laser treatments to promote hair growth, but wonder if the therapy lives up to its advertised promise. "Laser comb treatment is for patients who have maxed out medical therapies and are not candidates for hair transplantation," says Dr. Rogers. "It is based on the observation that lasers used for hair removal sometimes trigger a paradoxical growth of new hair. Its mechanism of action, however, is still unclear, and much more research is needed to identify which wavelengths, exposure times, and dosing frequencies are most effective."

As for Mary Pitre, she continues her visits with Dr. Rogers and advises anyone dealing with hair loss to learn from her experience. "As I look back, the teasing, pulling, and hairpieces probably did more harm than good," she says. "After two decades coping with the condition, I recommend that women who notice their hair is thinning first see a qualified dermatologist. Today, I may not have a whole lot of hair, but I have more hair- and many hats. Most of all, I have a physician I can relate to, and that’s a tremendous relief."

Copyright Benjamin Franklin Literary & Medical Society May/Jun 2011 (c) 2011 Saturday Evening Post

Share This Post

Leave a Reply

Lost Password

Register

Like Our Page!

Receive our updates via Facebook!