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NEW YEAR, LESS HAIR. FATHER TIME, OR SOMETHING ELSE?

December 28, 2017

 

What a year 2017 has been! Whew! It’s gone by soooo fast, yet I feel like 2017 was 5 years of activity all crammed into one year. From starting Renew Dermatology, to celebrating my first Anniversary with my husband Bill, to getting to know more people in Summit County and becoming more engaged in the community through multiple different organizations…makes me tired just reliving all the fun for the few seconds it took to write that! 

 

Reminiscing about this past year is great but I find focusing on the future and all of the amazing changes I am making to be far more exhilarating! Then I will probably stop all this thinking and dreaming sometime around midnight, pop some champagne with Bill, and fall asleep so fast that I, I, ….. zzzzzzz.

 

Sorry about that. I drifted off. So here we are, on the eve of a new year. A year destined to be filled with intrigue, promise, and vulnerability with a large side of accomplishment.  And one fact we can all absolutely count on is that we will be another year older. Booooooo. :(

 

Let’s face it, aging is not fun for many of us, that's for sure. For instance, we all get to witness the general problems of getting older such as losing our taut and super youthful skin, feeling the aches and pains a little bit more every morning, and for quite a few of us, this also means losing our hair (whether this is gradual and barely noticeable to suddenly finding your scalp missing a large amount of your coveted strands).

 

Hair loss at any age can be worrisome and stressful to say the least.  For many, our hair is a part of our identity and seeing it less and less can affect our self esteem.  For some, this may mean choosing to wear a wig to curb the embarrassment or constant questions from well-meaning friends and family about the changes going on up top. Then, in the case of permanent hair loss, we get to be even more diligent and mindful about protecting the scalp from exposure to the sun which can lead to precancerous lesions and skin cancers.

 

The concept of hair loss is not new. For decades, we have been bombarded with hair loss commercials and infomercials for this product or that product attempting to sell us with catchy slogans like "Use It Or Lose It" (thanks Rogaine, forever stuck in my head). Or how about the numerous  procedural options (some older and some new) available including hair transplants, low light laser therapy, stem cells, or platelet-rich plasma (PRP) injections? How do you choose which one is right for you? Now wait, I saved the best for last. How about the spray paint for bald spots...who remembers those? If this wonderful invention has left your memory recall, please see below. Yikes.  We can laugh about it now. But the truth is, when something is important, I have found that people will try almost anything to look and feel better. 

 

That's why I am writing this blog. Because after about 10 minutes of reading, I am confident you will have a better understanding of why hair loss occurs (even though it is not an exact, well-understood science in many cases), some treatments that may work for you, and some things to avoid in order to maintain your gorgeous mane. Read on my friends...

 

 

THE REASONS YOU LOSE YOUR HAIR

 

First things first. Let’s put the myths and misconceptions of hair loss to bed right now. Here is one of the most common questions I usually hear from my patients - "How much hair your mom's father had determines how much hair you have, right?"

 

NOT EXACTLY TRUE. Goodnight myth. See more accurate information below:

 

According to a recent article from Prevention Magazine Online - “You can't predict hair loss by looking at your family tree. Like many traits, hair loss is polygenetic, which means that your fate is decided by a (pretty random) assortment of genes from both immediate and extended relatives," says Nicole Rogers, MD, a hair transplant surgeon and board-certified dermatologist based in New Orleans.  "That said, if hair loss generally runs in your family, you're more likely to deal with it, too."

 

Source: https://www.prevention.com/beauty/myths-about-thinning-hair-and-hair-loss

 

Another inaccurate statement I hear frequently is that "I think that washing my hair too often is causing me to lose my hair."

 

ALSO UNTRUE. SO PLEASE...WASH. YOUR. HAIR.  

 

Now, prepare yourself for a "Derm-Nerd Fancy Word Alert": Androgenetic Alopecia (also known as "male and female pattern baldness") is the most common type of hair loss for both men and women, affecting "around 30 million women and 50 million men across the United States" according to a June 2017 article in Medical News Today.

 

This article goes on to document that "male hair loss can start as early as adolescence for some individuals but generally develops in 66% of men by age 35, and around 85% of men by the age of 50."

 

Women, however, continue to lose hair to some degree as they age. And, per Sarah Taylor, MD in a February 2017 article of Healthline, "up to two-thirds of women experience hair loss after menopause {and} less than half of women will make it past age 65 with a full head of hair."

 

BUT WHY IS THIS HAPPENING (BESIDES MY UNLUCKY GENE POOL)? Your hormones do play a big part in hair growth/loss and the growth cycle of your hair may begin to change with age, if you have certain medical conditions or if you take certain medications. If you are noticing hair loss, this typically means that the time in between losing a hair strand and getting the new replacement to come in lengthens.  It's like your hair goes on a break.  Yep, go figure...It's harder and harder to find good help these days, am I right? :) Read on for more potential causes...

 

 

OTHER TYPES OF HAIR LOSS
 

Obviously when we say hair loss, we think of the hair on our head. But there is a special type of hair loss that can affect ALL hair-bearing areas on your body called (brace yourself for another fancy Derm-Nerd term) Alopecia Areata. If you have heard of this before or if you have even had it, extra bonus points are all yours. 

 

Alopecia Areata is a recurrent, non-scarring form of hair loss on your body that can include your scalp, eyebrows, arms, beard, eyelashes, legs, armpits and other hair bearing areas. It is typically asymptomatic (meaning no symptoms such as pain, burning or itching, etc) but a small percentage of people affected can have these symptoms to some degree. This loss of hair generally occurs in small round patches and the exact cause is unknown, although the most popular evidence suggests it occurs as a result of an autoimmune disorder (when your immune system fails or fights against your own body) in genetically predisposed individuals. 

 

 

A May 2017 article in Medscape confirms that "the natural history of alopecia areata is unpredictable. Most patients have only a few focal areas of alopecia [hair loss], and spontaneous regrowth usually occurs within 1 year." But permanent hair loss can be a reality for a small percentage of individuals and researchers are still unsure of why this happens in some patients and not in others. There currently is no "cure" so to speak for this hair loss condition, however there are multiple treatments than can help with regaining the lost hair and restoring your dignity as quickly as possible. Follow with a dermatology provider sooner rather than later for optimal results.

 

Another Special Type of Hair Loss: Telogen Effluvium - means that your scalp begins to shed hair at a much faster rate than it grows new hairs as a result of a metabolic or hormonal stress and may even be caused by side effects of certain medications.

 

This form of hair loss is very common and is generally reversible within about 6 months for the majority of patients.  However, for a small percentage of unfortunate individuals, this condition can be chronic, leaving their hair in a more permanent resting phase. Who knew your hair could fall into a Rip Van Winkle stage? See, the body IS SO FASCINATING! :)

(I know, I know...you are correct if you were just thinking that only those who AREN'T affected by any of these weird hair loss medical conditions could believe that)

 

What triggers this resting period you might ask? Like most things that affect your body and your overall health, there is a long list of variables. That’s like asking, “Hey Kelly, what will happen to me next year?”

 

But let me give you a few examples. Many times, telogen effluvium can develop when you have a reaction to a physical, environmental, and/or diet trigger. Major trauma or stress on the body such as surgery, cancer, pregnancy and childbirth, and crash diets are known exacerbating factors. But not everyone who goes through these events or others thought to lead to increased risk of hair loss actually develop this condition. Inquiring minds are still trying to figure this concept out.

 

Now that we have reviewed some potential causes, I know all of you practicing Derm-Nerds out there want to know how to treat this. You may not like the first and most important prescription but here goes…. ABUNDANT PATIENCE. Yep. Sitting tight and giving your body some time to recover from whatever it is enduring is key as the majority of cases are reversible.

 

However, if there is a cause that can be remedied, fix it as quickly as possible.  (i.e. ok, maybe that crash diet of eating 500 calories per day WASN'T such a great idea OR if it is caused by a medication that your provider can stop or switch to another one that doesn't have hair loss listed as a potential side effect)

 

AND LET'S ADDRESS ONE MORE POTENTIAL CAUSE OF HAIR LOSS: Scarring alopecia can occur in less than 5% of the population worldwide from a group of rare conditions such as lichen planopilaris, dissecting cellulitis of the scalp, and traction alopecia (wearing your hair pulled back or braided tightly on a regular basis) to name a few.  This is worst case scenario out of all of the conditions we have discussed so far because you lose hair, maybe gradually or in patches, and the hair may not return. Instead, scar tissue can build up where you used to have hair. And for some people, this can be painful, burning, itchy, or associated with blisters.  This is especially devastating not only for the day-to-day embarrassment and discomfort, but also because of the long-term cosmetic and psychological concerns.

 

 

According to webMD - “Affected areas may be smooth and clean, or may have redness, scaling, increased or decreased pigmentation, or may have raised blisters with fluids or pus coming from the affected area.”

 

 

Sources: https://www.webmd.com/skin-problems-and-treatments/hair-loss/scarring-alopecia#1

 

https://www.medicalnewstoday.com/articles/317788.php 

 

 

 

Treatment for this type of hair loss, once diagnosed, needs to be pretty aggressive for best results. Your dermatology professional may prescribe a number of specific treatments based on whatever is causing your hair loss, including but not limited to topical ointments, oral anti-inflammatory medications, injectable treatments, and/or surgery along with a wig or hair piece.

 

OH, AND ONE LAST CAUSE OF HAIR LOSS that is much more common than scarring alopecia (especially in kids)....Tinea capitis (fungal infection of the scalp that can be passed from direct contact with another infected human or from our furry friends like dogs and cats). This infection attacks the follicle causing, you guessed it, hair loss. And even worse...it's highly contagious so you want to get this diagnosed and treated appropriately quickly before it becomes a widespread issue in your family, your child's school, daycare facility, well, you get the picture.  

 

 

 

What makes this form of hair loss unique is that it has been called "ringworm of the scalp" even though it does not actually involve a worm at all. Its called this because of the way it effects the skin on your scalp, causing circular patchy areas of dry, scaly skin that resembles a worm or a worm path through your hair.  

 

This is the most common cause of hair loss in children that is not only contagious but can also be scarring and permanent in some cases so you parents, grandparents, aunts, uncles, or even those of you who have just seen a kid before...BE AWARE & SEEK TREATMENT RIGHT AWAY IF YOU SEE ANY HAIR LOSS OR SIGNS OF INFECTION.  

 

Treating this condition usually involves not sharing any products that come into contact with the infected area (hat, brush or comb if on the scalp) and getting prescriptions for an antifungal medication or medicated shampoo. 

 

TREATMENT 101...THE BASICS:

  • Minoxidil (AKA "Rogaine") is probably one of the most common over-the-counter remedies used for hair loss as this topical medication is designed to promote hair growth. Unfortunately, it is not an overnight miracle, but over time if used diligently (up to 12 months of use for some to see results) it has been proven to regrow hair in both women and men.

  • Avoid Smoking. It can accelerate hair loss by damaging hair follicles.

  • Follow a healthy diet rich in fresh fruits and vegetables. Several different vitamin and nutrient deficiencies are thought to contribute to hair loss based on recent research studies including iron, zinc, Vitamin B3, fatty acids, and protein.

  • Avoid medications that can cause hair loss as a side effect.  Examples of this are in some blood thinners, gout medications, blood pressure medications, antidepressants, male or female hormones, or high doses of Vitamin A. 

  • Light Therapy has been shown to improve hair loss by improving blood flow in the scalp and promoting new hair growth. Your medical professional can help you decide which method of light therapy is best for you. 

  • Multiple topical, oral and injectable medications can be prescribed to treat your hair loss depending on what the cause is. In general, the sooner you seek treatment, the better chance you will have of optimal results.

  • Do not be an enemy to yourself.  This means avoid wearing tight hairstyles such as braids or buns that put unnecessary stress on your hair follicles and do not develop habits of pulling or twisting your hair compulsively. Also, avoid harsh treatments to your hair like hot rollers, getting permanents or using straightening irons regularly. All of these habits have been shown to increase stress on the hair follicle and may cause accelerated hair loss. 

 

WHY IS THIS ARTCLE IMPORTANT?

 

As with many of my blogs, I definitely struggled with balancing the somewhat to very technical information contained in this article with trying to give you the best overall picture of what to pay attention to, what can be causing hair loss, and how it can be resolved. And, with all of this in mind, I always make it my goal not to scare you into thinking that "something awful" is inevitable or unrecoverable. As with most conditions that are found in the dermatology realm, each individual can have varying degrees of hair loss caused by a large laundry list of bad stuff and any number of treatment options available to them based on current research. 

 

Our hair is like the crown on our head, and just like a King or Queen, a Prince or Princess, our crown is part of our identity. For some, a crown represents beauty, power, victory, honor, and glory. And, 20 years in medicine has taught me that, to some people, their hair is no different. So I want to do all I can to support you in wearing your crown (or hair) with pride. 

 

All of the above aside, I realize there is definitely a movement among men mostly, but also in women, to embrace the 100% bald look. And if that is your thing, I will absolutely support you in that too. I have and will always practice from a place of NO JUDGEMENT. Meanwhile, I will be envious of your carefree and  "easy-to-take-care-of" scalp. Just use your sunscreen diligently please. ;)

 

I hope you found this information useful. As always, I encourage all to seek professional medical advice for any condition you think falls into the category of "concerning" or "not normal."

 

Being properly educated and examined may protect you from further, larger problems with your health when it comes to your hair. But even more empowering than that, you can have the self confidence of doing something about any hair loss you may be experiencing by addressing it early and making a plan to treat and manage the condition properly.

 

MY FINAL WORDS FOR 2017

 

It is my sincerest wish that you had a wonderful year and holiday season in 2017 and that 2018 is even more fantastic than you could ever imagine. But most importantly, I pray that you and your family feel safe, warm, well-fed and incredibly loved. 

 

I look forward to meeting you in person at my office in Frisco or even when I am out and about running errands. I am also known to frequent the chair lifts and mountain trails around Summit County. You'll usually know me by the obsessive amounts of sunscreen in my pack or smeared on my face in what my husband calls "mime-style." Whatever. We will see who gets skin cancer first. Stay tuned friends and Derm Nerds In Training....

 

 

 

Kelly Ballou, PA-CCo-Founder Renew Dermatology Frisco, Colorado (Summit County)

 

 

 

 

 

 

 

 

 

NOTICE:
NEVER DISREGARD PROFESSIONAL MEDICAL ADVICE OR DELAY SEEKING MEDICAL TREATMENT BECAUSE OF SOMETHING YOU HAVE READ ON OR ACCESSED THROUGH THIS WEBSITE. RENEW DERMATOLOGY IS NOT RESPONSIBLE NOR LIABLE FOR ANY ADVICE, COURSE OF TREATMENT DIAGNOSIS OR ANY OTHER IFORMATION, SERVICES OR PRODUCTS THAT YOU OBTAIN THROUGH THIS WEBSITE.

CLICK HERE TO READ FULL DISCLAIMER.

 

MORE SOURCES: 

https://www.everydayhealth.com/hair-loss/medications-that-can-cause-hair-loss.aspx 

https://emedicine.medscape.com/article/1069931-overview 

https://emedicine.medscape.com/article/1071566-overview

https://emedicine.medscape.com/article/1073559-overview

http://www.ifd.org/protocols/tinea-capitis

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Toll Free: 844-4RENEWME

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© 2017-2019 Renew Dematology - www.RenewDermatology.com

A Message from Scott and Kelly - Dr. Scott Bennion, MD, FAAD, FACP
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