Clinical Presentation-Skin Disorders

Tinea capitis, or “ringworm” of the scalp, presents as one or more sharply marginated plaques of partial alopecia. Inflammation and scale are present, but often these two changes are quite minimal. The recognition of broken hairs (stubble and black dots at the follicular orifices) is the best clue to correct diagnosis. Nearly all cases occur in children, but the diagnosis should be considered in any adult presenting with evidence of localized alopecia . Kerion formation is a complication that occurs in about 10% of cases. This represents a sensitization phenomenon whereby the fungi induce a remarkably brisk inflammatory reaction with resulting pustulation, crusting, and edema formation. Wood’s lamp examination does not reveal fluorescence in the most common forms of tinea capitis or in kerion formation. Unfortunately, KOH preparations are difficult for the inexperienced to interpret. For this reason, any suspected diagnosis requires the plucking of infected hairs for fungal culture. Course and PrognosisTinea capitis and zoophilic tinea corporis usually resolve spontaneously after 6 to 12 months of activity. Tinea pedis, tinea cruris, and anthropophilic tinea corporis continue indefinitely. There are, however, periods of relative quiescence and exacerbation. All of these fungal diseases respond well to treatment, but with the exception of tinea capitis and zoophilic tinea corporis infections, recurrence following treatment is rather likely. PathogenesisTinea pedis, tinea cruris, and anthropophilic tinea corporis are most commonly caused by Trichophyton rulnum. Trichophyton interdigitate and Epidermophhyton floccoswn infections are also seen. Generally, one cannot predict the causative organism on the basis of clinical appearance. Zoophilic tinea corporis can be caused by Microsporum canis, Trichophyton mentagrophytes, and Trichophyton verrucosum. Tinea capitis is caused by Trichophyton tonsurans in 90% of cases. The likelihood of inoculation with any of these fungi is enhanced if cuts and scratches are present on the skin. Clinical evidence of infection following inoculation is enhanced by the presence of warmth and moisture, such as occurs in the groin and under footwear. Depression of cell-mediated immune responsiveness, as in atopic patients, is a major predisposing factor for the development of T. rubrum infection. TherapyTinea cruris and those cases of tinea pedis that involve only the web spaces can be treated with any of the topical antifungal agents. Other forms of tinea pedis usually require the use of griseofulvin. Mild cases of tinea corporis also respond well to topical agents. Extensive disease and those cases with a component of follicular involvement are best treated with griseofulvin. Tinea capitis requires the use of griseofulvin. Orally administered ketoconazole therapy is rarely appropriate for either tinea corporis or capitis. Kerion on nation, if present, can be treated with intralesional steroid injections or with a short burst of systemically administered steroids.

Hair loss Treatment for Children’s

Hair loss Treatment for Children’sHair loss in children is more common than most people realize. When a child is diagnosed with medically related hair loss, many times one parent must stop working in order to stay home and care for the child or to be available to accompany the child on medical trips for treatment. Discretionary income may decline drastically (virtually being cut in half), and wigs can often not be worked into the family budget with such a dramatically reduced income. Children are subject to several causes of hair loss, some common, some rare. Causes of Hair Loss In Children’sChildren’s Tinea Capitis hair loss: Tinea Capitis is a disease caused by fungal infection of the skin of the scalp, eyebrows, and eyelashes, with a propensity for attacking hair shafts and follicles. It is also called “ringworm of the scalp”. The condition is caused by a fungus that invades the hair shaft and causes the hairs to break. Children’s Alopecia Areata hair loss: Alopecia areata is another common form of patchy hair loss in children. The typical story is the sudden appearance of one or more totally bald areas in the scalp. Children’s Traction Alopecia hair loss: Traction Alopecia, or physical damage to the hair, is another common cause of hair loss, particularly in girls. The human hair is quite fragile and really does not respond well to the many physical and chemical assaults it has to endure in the name of beauty. Children’s Trichotillomania hair loss: Trichotillomania is the compulsion to pull out one’s own hair. It results in irregular patches of incomplete hair loss, mainly on the scalp, but may involve the eyebrows and eyelashes as well. Children’s Telogen Effluvium hair loss: Following a high fever, flu, or severe emotional stress, hairs that were in their growth phase can sometimes be suddenly converted into their resting phase. Natural Steps to Prevent Hair LossEat and drink biotin: biotin is a very essential vitamin that will aid in hair growth andyou can get this in foods such as honey, milk and bananas. A great, healthy and tasty way to get biotin is to make a blended shake with these ingredients and yogurt.Stop Stress: The reasons for occurring stress can be the environment, or internal factors, such as depression, grief or resistance to change. If the continuation of stress is not solved it will start to affect the way in which the body reactsMassage your scalp every time: It is useful to promote the new capillaries growth in scalp tissue. It may help to strengthens the capillaries walls which are nourished the hair follicles. It is very effective to increase in the elasticity and flexibility of the scalp. Sleep plays an important role in allowing the body to repair and regenerate. One in four of us suffers from some form or sleep problem! Alterations in the sleep-wake cycle have been shown to affect the body systems including immune function, hormone secretion, physical and mental emotional stamina. Get vitamin B in your everyday foods and supplements: Deficiency in B vitamins- especially B6, inositol, Biotin, and folic acid. B vitamins, especially B5 (pantothenic acid) and B3 (Niacin) in diet can cause hair loss. Therefore it is necessary to include these vitamins in regular diet as it forms an important part in the growth of hair follicle. In order to cure hair loss, Vitamin supplement intake should be performed carefully. Research shows that an excessive intake of vitamin B6 by men results in stimulated hair growth.disorder has a relative with bipolar disorder, or they may develop bipolar disorder themselves.

Hair Loss In Children: Why My Child?

Children often take hair loss better than adults, up until the age of ten. Less of their identity is tied into their appearance, and so the loss of hair is not as shocking for them. There are several reasons that a child may lose their hair which are not life threatening.Common Reasons for Childhood Hair LossA reason that many children begin losing their hair is Tinea Captis, also known as ringworm of the scalp. This is a fungal infection which affects both the hair follicles and individual strands. If not treated with medicine immediately, it can be contagious.Another reason for childhood hair loss is Alopecia Areata, which can cause baldspots on the head and other areas of body hair. It is theorized to occur when the immune system begins attacking follicles. With treatment started immediately, some body hair may be saved.Another cause of childhood hair loss is called Trichotillomania. It is a self-inflicted condition which is considered on the obsessive compulsive spectrum. In it, a child feels the need to obsessively pluck hair from their head.This condition is usually treated with some kind of behavioral therapy, often including relaxation techniques. Because the hair follicle is not usually damaged, hair should grow back when the plucking of it is ended.Other conditions which can cause hair to stop growing include individual trauma, and traction alopecia. In this disease, the hair is pulled at or rubbed constantly. The resulting trauma to the hair shaft can cause hair to stop growing. Severe hair styles may also cause this reaction.A body’s response to trauma can also lead to hair loss. After a traumatic event, some people’s bodies withdraw nutrients from the hair, causing it to fall out. Hair loss does not need to traumatize a child. A parent with the right attitude can help their child through hair loss with support.

Ringworm effects on the skin

Ringworm is a skin infection which, despite its name, is not caused by a worm at all. Ringworm is actually caused by several fungus organisms known as dermatophytes. Ringworm is a fungal infections of the skin resulting in raised red swellings or lines that resemble burrowing worms; includes the diseases known as athlete’s foot, jock itch, and ringworm or the scalp. Ringworm is not caused by a worm. It is caused by a fungus. The kinds of fungi (plural of fungus) that cause ringworm live and spread on the top layer of the skin and on the hair. They grow best in warm, moist areas, such as locker rooms and swimming pools, and in skin folds. Although the world is full of yeasts, molds, and fungi, only a few cause skin problems. These agents are called the dermatophytes, which means “skin fungi.” Skin fungi can only live on the dead layer of keratin protein on top of the skin. They rarely invade deeper into the body and cannot live on mucous membranes, such as those in the mouth or vagina. Body ringworm (tinea corporis) may be caused by Trichophyton, Microsporum, or Epidermophyton. The infection generally produces round patches with pink scaly borders and clear areas in the center. Sometimes the rash is itchy. Body ringworm can develop anywhere on the skin and can spread rapidly to other parts of the body or to other people with whom there is close bodily contact. Ringworm is very mildly contagious. It can be caught from domestic animals (especially dogs and cats) as well as most farm animals. The infection can be caught from the animal directly, or from anything the animal rubs against. Ringworm can also be caught from other humans, both by direct contact and by prolonged contact with flakes of shed skin. Ringworm of the scalp may start as a small sore that resembles a pimple before becoming patchy, flaky, or scaly. It may cause some hair to fall out or break into stubbles. It can also cause the place where the infection is to become swollen, tender, and red. Anyone can get Ringworm . Scalp Ringworm often strikes young children; outbreaks have been recognized in schools, day-care centers, and infant nurseries . School athletes are at risk for scalp Ringworm, Ringworm of the body, and foot Ringworm; there have been outbreaks among high school wrestling teams . Children with young pets are at increased risk for Ringworm of the body. There are several other skin conditions that can mimic the ring-like appearance of ringworm. None of these, however, are serious. They include eczema, contact dermatitis, psoriasis and seborrhea. If treatment for ringworm fails, your doctor may consider these other possibilities. Scalp and beard infections may cause patches of baldness. In scalp infections, the lymph nodes at the back of the neck may become swollen and tender. Inflammation and scaling are usually fairly mild and may look like a patch of dandruff.Diagnosis is usually made based on the appearance of the typical ringworm rash. Cultures, especially scalp cultures for tinea capitis, can be done though. Topical steroids are a usual first treatment most parents use, but this can change the appearance of ringworm, so be sure to mention to your Pediatrician if you have been applying any topical creams to your child’s rash.

Dealing with hair loss in Children

Children can be a bit calmer when dealing with hair loss compared to most adults. This is probably because children are less vain than adults, especially children under the age of ten years. There are many possible reasons for hair loss in children that does not include any diseases that are fatal or need exposure to chemicals and elements for treatment.Common causes of hair loss in childrenHe was the head is one of the most common reasons for hair loss in children. Doctors say that I head is a fungal infection that remains on the scalp attacking the hair follicles and the shafts of hair strands. This form of hair loss in children is also known as ringworm of the scalp, but it may be true in eyelashes and eyebrows as well. Without the use of medication, the infection can be contagious, hence the need for immediate attention.Alopecia Areata is another cause of hair loss in children that may cause bald patches on the head of the child and other areas with body hair. A theory that stands out for the cause of this disease is that the immune system of the individual is one of the causes to it by attacking the follicles. This disease has immediate treatment because it is not taken for granted, the child may lose all body hair.Trichotillomania is another common cause of hair loss in children. This condition is aggravated by the fact that he is the son who does this for himself. This condition that causes hair loss in children is regarded as an obsessive compulsive behavior when the child feels the need to pluck your hair consistently. Treating hair loss in children of this type will require more likely relaxation techniques and behavioral therapy. The hair follicles in his condition are not usually damaged hair and most likely will grow back when the behavioral therapy improves.Other causes of hair loss in children can be of traction alopecia and trauma to the individual. Traction alopecia is a condition where the hair is consistent rubbed or pulled, resulting in stress on the hair shaft. Hair then cease to grow on the spot frequently or disturb the hair has a tendency to break the cease to grow due to pressure from hairstyles.Trauma can take many forms and can affect a person in different ways. Our bodies can react to trauma by withdrawing nutrients to the hair, resulting in hair loss in children and in adults as well. Hair Loss in children need not be traumatic for them. The father has the right attitude to take when confronted with your child’s hair loss is a loving and caring attitude.For more information on hair loss depression and where you can go to get help, please visit my website at http://www.linkey.info and http://ro.linkey.info

Ringworm hair loss occurs due to Tinea capatis, or ringworm of the scalp and is a problem that some may experience. You need to define a variety of characteristics prior to finding the proper treatment that are related to ringworm of the scalp. To help prevent hair loss from this problem its better to understand how you can get this type of ringworm and how to find the right help.

Signs of ringworm hair loss

When you have ringworm hair loss, you can observe on the head that some patches to form. Generally, ringworm will result to lose an average of one hundred hairs per day due to the slower development of hair loss. Beginning of an infection in the scalp area is the reason for this. If not treated proper way, causes fungus to develop in that area, which leads to ringworm. The initial symptom of the ringworm one may notice is itching that occurs on the head. Later on the scalp may become irritated and red. Balding follows later.

Causes of the disease

Occurring of ringworm hair loss in someone has a variety of reasons. In children ringworm hair loss is present usually. Most often, it is a consequence of bad hygiene. During the sweating which produces wetness from the skin, which is not washed off, is also one of the cause for this. Ringworm may also occur if there is a wound or scratch from the skin. It can easily leads to an infection if not proper care is taken. One important thing to understand is ringworm is not an actual worm, rather a fungus.

Consult your health care provider

If your scalp is irritated or you are noticing ringworm hair loss, it is important to get diagnosed right away. To check whether there is bacteria or fungus that is being formed in your scalp, your health care provider will be able to give you a skin lesion biopsy. If the infection has been occurring for a longer amount of time, it can be found easily through placing a light on the area where it is irritated and balding.

Anti-fungal medication

Getting an Anti-fungal medication is the first step you need to do if you have ringworm. The bacteria in that particular place will be killed off with this medication. In order to keep the area where the fungus was being produced entirely clean you will need to use a medicated shampoo. The common ingredient that is found in the shampoo is Selenium sulfide. Ringworm of the scalp is also infectious; meaning others around you should be checked for the problem.

Symptoms

If you are experiencing the symptoms like irritation in the scalp, or hair loss in a large amount then you should get examined for ringworm hair loss. This particular problem comes from an infection that develops in your scalp area and can become severe if not treated immediately. By understanding the symptoms of ringworm, as well as what it can affect, you can easily solve the problem and prevent hair loss, irritation or more serious matters from occurring because of ringworm.

Tinea capitis, or “ringworm” of the scalp, presents as one or more sharply marginated plaques of partial alopecia. Inflammation and scale are present, but often these two changes are quite minimal. The recognition of broken hairs (stubble and black dots at the follicular orifices) is the best clue to correct diagnosis. Nearly all cases occur in children, but the diagnosis should be considered in any adult presenting with evidence of localized alopecia . Kerion formation is a complication that occurs in about 10% of cases. This represents a sensitization phenomenon whereby the fungi induce a remarkably brisk inflammatory reaction with resulting pustulation, crusting, and edema formation. Wood’s lamp examination does not reveal fluorescence in the most common forms of tinea capitis or in kerion formation. Unfortunately, KOH preparations are difficult for the inexperienced to interpret. For this reason, any suspected diagnosis requires the plucking of infected hairs for fungal culture.
Course and Prognosis

Tinea capitis and zoophilic tinea corporis usually resolve spontaneously after 6 to 12 months of activity. Tinea pedis, tinea cruris, and anthropophilic tinea corporis continue indefinitely. There are, however, periods of relative quiescence and exacerbation. All of these fungal diseases respond well to treatment, but with the exception of tinea capitis and zoophilic tinea corporis infections, recurrence following treatment is rather likely.
Pathogenesis

Tinea pedis, tinea cruris, and anthropophilic tinea corporis are most commonly caused by Trichophyton rulnum. Trichophyton interdigitate and Epidermophhyton floccoswn infections are also seen. Generally, one cannot predict the causative organism on the basis of clinical appearance. Zoophilic tinea corporis can be caused by Microsporum canis, Trichophyton mentagrophytes, and Trichophyton verrucosum. Tinea capitis is caused by Trichophyton tonsurans in 90% of cases.

The likelihood of inoculation with any of these fungi is enhanced if cuts and scratches are present on the skin. Clinical evidence of infection following inoculation is enhanced by the presence of warmth and moisture, such as occurs in the groin and under footwear. Depression of cell-mediated immune responsiveness, as in atopic patients, is a major predisposing factor for the development of T. rubrum infection.
Therapy

Tinea cruris and those cases of tinea pedis that involve only the web spaces can be treated with any of the topical antifungal agents. Other forms of tinea pedis usually require the use of griseofulvin. Mild cases of tinea corporis also respond well to topical agents. Extensive disease and those cases with a component of follicular involvement are best treated with griseofulvin. Tinea capitis requires the use of griseofulvin. Orally administered ketoconazole therapy is rarely appropriate for either tinea corporis or capitis. Kerion on nation, if present, can be treated with intralesional steroid injections or with a short burst of systemically administered steroids.

For more info about clinial dermatology and skin care advice have a look at authors site.

What is Alopecia?

Alopecia (also known as baldness or hair loss) refers to loss or lack of hair on part of or the entire scalp and in some cases, other parts of the body. Hair loss can be temporary or permanent and can affect people of all ages. Although alopecia can occur anywhere on the body, it is most distressing when it affects the scalp. It can range from a small bare patch, which is easily masked by hairstyling to a more diffuse and obvious pattern [3, 4].

Causes of Alopecia

Causes of alopecia include,

1. Genetics

2. Prolonged fever

3. Hormonal changes, such as childbirth, use of birth control pills or thyroid disease

4. Treatment for cancer, such as chemotherapy

5. Continual hair pulling or scalp rubbing

6. Burns or radiation therapy

7. Emotional or physical stress

8. Ringworm of the scalp (Tinea capitas)

9. Some prescription medicine

(To mention a few)

Types of Alopecia

The different types of alopecia associated with loss of hair on the scalp include,

1. Androgenetic alopecia (Genetic hair loss)

Androgenetic alopecia, also known as male pattern hair loss is a major problem affecting men and is such that by the age of 50, up to 50% of men who are genetically predisposed will be affected. It is characterised by progressive, patterned hair loss from the scalp and its prerequisites are a genetic predisposition and sufficient circulating androgens (steroid hormone such as testosterone or androsterone, which promotes male characteristics). According to Sinclair (1998) every Caucasian male possesses the autosomal inherited predisposition, and as such, 96% lose hair to some degree. Sinclair also mentions that Caucasian men are four times more likely to develop premature balding than Black men. Hair loss does not usually start until after puberty with an extremely variable rate of progression [1, 5].

The condition is also fairly common in women and is referred to as female pattern hair loss. In women, “it is characterised by a diffuse reduction in hair density over the crown and frontal scalp with retention of the frontal hairline” [6]. Birch et al (2002) make mention of the fact that in some women, the hair loss may affect a small area of the frontal scalp whilst in others the entire scalp is involved. In advanced female pattern hair loss, the hair becomes very sparse over the top of the scalp bit a rim of hair is retained along the frontal margin. The vertex (crown or top of the head) balding seen in men is rare in women; however, a female pattern of balding is not uncommon in men [6]. The androgen-dependent nature or the genetic basis of female pattern hair loss has not been clearly established, although a study carried out by Sinclair et al (2005) showed that androgens play an important role in the development of female pattern hair loss.

2. Alopecia areata (AA)

Alopecia areata (AA) is a common, immune-mediated, nonscarring form of hair loss, which occurs in all ethnic groups, ages (more common in children and young adults), and both sexes, and affects approximately 1.7% of the population [8, 9]. Alopecia areata is unpredictable and patients usually present with several episodes of hair loss and regrowth during their lifetime. Recovery from hair loss may be complete, partial, or nonexistent. It is thought that 34 to 50% of patients with AA will recover within a year whilst 15 to 25% will progress to total loss of scalp hair or loss of the entire scalp and body hair where full recovery is unusual [8, 11]. It usually presents as a single oval patch or multiple confluent patches of asymptomatic (without obvious signs or symptoms of disease), well circumscribed alopecia with severity ranging from a small bare patch to loss of hair on the entire scalp. Frequent features of AA patches are exclamation mark hairs, which may be present at its margin; the exclamation mark hairs are broken, short hairs, which taper proximally. The hair loss from AA may be the only obvious clinical abnormality or there may be associated nail abnormalities. Other less common associated diseases include thyroid disease and vitiligo [4, 10, 11].

Clinical presentation of AA is subcategorised based on the pattern and extent of the hair loss. If categorised according to pattern, the following are seen;

a. patchy AA, which consists of round or oval patches of hair loss and is the most common,

b. reticular AA, which is a reticulated (networked) pattern of patchy hair loss,

c. ophiasis band-like AA, which is hair loss in parieto-temporo-occipital scalp (middle-side-back of scalp),

d. ophiasis inversus, which is a rare band-like pattern of hair loss in fronto-parieto-temporal scalp (front-middle-side of scalp), and

e. diffuse AA, which is a diffuse decrease in hair density.

[Taken from Shapiro J and Madani S, 1999]

If categorised according to the extent of involvement, the following are seen;

a. alopecia areata, which is the partial loss of scalp hair,

b. alopecia totalis, which is 100% loss of scalp hair, and

c. alopecia universalis, which is 100% loss of body hair.

[Taken from Shapiro J and Madani S, 1999]

3. Telogen Effluvium (TE)

Telogen effluvium is an abnormality of hair cycling, which results in excessive loss of telogen (resting phase of hair cycles) hairs and is most common in women. Women with this disorder would usually notice an increased amount of loose hairs on their hairbrush or shower floor. Daily loss of hair may range from 100 to 300 hairs. It is thought that TE may unmask previously unrecognised androgenetic alopecia. The most common underlying cause of TE is stress; other causes include certain diseases such as thyroid and pituitary diseases, some medication and child birth, to mention a few. In many cases however, no cause can be found. TE usually begins two to four months after the causative event and can last for several months [4, 12]. Unlike some other hair loss conditions, TE is temporary and hair regrowth is possible [4]. Telogen effluvium presents in about three forms;

a. Acute telogen effluvium, where shedding of hair is expected to cease within 3 to 6 month

b. Chronic diffuse telogen hair loss, which is telogen hair shedding persisting longer than 6 months. Common causes include thyroid disorders, acrodermatitis, profound iron deficiency anaemia, and malnutrition.

c. Chronic telogen effluvium (CTE) is the most common cause of hair loss in women, affecting 30% of females, between the ages of 30 and 60 years old, in the UK. CTE is such that there is a relative change in the proportion of growing to resting hair and in most cases, excessive shedding of hair has been present for at least 6 months. According to Rushton et al (2002) studies have shown that 95% of CTE cases arise from a nutritional imbalance involving the essential amino acid L-lysine and iron. Other common causes of CTE include drugs, thyroid disease and childbirth [1, 11].

4. Cicatricial alopecia (scarring alopecia)

Circatricial alopecia, also known as scarring alopecia, refers to a group of rare hair disorders resulting from a condition that damages the scalp and hair follicle. They present as areas of hair loss in which the underlying scalp is scarred, sclerosed, or atrophic. In other words, the disorders destroy the hair follicle and replace the follicles with a scar tissue consequently causing permanent hair loss. Conditions associated with circatricial alopecia include autoimmune diseases such as discoid lupus erythematosus, scalp trauma, infections such as tuberculosis and syphilis, and radiation therapy. Circatricial alopecia affects both adults and children, and may present as primary or secondary circatricial alopecia [4, 13].

5. Chemotherapy-related alopecia

Alopecia caused by chemotherapy may vary from slight thinning of the hair to complete baldness. The extent of alopecia depends on the choice of drugs and its dose. Drugs which cause severe alopecia include methotrexate, vinblastine, adriamycin, ifosphamide, vincristine, and taxoids to mention a few. When drugs are used in combination, which is usually the case with many treatment regimes, the incidence and severity of alopecia can be greater than usual. According to Randall et al (2005) “chemotherapy-related alopecia has been rated by patients as one of the most severe, troublesome and traumatic chemotherapy-related side effects”. Hair loss due to chemotherapy is not permanent and as such, the hair will grow back once treatment has ended [14].

6. Traumatic alopecia

This is usually a very common cause of hair loss in women of some ethnic backgrounds (particularly women of African/Caribbean descent). It is caused as a result of hair grooming techniques by the use of hair reshaping products such as relaxers, straighteners, hot combs, foam rollers and permanent wave products, as well as hair braiding methods. These techniques damage hair follicles over time [15]. Traumatic alopecia is divided into three categories;

a. Traction alopecia, which results from persistent pulling of the hair by tight rollers, tight braiding or ponytails. The use of blow-dryers, vigorous combing or brushing and bleaching of the hair can also contribute to hair breakage. Thinning begins above the ears and the forehand, and if the causative styling methods are not stopped, irreversible hair loss can result as the hair follicles are destroyed [15, 16].

b. Chemical alopecia, which results from the use of commercial relaxer and styling products. These products contain chemicals such as thioglycolates, which create curls or straighten the hair by destroying the disulphide bonds of keratin. Apart from curling or straightening the hair, these chemicals may have irritant effects on the scalp, which can result in hair shaft damage, inflammation of the scalp and loss of hair roots. All these can lead to irreversible damage of the hair follicles [15, 16].

c. Hot-comb alopecia, also known as follicular degeneration syndrome, results from the excessive use of pomades with a hot comb or iron, which leads to a gradual destruction of hair follicles. When pomade comes in contact with a hot comb or hot iron, it liquefies and drips down the hair shaft into the follicle. This results in chronic inflammatory folliculitis, which can lead to scarring alopecia and consequently permanent hair loss. Thinning usually begins at the crown and then spread evenly throughout the head. The condition is irreversible [15, 16].

Common baldness/hair loss myths

Several myths about hair loss exist, some serious, others not so serious. These myths include;

1. Male pattern baldness (as well as female pattern baldness) is inherited from the mother’s side of the family: This is not true as studies have been conducted, which conclusively suggest that it can come from either side of the family.

2. Cutting the hair can make it grow faster and stronger. When hair grows longer, it is worn down by normal wear and tear and as such gets slightly thinner around the diameter of the shaft. Cutting the hair cuts it back to where there is less wear and tear and subsequently the hair shaft is slightly thicker, giving the impression that cutting the hair makes it thicker. It would also not grow faster as hair grows almost exactly half an inch per month regardless of whether it is cut or not.

3. Wearing a hat can cause hair loss. This can only happen if the hat is prohibitively tight as any form of pulling or tightening of the hair can have some effect on hair loss; however, wearing a hat on its own cannot cause hair loss.

4. Towel drying your hair rigorously will make your hair fall out faster. This can only occur if the hair was due to fall out anyway; however you won’t be promoting additional hair loss by towelling rigorously

5. Rubbing curry on the head will help hair loss. Not only will it not work, you’re likely to smell afterwards as well.

6. Split ends can be repaired. This is not true as split ends cannot be repaired and should be cut off immediately to avoid them splitting higher and causing more damage to the hair.

7. Having a cow lick the top of your head can help hair loss. This would not help your hair loss, but might be entertaining to watch.

8. Standing on your head, or hanging upside down will increase the blood flow to the head and reduce hair loss. It is true that standing on your head or hanging upside down will increase the blood flow to the head; however, it won’t do anything to hair loss.

Quality of life and psychological aspects

The hair constitutes an integral part of our self and our identity and as such hair loss may cause a wide range of psychological problems related to our identity. Alopecia in itself has few physically harmful effects; however, it may lead to problems such as high levels of anxiety, social phobia, paranoid disorder and serious depressive episodes. The extent of alopecia is one of the predictors of the severity of psychological distress [12, 17].

There is an important link between hair and identity, especially for women. Feminity, sexuality, attractiveness, and personality, as reiterated by Hunt et al (2005), are symbolically linked to a woman’s hair and as such hair loss can seriously affect self esteem and body image. Hunt et al (2005) also stated that about 40% of women with alopecia have had marital problems as a consequence whilst about 63% claim to have had career related problems [18].

Psychological problems can also be experienced by children affected by alopecia.

Management of Alopecia

Alopecia can be managed in different ways, depending on type and severity. The various methods of management include;

1. Medical treatment such as the use of topical minoxidil, oral finasteride, topical tretinoin, exogenous estrogen, spironolactone and anti-androgens for androgenetic alopecia. The type of treatment and dose may vary depending on gender and age (i.e. adult or children).

2. Medical treatment such as the use of immunomodulatory agents (e.g corticosteroids, 5% minoxidil, and anthralin cream) and topical immunotherapeutic agents (e.g dinitrochlorobenzene and diphenylcyclopropene) for alopecia areata.

3. For hair loss caused by telogen effluvium, the underlying cause is usually treated first.

4. Cicatricial alopecia is sometimes managed using both systemic and topical therapy, this includes the use of hydroxychloroquine, topical immunomodulators (e.g tacrolimus and pimecrolimus), intralesional injections of triamcinolone, mycophenolate mofetil, cyclosporine, and isotretinoin, to mention a few.

5. When hair loss is extensive, wigs may be worn; there is also the option of hair transplantation (using minigrafts).

6. To reduce the risk of traumatic alopecia, techniques for hair grooming should be used with caution bearing in mind the sensitivity of the scalp and hair follicles. Discontinuance of styling practices may result in an abatement of hair loss and partial hair growth; this depends on the length of insult to the roots. Complete re-growth is possible if hair loss is managed early [15].

7. The use of laser phototherapy, which offers a respite from drugs, chemicals, lotions, visits to hospitals, dermatologist centres and surgery, is non-toxic, safe and can be used at home (see our new Hairbeam Phototherapy product).

Recommended Products for Hair loss

References

1. Rushton DH, Norris MJ, Busuttil N.Causes of hair loss and the developments in hair rejuvenation. Int J Cosmet Sci 2002; 24: 17-23.

2. Biondo S, Goble D, Sinclair R. Women who present with female pattern hair loss tend to underestimate the severity of their hair loss. Br J Dermatol 2004; 150: 750-752.

3. Anonymous. What should I know about hair loss? Am Fam Physician 2003; 68(1):107-108.

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Disclaimer

This article is only for informative purposes. It is not intended to be a medical advice and is not a substitute for professional medical advice. Please consult your doctor for all your medical concerns. Kindly follow any information given in this article only after consulting your doctor or qualified medical professional. The author is not liable for any outcome or damage resulting from any information obtained from this article.