Hair Loss & Hair Thinning
Our hair is one of the main features and important characteristics on our bodies. Having ‘a bad hair day’ almost certainly reflects in our mood, so you can imagine the devastation of losing one’s hair. Some people are so self-conscious or embarrassed that they can become a social recluse and cannot even confide in their partners about their problem.
Not only is our hair of huge psychological importance to us, it is also often a barometer of our health. The hair is the second quickest dividing cell in the body, therefore often one of the first things to suffer as an associated sign of an underlying medical condition or nutritional deficiency. Trichologists help to diagnose, offer advice and treat hair and scalp problems, including some forms of alopecia or scaly, dry or greasy scalps. When necessary it may be appropriate to liaise with a client’s GP for medication, refer them to a dermatologist, or request a blood test where an underlying medical problem is suspected.
There are up to 50 different identifiable causes, sometimes multi-aetiological, for a hair loss or thinning problem. At the NHSC, an in-depth consultation is undertaken so as all possible reasons for your problem can be identified, with successful diagnosis giving you an accurate prognosis.
Patients visiting the clinic with a hair loss problem could be experiencing male- or female-pattern baldness, thinning hair, alopecia bald patches, breakage, losing lots of hair when they wash it and sometimes an itchy, sensitive scalp combined with hair loss too.
It can be very distressing to see excess hair lost when washing, brushing or finding around the house and can heighten our anxieties of losing the majority of our hair. It is a natural worry to fear the hair not coming back, or how to conceal it on a daily basis when it continues to fall out. The NHSC realises how soul destroying this is, but our Trichologist’s extensive training delivers a 100% success rate in identifying the cause of your hair loss, allowing us to offer solutions for how you can improve your situation.
Quite often patients come to the clinic saying the results of blood tests from their GP were found to be "normal" and that "everything was tested", therefore being dismissed by the GP and leaving the patient with little faith of finding the cause of the problem. We ask patients to bring in a copy of the results from their GP, as while some tests are deemed satisfactory for medical health, as Trichologists we know they are not adequate for optimum hair growth. Also through clinical evidence gathered from medically qualified members and dermatologists of the IOT, we are guided toward specific tests to conduct for hair that the GP would not necessarily employ.
Treatments can therefore vary between patients dependant on the causative factors. Sometimes it can be 2 or 3 factors combined and it is possible to have multiple types of different hair loss at the same time, exacerbating and complicating matters. This highlights the importance of seeking the correct diagnosis from a qualified Trichologist, as your condition will not improve if there are still underlying issues to address.
All treatments are ethical and we will fully explain how they work for the type of hair loss you are experiencing. Hand outs are given on your condition and personalised hair nutritional advice is given. Affordable treatments for home use are £20-£45 per month dependent on the diagnosis.
Male and Female Pattern Baldness
Male and female baldness may also be known as male/female pattern alopecia, or androgenetic alopecia, and may be caused by a few factors, one of them being the hormone testosterone.
Androgens (or testosterone – the male sex hormone) are present in both males and females, and when an individual becomes sensitive to it, it can gradually shrink the hair follicle over a period of time on certain areas of the head.
In males, the first onset is usually the frontal hairline, which begins receding at the temple area. By the age of 25, a quarter of all males may be experiencing some form of thinning; by 50 there may be as many as half of men showing thinning to the frontal hairline or the top of the head. Men experiencing baldness frequently choose to crop their hair short. For some, the taunting and social stigmas associated with alternatives such as hairpieces or ‘miracle cures’ being perceived as vanity result in deepening feelings of self-consciousness.
In females, baldness (pattern alopecia) is usually presented by a different pattern of loss compared to the areas affected by men. Women usually keep their frontal hairline and can notice their parting is becoming wider apart. They are often affected a decade later than men, however any hormone levels changing in our body can lead us to become susceptible to a sensitivity to the testosterone hormone. In the sensitive individual, testosterone in the hair follicle is converted into the more potent dihydrotestosterone (DHT) by the enzyme 5-alpha reductase and shrinks the hair follicle with each succeeding hair cycle.
There are only two licensed products on the market which Trichologists recommend or use; many lotions and potions are available on the market claiming to re-grow lost hair – often at great cost too. Licensed products either help stop the specific hormone DHT (dihydrotestosterone) being converted into the hair follicle or help stimulate the blood to the surface and create a side effect to produce hair. These products have to be used for life and are dependent on the sex of the patient and suitability of the individual.
The NHSC has the tools, knowledge and ability to measure individual hairs with our Trichoscope digital scalp camera. This allows us to monitor your condition, compare results and observe the progress of your treatment plan in any future follow up appointments. We can also help rebuild your confidence by offering advice on camouflage methods to thicken/disguise your hair loss or even refer you to a hair system specialist (a bespoke hair piece) or a reputable hair transplant surgeon if desired.
Scarring can be caused by a number of factors. Auto immune disorders such as as lichen planopiliaris, frontal fibrosing alopecia, folliculitis decalvans and lupus are all but a few that can destroy the hair follicles, preventing it from growing back. Spotting a condition early enough may help prevent the condition spreading further across the scalp to other hair follicles with appropriate referrals and treatment.
Any abrasions “picked at” on the scalp, whether it is anything from a simple dry spot or a burn from chemically relaxing or bleaching the hair may become secondary infected. In some incidents the bacteria under our fingernails may cause an infection to the lesion and cause cicatricial (scarring) alopecia.
Traction alopecia due to tight ponytails, heavy hair extensions, tight plaiting or repeated harsh use of straightening irons are also prime factors of scarring alopecia when employed over a period of time. Follicles decrease in size and can be eventually destroyed, resulting in patches of sparse or missing hair.
Non-scarring alopecia will grow back in time due to the hair follicles still being present (alopecia totalis and universalis is debatable).
A disruption of the hair growth cycle is evident in anagen effluvium and telogen effluvium. Anagen effluvium is the result of a direct toxic shock to the hair follicle, usually due to drugs such as those used in chemotherapy. The hairs are shed en masse and break at the hair’s bulb (but with the bulb remaining intact). Removal of the insult will resume normal growth as the bulb had temporarily stopped its usual growth process.
Telogen effluvium is a common complaint within the Trichology clinic, affecting a proportion of the whole scalp. The normal hair cycle consists of an 85% actively growing phase (anagen), a small transitional (catagen) stage and a 12% falling out (telogen) period. Factors such as medication, radical diets, iron deficiency, pregnancy, thyroid imbalances, stress, illnesses, surgery and accidents are just a few things that can alter these ratios, resulting in a more noticeable hair loss that can be seen in the shower plughole, or come out when we comb or brush it.
Alopecia areata is a non scarring condition noticed by one or more small patches of hair loss on the scalp, but in more severe cases it can take the form of larger patches or areas around the periphery of the hairline. Its prognosis is unpredictable and is caused by an auto immune gene combining with an external trigger to cause the onset of the disorder. Alopecia areata may also affect other areas of hair, for instance the fingernails or men’s beards due to our immune system attacking the hair follicle, believing it is a foreign entity.
Some other forms of hair loss a Trichologist can diagnose are general diffuse thinning, fungal infections (ringworm) and trichotillomania (the need to pull out one’s hair).