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Hair Loss: Types, Management and Effects on Mental Health

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Hair loss is a medical condition that is experienced by almost everyone at some point in their lives. Even if it is easy to confirm by visual inspection, there are a lot of factors to be considered and usually, it is hard to rule out a single cause. Asians have the lowest incidence of hair loss, but those who are affected can still face serious health consequences and damage to self-esteem.

Diagnosis

The cause of hair loss should be determined to know the appropriate treatment. The following symptoms may warrant a doctor’s consultation:

  • Unsure of the cause of hair loss
  • Sudden onset of hair loss
  • Itching or pain on the scalp
  • Generally not feeling well
  • Easily tired

Types of Hair Loss

To treat hair loss accordingly, it is categorised into three major types: scarring alopecia, non-scarring alopecia, and structural hair disorder. 

1. Scarring Alopecia

  • Characteristics: Irreversible and permanent hair loss
  • Causes: Mostly idiopathic, some factors include ageing, race, or trauma/surgery on the scalp
  • Conditions: Keratosis follicularis spinulosa, tinea capitis, neoplasms, radiation therapy

2. Non-scarring Alopecia

  • Characteristics: Reversible, spontaneous or medication-induced hair growth is possible
  • Causes: Prolonged pressure on the scalp, prolonged pull or tension (e.g. tight hairstyles) chemotherapeutic agents, stress, childbirth, dietary restriction, certain medications, arsenic/thallium/mercury poisoning 
  • Conditions: Congenital Triangular Alopecia, Trichotillomania, Loose Anagen Syndrome, other conditions with scalp affectation like Psoriasis and Dermatitis

3. Structural Hair Disorder

  • Characteristics: brittleness and fragility of hair; can be inherited or acquired, may also appear as “split ends”, may lead to permanent hair loss
  • Causes: Harmful hair routines such as excessive teasing, excessive brushing, excessive heat application, and constant exposure to chemicals and chemical processing
  • Conditions: Menkes Disease, Monilethrix, Trichothiodystrophy, Bamboo Hair Deformity

Psychosocial Effect

Both women and men experience hair loss at an older age due to hormonal changes and genetic predisposition. They are all susceptible to hair loss-related stress and reduced self-esteem, but women tend to get more affected by it. They experience a more negative body image and less sense of control over their lives. Their perception about their hair loss is usually greater and more severe than the objective findings of the clinician, especially for adolescent girls. Seeking psychological help should be considered to avoid problems with school, work, and relationships.

General Intervention

The following are usually prescribed by the doctor:

  • Treating associated health problems
  • Discontinuing or replacing drugs that cause hair fall
  • Local, topical, or systemic corticosteroids
  • Immunotherapy 
  • UV laser

Cosmetic options:

  • Hair wigs
  • Hair extensions
  • False eyelashes
  • Make-up
  • Temporary tattooing of eyebrows

Preventing Hair Loss

  • Good water hydration
  • Avoiding smoking and alcohol
  • Eating a balanced diet with sufficient protein and enough caloric intake
  • Stress management and relaxation techniques
  • Use of more water-based and organic hair products
  • Avoiding products with sulfate, paraben, silicone, phthalates, fragrance, synthetic colours, formaldehyde, propylene glycol, and coal tar

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