Hair Loss and Scalp Conditions - Elan Clinic

Our Hair Loss Specialist Clinic in Warwickshire offers a wide range of treatments for patients dealing with hair loss and scalp issues. Over the years, we have successfully helped patients identify the right diagnosis and find the treatments that work for them.

This article covers many different parts of hair loss and scalp conditions. For ease of browsing each part can be found by selecting the tag below which will automatically take you to the relevant section of the article

Alopecia Areata

‘Alopecia’ is a general term for hair loss – from temporary and mild shedding to permanent and profuse loss – ‘areata’ simply means ‘in areas’. Alopecia Areata causes specific areas of hair loss that can appear randomly across the scalp, it can be temporary, semi-permanent (recurring) or permanent and may also affect eyebrows, eyelashes and body hair (as well as beard hair in men). A diagnostic feature of alopecia areata is the presence of ‘exclamation mark hairs’ around the perimeter of hair loss patches (so-called as they are thicker at the top and tapered at the root area – representing an ‘exclamation mark’). Inflammation within the hair follicle is a symptom (but not one that is visible), in some rare cases, patches of alopecia areata can expand, overlap and progress to total hair loss (alopecia totatlis).

Alopecia areata is widely accepted to be an autoimmune disorder, a condition where your own immune system attacks the body, mistaking certain hair cells as foreign enemies and attacks them. What triggers this response isn’t entirely understood, but 90% of cases are associated with stress, shock, bereavement, an accident or illness or genetic factors. Alopecia areata is also more common in those that suffer from Addison’s disease, hayfever, eczema, pernicious anaemia, rheumatoid arthritis, ulcerative colitis, lichen planus, diabetes mellitus, vitiligo, lupus and thyroid disease.

*Alopecia areata affects approximately 4% of the population (90,000 in the UK alone).

*Approx: 98% of those diagnosed recover.

Alopecia areata can affect all ethnic groups and ages
It is most likely to occur between the ages of 20 and 50.
It occurs equally in both men and women.

Alopecia Treatments

In many cases, alopecia areata may resolve itself within a year – but there are also treatments available to help encourage remission.

1. Corticosteroid Injections

Corticosteroid injections are considered an effective treatment, particularly when used on small patches. They are administered every few weeks and can be used to treat hair loss on the scalp, eyebrows and body. They work by suppressing the immune system so that it no longer attacks the hair follicles (side effects may include pain at the injection site and thinning of the skin).

2. Topical corticosteroids

Topical corticosteroids are applied daily to affected scalp areas (but cannot be used on your face or body). Possible topical creams and gels include: betamethasone, hydrocortisone and mometasone. They work also work by suppressing the immune system (side effects may include acne and thinning of the skin).

3. Ultra-violet Rays

U.V rays work by lightly inflaming the scalp causing your immune system to focus on the hair cells affected, which can encourage the hair to regrow.

Telogen Effluvium

Telogen effluvium is a form of diffuse hair loss that occurs when the anagen (growth) phase of the hair growth cycle is disturbed by an internal trauma or event, subsequently triggering many more hairs than usual to move from anagen into the telogen (shedding) phase, resulting in excessive diffuse hair shedding.

Telogen effluvium can be either acute or chronic depending on the severity and time involved (hair loss may occur 6 – 12 weeks after the causative event).

On average, we may lose naturally up to 100 – 120 hairs a day, however, telogen effluvium can result in as many as 300 hairs being shed in a single day! What is noticeable is the amount of hair coming out when you brush and style, when you shower and the amount of hair that appears on your clothes, bedding, carpet and in your car.

Telogen Effluvium may be caused by a wide range of factors that include, iron deficiency, ferritin (stored iron) deficiency, protein deficiency, shock, rapid weight loss, crash dieting, stress, high fever, sepsis and pregnancy.

Treatment for Telogen Effluvium

Telogen Effluvium resulting from short-term illness or stress will often resolve itself. However, chronic telogen effluvium may require appropriate nutritional supplements, relaxation therapies or the removal of causative factors. Blood tests may be very helpful and are strongly recommended if you have noticed hair loss for 6 weeks or more (telogen effluvium is almost always a temporary type of hair loss with hair regrowth once causative factors are resolved).

Fine / Flat Hair

Over 1 in 5 women in the UK experience a reduction in hair volume, this may be a result of a gradual reduction in the thickness of individual hair strands. Commonly known as ‘androgenic thinning’ it is related to androgens (male hormones) and is genetically determined (both men and women have a percentage of male hormones).

A Reduction in hair volume may be influenced by many different factors, e.g. diet, stress and hormonal or metabolic imbalances. However, a genetic predisposition to follicle sensitivity is always a factor, causing the anagen (growth) phase to gradually shorten and follicles miniaturise and produce finer, shorter hairs during each successive hair growth cycle (this can occur on its own – or alongside increased hair shedding.) As this process takes place over an extended period of time, treatment may also take time. However, there are effective products available to help slow the thinning and improve hair density.

Traction Alopecia

Traction alopecia is a type of hair loss caused by aggravated pulling on the hair. It is most commonly seen in women who wear weaves, tight braids, hair extensions and tight ponytails or buns, or as a result of excessive or harsh styling techniques.

Traction alopecia is commonly seen on the front hairline and the margins of the hairline, where most pressure is exerted, resulting in an obvious recession of the hairline and breakage along with the temples and front of the scalp. The use of tight rubber bands may also cause breakage of strands throughout the hairs’ mid-lengths.

If diagnosed in its early stages, traction alopecia is reversible, but over a prolonged period irreversible damage can be done.The constant pulling of the hair eventually distorts and atrophies the follicle, weakening the hair and causing it to grow finer and shorter. Severe and prolonged instances may result in permanent scarring, which means that the hair will not regrow.

Cosmetic & Traumatic Scarring Alopecia

Permanent scarring alopecia is a ‘secondary’ cicatricial alopecia. In this case, the term ‘secondary’ scarring is describes hair loss due to external damage to hair follicles.

This may include causative factors such as: cosmetic burns, hair styling tools, radiotherapy, chemical straightening/smoothing/colouring and any trauma involving the scalp, e.g. a car accident, a bad fall, an operation. Such hair loss may either be immediate, or cumulative as a result of repeated damage.

Frontal Fibrosing Alopecia

Frontal fibrosing alopecia (FFA) is a ‘primary cicatricial alopecia’ (encompassing a group of hair loss disorders in which the hair follicle is irreversibly damaged and replaced by fibrous tissue); this results in permanent hair loss along the frontal hairline.

Other areas of hair loss may include the top or back of the scalp, eyebrows, eyelashes, eyebrows and body hair.

FFA is most common in middle-aged or older women. Upon examination – the scalp shows alterations in the front hairline, including scattered isolated hairs or ‘lone hairs’. Thinning of the skin is often associated with FFA – resulting in more readily visible veins. The actual cause of FFA is currently unknown – although hormonal abnormalities may be present in some women.

Unfortunately, as with other scarring conditions, there is (as yet) no successful treatment for areas where scarring hair loss is already present, although topical applications (steroid creams) can help prevent the condition from progressing.

Common signs in Frontal Fibrosing Alopecia Diagnosis:

1. Eyebrow loss is common, often it is the first sign – although not always recognised

2. Both areas of the hairline in front of the ear have receded .

3. Fine/short hairs are no longer present in the front hairline. Instead there are individual long hairs. There is often a faint ‘redness’ around the base of the hair.

4. Veins may be more visible (scalp/front hairline) and the skin itself often seems smoother and ‘paler’ in colour.

5. The average age for FFA is 46 – 66

Frontal fibrosing Alopecia is a complex condition, as with many conditions there is no ‘one way’ that it appears – it can present in many variations and diagnosis should be performed by a registered trichologist.

Thyroid Dysfunction

The thyroid is a gland that regulates metabolism, its function may be affected by many things, including pregnancy, menopause, nutritional deficiency, medications or a genetic predisposition.

Thyroid function is important as it is involved in the production of proteins. Having either a hypothyroid (low) or a hyperthyroid (high) condition can cause hair loss, hair thinning or reduced hair growth. Both are easily diagnosed by blood test analysis, however, readings just within the normal range may require further investigation if you are experiencing hair loss. Thyroid Conditions

Symptoms of Hyperthyroid can include:

High blood pressure
Rapid heartbeat
Increased sweating
Insomnia
Weight loss (despite increased appetite)
Bulging eyes
Hair thinning
Slower pulse
Hoarse voice
Intolerance to cold
Weight gain
Some loss of eyebrow hair
Thinner and dryer hair

If you begin to notice any of these symptoms, we suggest you consult with your doctor.

Once your thyroid is being treated by your doctor, there are particular hair products we can recommend to help promote hair regrowth, strengthen hair and combat loss.

Trichotillosis

The compulsion to pull, twist or constantly ‘play’ with your hair can cause thin or bald patches. If hair grows back but is repeatedly pulled out over a prolonged period, the hair follicles can be irreversibly damaged, resulting in permanent hair loss. Trichotillosis may also affect the eyelashes and eyebrows. The act of pulling out a hair can provide some feelings of satisfaction, making it hard to stop.

This is an extremely emotional and distressing condition, and it is best to consult a doctor, psychiatrist and/or trichologist for advice.

There are often underlying causes; ranging from anxiety, stress, depression, or a traumatic experience, which appears to particularly effect children and young persons. A diagnostic feature of this condition is uneven hair breakage, and a pattern of hair loss that is usually worse on the right side of the scalp if you are right-handed and vice versa if you are left-handed.

Treatments for trichotillosis will take time, but generally (unless the follicle has extensive damage) hair can grow back. Sometimes, If it has been going on over a long period of time, it may be finer, less dense or a different texture – but improvement is possible.

Chemotherapy

During chemotherapy treatment the drugs used can have a toxic effect on other parts of your body, including your hair, causing it to bypass the normal shedding (telogen) phase, and fall out excessively in the hairs’ growing (anagen) phase, this typically occurs within 4-6 weeks of starting treatment (some chemotherapy does not result in hair loss). Some people undergoing chemotherapy prefer to shave their heads before it falls out – allowing them to gain a certain amount of ‘control’. It may at least be advisable for those with long hair to have a shorter style. Other ways to help cope with hair loss is to wear a hairpiece or a wig, which we can provide expert advice and help with, as we have our own ‘elan’ collection of both synthetic and human hair ultra-realistic wigs.

Hair lost as a result of chemotherapy does grow back and there are methods to help reduce hair fall.

Cold Caps

Cold caps are tightly bandaged ice packs around the head, which inhibit the flow of the chemical therapy around the head. Some hair loss will still occur, but not to the extent one would normally expect. However, cold caps can be extremely uncomfortable and some may find the amount of hair saved does not warrant their use.

Post Chemotherapy

In almost all cases, hair grows back after chemotherapy, but it may grow back differently, resulting in a change of colour and texture. It could also initially grow back fine and fluffy. This is only a preliminary change, until the follicles produce mature hairs.

Radiotherapy

Localised radiotherapy can cause hair loss in the treated area, If the area is the scalp, then any hair follicles in direct contact are permanently destroyed. Hair transplantation can be extremely successful, but, as with other forms of surgery, it is essential that you are referred to the best specialists.

Blood Tests

The information blood tests can provide is often crucial in the diagnosis of hair loss and other hair conditions. We may wish to consult (with your permission) your general doctor and any other relevant medical specialists about your blood test results. Blood tests can be administered at your doctors’ surgery who then sends the blood to a laboratory for analysis. We then ask that you forward the results to us for further analysis. Alternatively, you may seek to have blood tests via a private clinic.

Medication & Hair Loss

A common cause of hair loss is the use of medications, drugs and the overuse of vitamin or mineral supplements. While medications can potentially cause some hair shedding, they might not do so in everyone. Although the percentage of hair loss from many drugs is very small, it’s a factor to consider – If you begin to lose your hair after starting a new prescription (such hair shedding may occur between 6 weeks and 3 months after starting a course of medication). If you are prescribed medication that lists hair loss as a possible side effect, it is important not to become immediately concerned, often it may have no such effect at all – or only a slight or temporary effec t

Hair loss and hair thinning in women

Hair loss and hair thinning in women can be caused by a wide number of factors, these may include:

stress
genetic disposition
poor health
improper diet
nutritional deficiencies
thyroid dysfunction
chemotherapy
traction alopecia
trichotillosis
hormonal imbalances
menopause
follicle sensitivity

With so many possible causes, it is necessary to get an accurate diagnosis from your doctor or a trichologist. Clinical examination and a recent blood test are vital aids in determining the cause of any hair loss and/or hair thinning.

Menopause

Menopause almost always has an affects on your hair. Symptoms may include dullness, dryness and thinning of your hair, hot flashes, mood changes, decreased sexual desire and increased facial hair.

Although 50 is the average age for menopause, changes to your hair can begin at an earlier age (nobody over 40 has the same volume of hair they had in their twenties).

Common symptoms include a gradual reduction in the thickness of each strand, a recession of the front hairline and temples and increased hair shedding.

Polycystic Ovarian Syndrome (PCOS) and Hair Loss

PCOS may cause hyperandrogenism – an overproduction of androgens (male hormones), which affect the degree and frequency of bleeding during your menstrual cycle and may also cause acne and oily skin. Follicle sensitivity is genetically inherited – If your hair follicles are affected you may experience a decrease in the growth of hair on your scalp and increase in the growth of hair on your body.

Treatment for Hair Loss caused by PCOS

Treatment for PCOS may be complicated – unless hair loss is the only dominant symptom, then treatment may be relatively straightforward. Hair thinning from PCOS is treated by orally and/or topically taking anti-androgens – the most common oral anti-androgens used for hair loss are combination oral contraceptives (e.g. Spironolactone or Dianette), but oral and topical solutions combined prove to be most effective.

Hair Loss During And After Pregnancy

Post-partum hair loss can occur a few months after giving birth (due to raised oestrogen levels dropping back to normal levels), although this can be worrying, it is only a temporary condition.

You may find less hair than normal is shed during pregnancy, so your hair will often feel much thicker (due to the temporarily raised oestrogen levels keeping your hair in the growing (anagen) phase for longer than usual).

Male Pattern Hair Loss

Although hair loss and hair thinning are experienced by the majority of men as they age, there are things that can be done to improve thinning hair, including reducing loss, increasing the diameter of individual hairs and promoting new growth

Follicle Miniaturisation

Male pattern hair loss usually occurs gradually over a long period of time, so it may not be noticed when its symptoms first appear. Generally, individual hairs become finer and thinner in diameter, and shorter during each hair cycle. Although follicle miniaturisation may occur in both men and women, it is more common and pronounced in men.

Thinner hairs obviously result in less volume and can get so thin and short (miniature) that they are no longer visible.

When a hair reaches a diameter of 40 microns, it seldom grows longer than 80mm (3.5 inches).

Follicle miniaturisation can often be slowed, and sometimes reversed, with topical and/or oral treatments.

Oral Treatments for Male Pattern Hair Loss

Finasteride (Propecia)

Internal treatments are designed to control your body’s conversion of testosterone to the more potent dihydrotestosterone (DHT) – (the male hormone that causes miniaturisation of hair follicles).

Propecia blocks type II, but not type I of the enzyme responsible for hair loss, so men with type I of the enzyme may not see results. If you stop taking Propecia, the beneficial effects will start to wear off after 6 months, and by 12 months your hair will have reverted back to its original state before treatment.

Possible Side Effects of Propecia

Including, but not limited to: erectile dysfunction, decreased libido, inability to ejaculate.

External topical Treatments

Minoxidil (Regaine)

Minoxidil (Regaine) is an external topical treatment for hair loss which dilates blood capillaries, it is clinically proven to help stop and even reverse hereditary hair loss, by reactivating your inactive hair follicles.

The exact mechanism by which minoxidil stimulates hair growth is not fully understood, but it can reverse the hair loss process of androgenetic alopecia by the following means:

*Increasing the diameter of the hair shaft.

*Stimulating anagen growth.

*Prolonging the anagen phase.

*Stimulating anagen recovery from the telogen phase.

Visit our Hair Loss Specialist Clinic in Warwickshire to have a consultation with our expert hair loss specialists. We will be able to assess your condition and find a treatment that works for you. We understand how frustrating it is to deal with this alone and this is why we are committed to finding a solution to your hair and scalp disorders. With a proven track of successful patients that have regained their confidence, you can count on our expert treatments and years of experience in this field.

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