Hair says it all. The way we cut, style, and dye it often represents who we are. But it’s about more than just aesthetics. It also has many important functions: for example, preventing heat loss from the skin or (in the case of eyebrows) keeping sweat out of the eyes.
Hair can also be a reflection of what is going on inside our body. Many diseases can alter the quality and appearance of our hair. Paying attention to its appearance can give us clues about the state of our health.
The hair cycle
Some of the tiniest organs in our bodies are the follicles, which produce and nourish hair. Hair can only grow where follicles exist.
Hair growth is a complex process. Each tiny follicle goes through several cyclical stages. The first is active hair growth (the “anagen” phase) before it stops (the “catagen” phase). The hair is then lost or shed from the follicle (the “telogen” phase).
Many factors, from genetics to hormones and age, can affect these follicles and their growth.
Excessive hair growth
Hypertrichosis is a condition in which hair grows excessively all over the body. In most cases, it is a reaction to starting a new medication, such as phenytoin, which is used to treat epilepsy. But it can also be caused by diseases such as anorexia and AIDS.
Some medical conditions also cause hair to grow in places where it shouldn’t. In newborns, the appearance of tufts near the base of the spine may indicate spina bifida occulta. This occurs when the lower vertebrae of the spine have not formed properly, leaving the delicate spinal cord covered only by skin.
The reasons for these conditions and their ability to trigger hypertrichosis remain poorly understood.
Hirsutism is another condition in which hair grows excessively, but in a typically male pattern: on the face, lips, chest, and arms. This is due to androgen hormones, specifically testosterone, which at high levels promote hair growth in these regions. This can be seen in polycystic ovary syndrome.
Hair loss
Hair may also begin to fall out in abnormal amounts, becoming thinner or absent in certain areas of the body. The medical term for hair loss is alopecia and it can be localized or generalized. The causes of alopecia are multiple and include infections, iron deficiency anemia, low thyroid hormone levels, and the use of medications (including chemotherapy).
Age, gender, and genetics are also to blame. Male pattern baldness occurs at the hairline and crown. It is influenced by the hormone testosterone, which shortens the hair growth phase and makes it thinner. Most men with male pattern baldness will begin to notice hair loss by the age of 20-25.
Female pattern baldness, on the other hand, usually affects the front hairline first and causes hair thinning rather than complete hair loss. The role of testosterone is more debatable in women but is attributed to a hormonal cause, as thinning is more common around and after menopause.
Hair loss can also be caused by pulling. Tight hair styling can cause traction on the follicle and loss of hair integrity. Some people may also pull out their hair out of habit. This is called trichotillomania.
Treatment of hair problems
Helping hair grow back may be as simple as treating the underlying condition causing it. Another treatment to consider is the drug minoxidil. It was initially developed for hypertension but was found to also promote hair growth. This may be due to a direct effect on hair follicles or improved blood flow to the scalp. These uncertainties may explain why some patients experience good improvement and others do not.
Hair transplants are also a possible remedy, as they relocate hair crops to bald areas. There are two ways to do this: several small, “punched” grafts can be repositioned, or a larger strip of skin can be repositioned. The grafts are taken from the patient’s hairy skin: this is an example of an autograft.
Sometimes the presence of hair in visible areas is undesirable, and there are certain treatments to stop excessive growth. Apart from traditional hair removal methods, the contraceptive pill and other medications that regulate the influence of hormones on hair (such as finasteride) can be considered in cases where the cause is a hormonal condition (such as polycystic ovary syndrome).
Analyze your hair.
To get a better idea of the health of your hair, you can perform a simple test at home, known as a hair pull.
Select a group of 30 to 50 hairs (a small clump) and run your fingers from the base of your scalp to the tips. You don’t need to pull hard; gentle pulling is enough to dislodge a hair that is falling out. Note how many you have pulled out.
Typically, a single tug will dislodge one or two hairs, but this can vary from person to person. If there are more than ten, your scalp is probably shedding more hairs than usual. This could be indicative of alopecia, although a closer inspection by a dermatologist can help you figure out if your hair loss indicates a more serious problem.
Changes in your hair may not simply be due to age or hairstyle. There are many patterns of hair growth and loss to be aware of. Pay attention to any differences that you or your hairdresser notice.
