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EYEBROW HAIR LOSS

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thinning-eyebrow

Eyebrows like the hair on our scalp can also thin out. This can be a troublesome matter as they can affect our overall facial appearance significantly.

Causes

Some of the causes that eyebrow hair fall out arises from our daily habitual activities - excessive plucking, constant rubbing of eyebrows, or vigorously applying eyebrow pencil, can cause eyebrows to fall out. Eyebrow hair can thin with aging, just as scalp hair can.

Telogen effluvium

This is a temporary condition where excessive hair falls out that can affect eyebrows as well as scalp hair. This is a normal "resting" stage of hair growth that can occur periodically. It can also be triggered by medications, stress, trauma, or medical conditions. It can be a fairly rapid type of hair loss. It is more noticeable when hair is also being lost through normal aging.

Medical conditions

"Hertzoge's sign" is a medical condition that causes a loss of hair on the outer third of the eyebrow. This is sometimes associated with low thyroid conditions (hypothyroidism) or endocrine imbalances. Alopecia areata, an autoimmune condition where a person's own antibodies attack hair follicles, creating patches of hair loss on the scalp and also can affect eyebrows and other areas where hair grows. Eczema can sometimes be associated with loss of eyebrows, often from scratching. Some medications may cause loss of eyebrows and scalp hair.

If you experience rapid loss of eyebrow hair, see your doctor to determine if an underlying medical condition or medication is causing the hair loss. If the cause is simply aging, gently applying eyebrow cosmetics can help. If the cause is telogen effluvium, Eyebrow Rogaine may be helpful in diminishing hair loss.

When Should I seek Medical Help

If you experience rapid loss of eyebrow hair, you can seek medical specialist to determine if an underlying medical condition or medication is causing the hair loss. If the cause is simply aging, gentle application of eyebrow cosmetics can help. If the cause is telogen effluvium, certain topical medication Growell (Minoxidil) may be help, another option is eyebrow transplant.

FEMALE PATTERN HAIR LOSS (FPHL)

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female-pattern-baldness

Hair loss often has a greater impact on women than on men, because it's less socially acceptable for them. Alopecia can severely affect a woman's emotional well-being and quality of life.

Female pattern hair loss (FPHL) is also otherwise known as androgenetic alopecia. As many as around 40% of women by age 50 show signs of hair loss and less than 45% of women actually reach the age of 80 with a full head of hair. As many as two-thirds among postmenopausal women suffer hair thinning or bald spots. 

Symptoms

FPHL is quite different from the male pattern baldness, which usually begins with a receding frontal hairline that progress to a bald patch on top of the head. 

In women, androgenetic alopecia begins with gradual thinning at the part line, followed by increasing diffuse hair loss radiating from the top of the head. A woman's hairline rarely recedes, and women rarely become bald unless there is excessive production of androgens in the body. However, some women may develop some hair thinning at the frontal hairline with normal aging.

The Ludwig (Savin) Scale Of Female Pattern Baldness

There are 3 types of FPHL as illustrated in the Ludwig (Savin) Scale Of Female Pattern Baldness:female-pattern-baldness

 The first image (labeled I-1) is a woman with no hair loss in the central parting of a woman. The images 2 to 4 (labeled I-2, I-3, I-4) the width of the parting gets progressively wider indicating thinner hair along the center of the scalp. The images labeled II-1 and II-2 show diffuse thinning of the hair over the top of the scalp. The image labeled III represents a woman with extensive diffuse hair loss on top of the scalp, but some hair does survive. The image labeled “advanced” represents a woman with extensive hair loss and little to no surviving hair in the alopecia affected area. Very few women ever reach this stage and if they do it is usually because they have a condition that causes significant, abnormally excessive androgen hormone production. The last image in the Savin scale is somewhat different, it shows a woman with a pattern of hair loss that is described as “frontally accentuated”. That means there is more hair loss at the front and center of the hair parting instead of just in the top middle of the scalp.

Causes

FPHL is closely related to genes although the mode of inheritance is not determined. There are many genes that contribute to this condition, and these genes could be inherited from either parent, or both. 

Currently, it is unclear if androgens (male sex hormones) play a role in FPHL, although androgens have a clear role in male pattern baldness. Many women with FPHL have normal levels of androgens in their bloodstream. Due to this uncertain relationship, the term FPHL is preferred to ‘female androgenetic alopecia’.

FPHL is more common after the menopause suggesting oestrogens may be stimulatory for hair growth. But laboratory experiments have also suggested oestrogens may suppress hair growth.

In either sex, hair loss from androgenetic alopecia occurs because of a genetically related shortening of anagen, a hair's growing phase, and a lengthening of the time between the shedding of a hair and the start of a new growth phase. (See "hair growth cycle") That means it takes longer for hair to start growing back after it is shed in the course of the normal growth cycle. The hair follicle itself also shrinks and produces a shorter, thinner hair shaft resulting in thicker, pigmented, longer-lived "terminal" hairs being replaced by shorter, thinner, non-pigmented hairs called "vellus."

Progress of FPHL

FPHL can affect women in any age group but it happens more commonly after menopause. The hair loss process is not constant and usually occurs in fits and bursts. It is common to have accelerated phases of hair loss for 3 to 6 months, followed by periods of stability lasting 6 to 18 months. Without medication, it tends to progress in severity over the next few decades of life.

Should I Seek Medical Help?

Majority of women affected by FPHL do not have underlying hormonal abnormalities. However a few women with FPHL are found to have excessive levels of androgens. These women tend also to suffer from acne, irregular menses and excessive facial and body hair. These symptoms are characteristic of polycystic ovarian syndrome (PCOS) although the majority of women with PCOS do not experience hair loss. Less often, congenital adrenal hyperplasia may be responsible.

A clinician diagnoses female pattern hair loss by taking a medical history and examining the scalp. She or he will observe the pattern of hair loss, check for signs of inflammation or infection, and possibly order blood tests to investigate other possible causes of hair loss, including hyperthyroidism, hypothyroidism, and iron deficiency. Unless there are signs of excess androgen activity (such as menstrual irregularities, acne, and unwanted hair growth), a hormonal evaluation is usually unnecessary.

MALE PATTERN HAIR LOSS (MPHL)

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male-pattern-baldness

Male Pattern Hair loss is also known as androgenic alopecia, is the most common type of hair loss affecting almost 70% of men at some point of their life. It usually follows a pattern of receding hairline and hair thinning on the crown, and is caused by hormones and genetic predisposition. 

Symptoms

Male pattern baldness usually starts at the hairline, and gradually moves backward to forms an "M" shape. Eventually the hair becomes finer, shorter and thinner, creating a U-shaped pattern of hair around the sides of the head. This has been referred to as a 'Hippocratic wreath', and rarely progresses to complete baldness.

The Hamilton – Norwood Diagram

In order to classify the stages of MPHL, hair restoration doctors use a 50-year-old system that compares the patient’s hair loss pattern to a set of black and white drawings. The system was introduced by Hamilton in 1951 and improved by Norwood in 1984. The Hamilton-Norwood classification provides 12 categories into which the hair loss pattern must be placed.male-pattern-baldness

Causes

The role of male hormones in MPHL has been considered since ancient times when Hippocrates and Aristotle observed the absence of baldness in eunuchs.

Now it is understood that the metabolism of testosterone to 5-alpha-dihydroxytestosterone (DHT) is catalyzed by the enzyme 5-alpha-reductase. DHT, a metabolite of testosterone, is the principal causative agent of MPHL. 

Studies have shown that balding scalp contains higher levels of 5-alpha-reductase and DHT than non-balding scalp. 

Fortunately, the drug Finasteride (Propecia), an inhibitor of 5-alpha-reductase, is proven to be the most effective medical treatment for MPHL.

MPHL also has a strong genetic component that is easily shown from family history.

When to Seek Medical Professional Help

  • When your hair loss occurs in an abnormal pattern, including rapid and widespread shedding, hair loss in patches, or frequent hair breakage.
  • When it occurs with itching, skin irritation, redness, scaling, pain, or other symptoms.
  • When the hair loss begins after starting a medication.
  • When it is affecting your self-esteem, causing anxiety or inconvenience in daily life.

MPHL can usually be diagnosed based on the appearance and pattern of the hair loss. However, a detailed skin biopsy, blood tests, or other procedures may be needed to diagnose other disorders that cause hair loss.