DANDRUFF
Dandruff is a common scalp condition in which small pieces of dry skin flake off from the scalp and is usually associated with itching. Dandruff is considered to be a mild form of an inflammatory disorder of skin called “Seborrhoeic Dermatitis”. Common triggers (factors that may worsen) include oily skin or scalp, emotional stress, weather (cold and dry), poor hygiene and infrequent washing or shampooing. Dietary factors do not play a role.
The treatment options include antidandruff shampoos, cleansers, anti-inflammatory creams/ lotions, antifungals and keratolytics. The choice of treatment depends on the sites affected, and extent of symptoms. Maintenance treatment is usually needed.
HAIRLOSS
Hair loss, both in men and women can be due to multiple causes, which depend on both genetic and environmental factors as well as co-existing medical conditions.
MALE PATTERN HAIRLOSS
Male pattern hair loss (MPHL) is the most common type of hair loss in men. Baldness appears gradually on the crown of the scalp or as receding hairline at the frontal and thinning of hair over temple areas. It affects about 30% of men by the age of 30 and 50% of men over the age of 50. The main causes are genetic and hormonal – due to increased levels of testosterone.
It presents as a receding frontal hairline is the usual pattern and there may be loss of hair from the top of the head. Hairs in the affected areas are thin and short before they become absent. Male pattern baldness is progressive and it does not improve or reverse without treatment.
FEMALE PATTERN HAIRLOSS
Female pattern hair loss (FPHL) is the most common type of hair loss seen in women usually occurring in the 40-60s years of age. It is due to genetic and hormonal factors. May be associated with conditions in which androgen (a group of hormones) levels are elevated such as polycystic ovarian syndrome (PCOS). Acne, increased facial hair, irregular periods and infertility are all signs of PCOS.
There is widespread thinning of the hair, mainly on the crown of the scalp. It may initially start as widening of the hair parting areas. Hairs in the affected areas are initially thinner and shorter compared to hairs in unaffected areas, before they become absent. FPHL can be controlled with appropriate treatment. However, it tends to progress very slowly, from several years to decades.
ALOPECIA AREATA
Alopecia means loss of hair. Alopecia areata is a type of localised hair loss which is typically seen as bald patches. It may affect any hairy area of the body. It affects males and females equally. It is considered to be an autoimmune disease. This occurs when the body’s own immune system damages its healthy cells. Genetics, atopy and environmental factors play a role. It typically occurs as one or more bald patches on the scalp. It can affect any hairy area of body. Hair loss may be seen on the scalp, beard, moustache, eyebrows, eyelashes or body hair may also be lost. Scalp is the common site affected in 90% of the cases. Apart from the bald patches, the scalp usually looks healthy and there is no scarring. The bald patches are round in shape and about the size of a coin. In majority of cases hair regrows after several months.
Other conditions causing hairfall include acute and chronic telogen effluvium, such as hair loss post pregnancy.
Fungal infections can be associated with patchy hair loss, and can be easily treated with oral medications and topical applications. Trichotillomania is a condition where the patient pulls out his/ her own hair, impulsively. Traction alopecia is very common due to the traditional hairstyles that pull and twist the hair into plaits/ pigtails or ponytails. With prolonged traction, this could lead to permanent hair loss.
HAIR LOSS TREATMENTS
It includes identifying the cause, correcting deficiencies and certain lifestyle modifications. The common treatment modalities include topical solutions, oral drugs, low level laser light treatment, scalp microneedling , platelet rich plasma (PRP) treatment and Growth factor concentrate treatment (GFC). The last resort is hair transplantation -a procedure in which hair is removed from back of scalp, the permanent hair-bearing region (the “donor” area) and transferred to bald or balding areas of the scalp (the “recipient” area). The transplanted hair has the same color and other characteristics as the hair of the donor area.