More than half of the patients who visit the dermatological office complain spontaneously about hair loss at some point during the consultation. Hardly any woman will deny the symptoms if we actively question. Why does it happen? Are we all sick? Is it an epidemic? Blame our food?
First of all, it is necessary to clarify something that may surprise most readers: hair falls as a normal part of its life cycle and it is important to differentiate between normal and pathological hair loss. Often the patients who come to us just moved in, changed the floor of the house or got married and started to be scared by the amount of “lost” wires out there. Depending on the length of the hair, this impression can be even more accentuated!
Therefore, it is up to the dermatologist to examine the scalp for changes and perform the traction exam, in which we pull the hair in tufts, over the entire head, to quantify the fall and determine if it is a normal fall in the hair cycle or if it’s a dysfunctional fall.
The dysfunctional fall is caused by systemic diseases such as anemia , thyroid diseases, nutritional disorders and can also arise after infections that have a high fever, after hormonal treatments, after surgery and after childbirth , among the most common causes. Some skin diseases can lead to a fall, such as alopecia areata, but in these cases, in addition to the fall, there is the presence of hairless areas.
However, as we mentioned earlier, in the vast majority of cases, it is just the normal fall of the hair cycle. And it is essential to clarify how it works to avoid doubts and unnecessary treatments with shampoos and “miraculous” formulas that often represent a useless expense.
The hair growth cycle
Hair growth is cyclical and not all strands are in the same growth phase: if that happened, we would be bald for a few periods. The hair grows for a genetically determined period, which lasts from two to six years. During this phase, called anagen, the wire will reach its maximum length. Depending on how long it lasts, your hair may be longer or shorter. After this phase there is an interruption in the growth of the threads and the catagen phase, which lasts a few weeks, begins. Finally the wire enters the telogen phase, in which it prepares to fall, but this only occurs when a new wire is ready to be born within that follicle. This last phase lasts about three months.
A normal adult has 10% of the wires in the telogen phase! This means that, considering the normal amount of hair on the scalp, it is absolutely normal and within the expected fall of about 100 hairs a day. Even when the patient has an increase in the fall, due to the presence of any of the aforementioned clinical conditions, we need to guide and clarify three very important points:
1) Even in large volumes, this drop will not result in baldness ;
2) It is the most benign problem that can occur in the hair, because once the cause is eliminated, the patient recovers all the lost hair;
3) Female baldness or androgenetic alopecia is another disease and has already been addressed in other content on the site.
Therefore, the dermatologist will, first of all, perform a clinical examination to determine whether the fall is pathological or not and then will clarify the patient about the hair cycle, in the first case, or order additional tests, in the second. I hope I helped to help you better understand these issues!