There are different types and reasons of Hair Disorder:
- Telogen effluvium (normal hair loss)
- Androgenetic Alopecia (male and female pattern)
There are different types and reasons of Hair Disorder:
It is normal to shed approximately 30-150 hairs from our scalp daily as part of our hair cycle, but this can vary depending on washing and brushing routines. Hair regrows automatically so that the total number of hairs on our head remains constant. Telogen effluvium occurs when there is a marked increase in hairs shed each day. An increased proportion of hairs shift from the growing phase (anagen) to the shedding phase (telogen). Normally only 10% of the scalp hair is in the telogen phase, but in telogen effluvium this increases to 30% or more. This usually happens suddenly and can occur approximately 3 months after a trigger.
Increased hair shedding in telogen effluvium occurs due to a disturbance of the normal hair cycle. Common triggers of telogen effluvium include childbirth, severe trauma or illness, a stressful or major life event (such as losing a loved one), marked weight loss and extreme dieting, a severe skin problem affecting the scalp, a new medication or withdrawal of a hormone treatment. No cause is found in around a third of people diagnosed with telogen effluvium.
Telogen effluvium usually resolves completely without any intervention as the normal length of telogen is approximately 100 days (3 to 6 months) afterwhich period the hair starts growing again (anagen phase). However,depending on the length of the hair, it may take many months for the overall hair volume to gradually return to normal. Telogen effluvium can return, especially if the underlying cause is not treated or recurs, and would be called chronic telogen effluvium if lasting more than 6 months.
Male pattern hair loss (MPHL) is the most common type of hair loss in men. It is also known as androgenetic alopecia. It affects about 50% of men over the age of 50.
MPHL is caused by a combination of genetic and hormonal factors. A hormone called dihydrotestosterone (DHT) causes a change in the hair follicles on the scalp. The hairs produced by the affected follicles become progressively smaller in diameter, shorter in length and lighter in colour until eventually the follicles shrink completely and stop producing hair.
Yes. It is believed this can be inherited from either or both parents.
Men can become aware of scalp hair loss or a receding hairline at any time after puberty. There are usually no symptoms on the scalp. Hair loss may cause significant psychological difficulties.
The usual pattern of hair loss is a receding frontal hairline and loss of hair from the top of the head. Hairs in the affected areas are initially smaller in diameter, and shorter compared to hairs in unaffected areas, before they become absent.
The diagnosis is usually based on the history of scalp hair loss on the front/ top of the head or receding hairline, the pattern of hair loss and a family history of similar hair loss. The skin on the scalp looks normal on examination. Occasionally blood tests may be carried out.
No, there is no cure. However, it tends to progress very slowly, from several years to decades. An earlier age of onset may lead to quicker progression.
Licensed topical and oral treatments:
It is important to note that all of the topical and oral treatments only work for as long as the treatment is continued.
Wigs and hair pieces:
Skin camouflage:
Surgical treatments:
Female pattern hair loss (FPHL) has also been called androgenetic alopecia. It is the most common type of alopecia (hair loss) in women and the severity can vary.
FPHL is caused by a combination of genetic and hormonal factors. The hairs produced by the affected follicles become progressively smaller in diameter, shorter in length and lighter in color until eventually the follicles shrink completely and stop producing hair. FPHL can 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.
Yes. It is believed that it can be inherited from either or both parents.
In women, the age of onset is later compared to male pattern hair loss, usually occurring in the 50s or 60s. Occasionally, FPHL in women may start earlier than this, in the 30s or 40s. FPHL is not usually associated with any scalp symptoms. Hair loss can, however, cause psychological consequences and have an impact on quality of life.
Patterned hair loss looks different in males and females. In females, there is widely spread thinning of the hair, mainly on the crown of the scalp. The hairline at the front of the scalp often remains normal. Hairs in the affected areas are initially thinner (smaller in diameter), and shorter compared to hairs in unaffected areas, before they become absent.
The diagnosis is usually based on the history of gradual thinning of hair or increased hair shedding on the top of the head, the pattern of hair loss and any family history of similar hair loss. The skin on the scalp looks normal on examination. Occasionally blood tests may be carried out.
No, there is no cure for FPHL. However, it tends to progress very slowly, from several years to decades. An earlier age of onset may lead to quicker progression.
Topical and oral treatments:
Skin camouflage:
Surgical treatment is not offered under the NHS. This can be sought privately. Hair transplantation is a procedure where hair follicles are taken from the back and sides of the scalp and transplanted onto the bald areas.
Alopecia is a general term for hair loss. Alopecia areata is a common cause of non-scarring (does not cause scarring to the scalp) hair loss that can occur at any age. It usually causes small, coin-sized, round patches of baldness on the scalp, although hair elsewhere such as the beard, eyebrows, eyelashes, body and limbs can be affected. In some people larger areas are affected and occasionally it can involve the whole scalp (alopecia totalis) or even the entire body and scalp (alopecia universalis).It is not possible to predict how much hair will be lost. Regrowth of hair in typical alopecia areata is usual over a period of months or sometimes years, but cannot be guaranteed. The chances of the hair regrowing are better if less hair is lost at the beginning. Most people, with only a few small patches get full regrowth within a year. If more than half the hair is lost then the chances of a full recovery are not good. The hair sometimes regrows white, at least in the first instance. Most people get further attacks of alopecia areata. In alopecia totalis and alopecia universalis, the likelihood of total regrowth is less.
Hair is lost because it is affected by inflammation. The cause of this inflammation is unknown but it is thought that the immune system, the natural defence which normally protects the body from infections and other diseases,may attack the growing hair. Why this might happen is not fully understood, nor is it known why only localised areas are affected and why the hair usually regrows again. Someone with alopecia areata is slightly more likely than a person without it to develop other autoimmune conditions such as thyroid disease, diabetes, lupus and vitiligo (white patches on the skin), although the risk of getting these disorders is still very low. If you have other symptoms then discuss these with your doctor. Your doctor may suggest a blood test. Alopecia areata is not catching and no connection has been made with food or vitamin deficiencies. Stress occasionally appears to be a trigger for alopecia areata, but it is possible that this link may be coincidental as many of those affected have no significant stress.
There is a genetic predisposition to alopecia areata. About 20% of people withalopecia areata have a family history.
No, alopecia areata cannot be cured. Depending on the extent of hair loss there is a good chance that, for 4 out of 5 affected people, complete regrowth will 4occur within 1 year without treatment. There may, however, be further episodes of hair loss in the future. If there is very extensive hair loss from the start, the chances of it regrowing are not as good. Those with more than half the hair lostat the beginning or with complete hair loss at any stage have only about a 1 in 10 chance of full recovery. The chances of regrowth are not so good in young children and those with the condition affecting the hairline at the front, side or back.
People with mild early alopecia areata may need no treatment, as their hair is likely to come back anyway without it. Some treatments can induce hair growth, though none is able to alter the overall course of the disease. Any treatments that carry serious risks should be avoided, as alopecia areata itself has no adverse effect on physical health.The treatments that are available include:
There are different types and reasons of Nail Disorder:
Fungal infections of the nails are also known as dermatophytic onychomycosis, or tinea unguium. The responsible fungus is usually the same as that that causes athlete’s foot – a common infection of the skin of the feet, especially between the toes. In athlete’s foot the responsible fungus lives in the keratin that makes up the outer layer of the skin. When the fungus spreads to the keratin of the nails, the result is a fungal nail infection.
Fungi spreading from athlete’s foot (known as ‘dermatophyte fungi’) cause most fungal nail infections. Less often a nail infection is due to other types of fungi, usually yeasts (eg. Candida) and moulds which do not cause athlete’s foot. These other fungi tend to attack nails that are already damaged, as it is easier for the fungus to invade. Fungal infections of the toenails are very common (1 in 4 people can be affected at a given time), those of fingernails less so. Both are seen most often in the elderly, those with impaired immune systems, and in people with diabetes and poor peripheral circulation. Warm, moist environment helps fungi to grow and cause infection. Wearing occlusive footwear or using shower stalls, bathrooms or locker rooms can increase the risk of fungal infections.
When fungi infect a nail, they usually start at its free edge, and then spread down the side of the nail towards the base of the cuticle. Eventually the whole nail may be involved. The infected areas turn white or yellowish, and become thickened and crumbly. Less commonly there may be white areas on the nail surface. The nails most commonly affected by fungal infections are those on the big and little toes. Sometimes, especially in those who carry out regular wet work such as housewives or cleaners, the skin around the fingernail becomes red and swollen. This is called paronychia, and can allow infection to get to the nail.
Fungal nail infections are usually diagnosed clinically.
Yes. However, to successfully cure fungal toenail infection requires long treatment and may take up to a year. Fingernails are easier to treat. Fungal nail infections commonly recur, especially on the toes.
Fungal infections of the nail do not clear up by themselves, but not all of them need treatment. It is important to treat people whose infections may cause significant health problems such as those with diabetes or immune suppression, in order to prevent potentially serious health problems.
Treatment options include:
Treatments applied to the nail (topical treatments)
Treatment by mouth (oral treatments)
Before starting on tablets, the doctor should send a piece of the nail to the laboratory to check that the diagnosis of a fungal infection is confirmed. Three medicines are available for use in fungal nail infections:
Laser treatments.
No, there is no cure for FPHL. However, it tends to progress very slowly, from several years to decades. An earlier age of onset may lead to quicker progression.
Topical and oral treatments:
Skin camouflage:
Surgical treatment is not offered under the NHS. This can be sought privately. Hair transplantation is a procedure where hair follicles are taken from the back and sides of the scalp and transplanted onto the bald areas.
The following are common nail abnormalities, with possible causes;
Transverse ridges are usually transient and due to a temporary disturbance of nail growth – eg, severe illness, trauma or infection. Beau’s lines occur in ALL nails, due a general cause preventing nail growth.
Other causes of transverse ridges include psoriasis, paronychia and eczema.
Causes include lichen planus, rheumatoid arthritis, myxoid cysts and peripheral arterial disease.
Causes include alopecia areata, psoriasis and eczema.
An increase in the soft tissue of the distal part of the fingers or toes; common causes of finger clubbing include:
These may be caused by pseudomonal infection, which results in green-blue or black dis-colouration.
May occur as a side-effect of certain medications, such as minocycline, hydroxyurea or mepacrine.
This may be congenital or due to minor trauma, hypoalbuminaemia in chronic liver disease, chronic kidney disease, Beau’s lines (as above, which may be white), fungal infection or lymphoma.
Yellow nail syndrome is characterized by slow-growing, excessively curved and thickened yellow nails which are associated with peripheral lymphoedema and exudative pleural effusions.
Causes include:
Medication including tetracyclines, captopril, trimethoprim, indometacin and isoniazid.