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Our Life | Наше життя June | Червень 2021 33 Ihor Magun, MD, FACP OUR HEALTH It is estimated that more than 50% of women will experience noticeable hair loss in their lifetime. This statistic is never welcome or easy to hear, but early recognition and intervention can halt progression of the problem. Hair loss in women, which frequently has a genetic predisposition, has many names, but the favored term is simply “female pattern hair loss.” This pattern manifests itself as thinning on the sides of the scalp as well as diffuse thinning across the central scalp, a characteristic “Christmas tree” pattern that can be observed along the midline part of the hair toward the front of the scalp but doesn’t produce the receding hairline that is characteristically seen with hair loss in men. To translate this into numerical/statistical language, women shed from 50 to 100 single hairs per day. No one actually counts the strands of hair that are lost, but if someone is shedding more than 125 strands per day, this should raise a red flag. Female pattern hair loss is typically diagnosed clinically. However, a common do-it-yourself test referred to as the “hair-pull” test is useful in detecting active hair loss. It is performed by grasping 50 to 60 strands of hair close to the scalp using the thumb, index, and middle fingers and pulling slowly. Six or more hairs coming loose from the scalp indicates a positive test result. Laboratory tests are routinely evaluated to address correctable causes: thyroid function tests, total iron panels, complete blood cell counts, comprehensive metabolic panels (these include electrolytes, kidney, liver, protein, calcium levels), zinc and vitamin D levels. Additional hormonal tests are performed if there is any indication of excess male hormone manifesting as male-pattern baldness and hirsutism (excess growth of dark or coarse hair in a male-like pattern). Specialized dermatology centers that deal specifically with hair loss perform a trichometric analysis, which is basically a sophisticated computerized tool that is used to analyze the characteristics of the scalp and hair. A folliscope, which is a high-definition microscope camera, can take photos of the scalp and hair and then display these on a computer monitor. This magnifies the image by 100% and thus provides a detailed look at the scalp and hair. The information derived is used to monitor response to treatments. So, what causes hair loss in women? Stress can be a cause of hair loss primarily because it affects hormone levels. Pregnancy, during which women experience normally expected hormonal changes, can also promote hair loss. So does smoking. Restrictive and rapid weight loss diets are also possible causes of hair loss. The goal of treatment is to promote hair growth as well as to prevent or slow further hair thinning or loss. Blood tests will guide any specific intervention and need for supplementation. Research on the use of biotin is very limited, and there is no concrete evidence that it is helpful. However, topical 2% minoxidil (sold over the counter without a prescription) is safe and effective if used twice daily. Some suggestions using non-medical approaches for hair thinning include the following: • Shorter hair with layers can provide an appearance of fullness. • Hair coloring adds volume, and use of proper shampoos can be helpful. • The Food and Drug Administration has approved a low-level laser hair growth device. The exact mechanism of action is unclear, but it may stimulate stem cells and increase blood flow, resulting in hair growth success. • Obviously, hair transplant is also an option and is frequently considered. Preventing hair loss is not an option when it is caused by disease, chemotherapy, injuries, aging, or physical stress. But for women not impacted by these issues, using common sense is always a good start: • Do not damage hair with excessive use of chemicals or tight hairstyles. • Maintain a good diet and get adequate rest. • Stop smoking. • Most of all, do not let hair loss affect your self- esteem. True beauty lies within. Hair Today, Gone Tomorrow
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