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Updated: February 23, 2013 18:43 IST

Hair barely there

DR. ARVIND POSWAL.
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Don't pull it all out. Photo: S.S. Kumar
The Hindu Don't pull it all out. Photo: S.S. Kumar

When severe hair fall does not respond to the usual home remedies, seek medical advice.

When an actor sports a bald look — whether it is Demi Moore, Shabana Azmi, Nandita Das or Lisa Ray — we remember their stark appearance. However, in real life, women often face ridicule when they suffer severe hair loss.

Though it is typically associated with males, the problem of baldness is not gender specific. Women too face it but the reasons are different from those in men. Female pattern baldness is often a hereditary condition characterised by a diffuse thinning of hair and/or hair loss behind the frontal hairline. It may or may not include a slight recession or thinning in the temples. In women, this rarely ends in complete baldness at the top of the scalp. Experts call it “Female Hereditary Hair Thinning” and the condition is not as easily recognisable as in men.

Hair transplant experts and doctors use the ‘Ludwig Classification of Female Pattern Baldness’ to identify the severity of the problem. Under this system, hair loss pattern belongs to three categories:

Mild to moderate central hair loss with retention of hair line.

Severe central hair loss with retention of hairline.

Mild, moderate or severe hair loss with receding hairline.

Once this is done, the cause behind the problem needs to be identified. Female pattern of baldness can begin at any age, as early as late teens to early 20s. The hair loss can be either temporary or permanent. Hormonal changes during pregnancy also lead to thinning hair. Certain illnesses also weaken the hair roots and lead to severe hair fall that contributes to baldness. Some women also face baldness because of their sensitivity to the male hormone (androgen). This is known as ‘Androgenic Alopecia’, an inherited problem. However, this does not develop in the same way as in men. Women rarely develop the “cue-ball” appearance often seen in men.

Most women do not realise why their hair is falling and thus require timely medical intervention. While medication, proper diet and hair care can sometimes reduce rate of severe hair fall, hair transplantation is often the best solution. Modern hair transplantation techniques like Follicular Unit Hair Transplantation (FUHT) and Follicular Unit Separation Extraction (FUSE) have a high success rate. These do not involve admission and the patient can leave for home the same day.

FUHT is an invasive procedure in which a hair-bearing strip of scalp is excised from the permanent donor area. The strip wound is then closed using self-dissolving surgical staples. The individual follicular unit grafts are then dissected from the strip under magnification and grafted in splits, which are created in the bald areas of the head. The procedure is performed under local anaesthesia. The slits heal within a week and the transplanted hair follicular units are locked firmly in their new location. The emergent new hair lasts till a ripe old age and is completely natural.

FUSE, on the other hand, is a minimally invasive hair-restoration method. It is a virtually non-scarring technique of extracting single hair follicular units. It involves separation of the graft-bearing skin till a certain level with tiny but sharp micro punches. The individual follicular units are then separated. Finally, the follicular units are gently grafted into the recipient bald area.

With proper post-procedure care and a healthy diet and supplements (as advised by the doctor) the patient will soon have a full head of hair. In case of hair fall that does not respond to the usual home remedies, it is best to seek medical advice. Barely there hair will definitely get you noticed, but for the wrong reason!

Other causes

Alopecia areata: an autoimmune disorder that causes patchy hair loss.

Triangular alopecia: Complete loss of hair in the temporal areas that sometimes begins in childhood.

Scarring alopecia: Hair loss due to scarring of the scalp area.

Telogen effluvium: A common problem that occurs when a large percentage of scalp hairs are shifted into “shedding” phase due to hormonal, nutritional, drug/stress-associated changes in the body.

Trichotillomania: Hair loss caused by compulsive pulling or twisting of the hair until it breaks off

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