Everyone loses hair. It is a normal part of the hair cycle. The average person sheds 50 – 100 hairs a day, with new ones growing back in their place. According to the American Hair Loss Association, up to 40% of women and 65% of men by age 60, have experienced excessive hair loss. Why does this happen, are there ways of preventing it and how can it be treated? CMDL asks Dr Sheetal Sapra of ICLS in Oakville, Ontario all about hair loss.
CMDL: What causes hair loss?
Dr. Sapra: Hair loss, especially in women can be devastating. There are many factors that come into play when someone is experiencing hair loss. There are multiple causes and reasons someone could be suffering, so it is important to meet with a dermatologist to obtain an accurate diagnosis. The diagnosis will enable your dermatologist to create an appropriate treatment plan for you.
CMDL: Are there different kinds of hair loss?
Dr. Sapra: There are 3 main causes of hair loss:
- Scarring Alopecia – occasionally there can be a disease in the scalp such as, lichen planus or lupus, which causes scarring at the scalp. Treatment for this usually involves oral medications to decrease inflammation and scarring. Unfortunately, in the scarred areas, the hair that is lost is permanent.
- Non-Scarring Alopecia – hair usually grows in 2 main phases: anagen (a growth phase) and telogen (a resting phase). The most common cause of hair loss is a telogen effluvium. With any acute stress either physical or emotional, hairs can move into the resting phase (telogen) and dramatic hair loss may occur. Over 500-1000 hairs may be shed per day and this condition is known as telogen effluvium.
Alopecia areata is another form of non-scarring alopecia. This condition results in patchy hair loss. This can lead to total hair loss on the scalp, known as alopecia totalis, or on your body known as alopecia universalis.
When you have pattern hair loss this is often a result of an androchronogenetic disease. Usually, there is a family history of baldness or thinning of the scalp in women. In this condition, the hormone testosterone causes miniaturization of the hair follicles and permanent loss.
- Hair Shaft Abnormality – hair shaft defects may be due to external injury (over processing) or genetic abnormality. Repeated physical injury is the most common cause of increase hair fragility. This is often due to excessive grooming, traction from braiding or tight pony tail and heat from hair tools.
CMDL: Should these different causes of hair loss be treated differently?
Dr. Sapra: The course of treatment would definitely be determined by what type of hair loss a patient is experiencing.
CMDL: What are the most common treatments for hair loss?
Dr. Sapra: Mainstay treatment of hair loss consists of making the correct diagnosis and initiating the appropriate medical therapy.
Topical nutraceuticals and supplements are used to help the hair grow thicker and more lustrous. A telogen effluvium is often treated with nutraceuticals that promote hair growth, and supplements designed to protect the integrity of the existing hair. In addition, a correction will usually involve removing either the emotional or physical stressor. This may be a newly diagnosed illness, low thyroid or vitamins issue, and even possibly the introduction of a new drug.
Alopecia areata is usually treated with topical preparations such as corticosteroids. Often your dermatologist will treat you with injections of cortisone directly into the affected areas. If the hair loss does become wide spread there are newer agents being developed known as JAK inhibitors both topical and oral.
Female pattern alopecia is treated with Minoxidil, but as an anti-androgen, we will often use Aldactone orally. Male pattern alopecia is treated again with topical 5% Minoxidil and oral anti-testosterone agents known as Propecia (Finasteride).
Light based devices such as laser have been used to initiate hair growth, but clinical studies have not shown how effective this is.
Newer therapies include topical antiprostaglandin inhibitors and possible stem cell therapy. In severe cases of female and male pattern alopecia, hair transplantation can be useful to cover bald areas.
CDML: We have heard Platelet Rich Plasma Therapy (PRP) is one of the most effective ways to treat hair loss. How does this treatment work?
Dr. Sapra: PRP (platelet rich plasma) therapy takes advantage of the growth factors and the platelet rich media to initiate hair growth. This treatment uses your own plasma found in your blood to stimulate tissue regeneration and growth. A small amount of blood is collected to isolate natural platelet-rich fibrin matrix for injection into affected areas. These platelets gradually release various growth factors that stimulate the body’s natural process of tissue regeneration. Treatment with injectable PRP has been shown to be successful in some cases, but unsuccessful in others.
CMDL: Are there other treatments you can do along with PRP?
Dr. Sapra: Combination treatment is suggested to encourage optimum results. Depending on the specific diagnosis nutraceuticals and supplements are often recommended in combination with PRP and prescription medications.
CMDL: Any additional advice you would offer those battling this sensitive yet common issue?
Dr. Sapra: The advancements in treatment are improving day by day. The most important thing to remember is once hair loss is experienced, it is of utmost importance to have an assessment by a dermatologist to determine the exact underlying cause. Once a diagnosis is reached your dermatologist will prescribe the appropriate treatment plan for you.
About Dr. Sheetal Sapra
Dr. Sheetal Sapra is not only a leader in the field of Dermatology, but he is also a pioneer of new technologies aimed at improving the lives and looks of his patients. As one of the founders of ICLS, Dr. Sapra’s philosophy of providing amazing patient care with state-of-the-art technology has helped turned ICLS into a premiere dermatology and plastic surgery practice.
Dr. Sapra has an unmatched dedication to finding the best ways to restore a vibrant, youthful appearance. This has made him a part of the vanguard of modern dermatology techniques, including the latest laser technologies.
A respected authority in his field, Dr. Sapra is an advisor and educator for different types of laser systems. “I am constantly seeking out newer, safer ways of helping my patients, which means keeping up with the latest technologies and listening to my patients’ needs.” By becoming an expert in some of the most state-of-the-art dermatology treatments, Dr. Sapra hope to provide only the safest, most effective, and comfortable treatments for his patients.
Dr. Sapra’s practice consists of both general OHIP and cosmetic dermatology, and he also upholds an active role as a primary investigator for various clinical research trials. Dr. Sapra has always prided his wide involvement in the field of dermatology, whether it’s personally treating his patients with great care or contributing to the advancement of dermatology through research.