What is baldness?

Baldness, also known as alopecia, is hair loss, or absence of hair. Baldness is usually most noticeable on the scalp, but can occur anywhere on the body where hair grows. The condition is more common in men than in women.

What causes hair loss?

Hair loss is believed to be primarily caused by a combination of the following:

• aging
• change in hormones
• illness
• family history of baldness
• burns
• trauma

However, hair loss is not caused by the following:

• poor circulation to the scalp
• vitamin deficiencies
• dandruff
• excessive hat-wearing
• a gene passed on from an individual's maternal grandfather

Generally, the earlier hair loss begins, the more severe the baldness will become.

What are the different types of baldness?

Baldness can be classified into various types, depending on the cause. Several of the many different types of baldness include the following:

• female-pattern baldness
  Although less common, female-pattern baldness differs from that of male-pattern baldness in that the hair generally thins all over the head, but the frontal hairline is maintained. Female-pattern baldness rarely results in total hair loss.
• male-pattern baldness
  Male-pattern baldness usually is a hereditary condition. The condition may begin at any age. Hair loss often begins on the front, sides, and/or on the crown of the head. Some men may develop a bald spot or just a receding hair line, while others may lose all of their hair.
• alopecia areata
  This hair loss disorder is characterized by sudden loss of hair in one particular area, which grows back after several months. However, if all body hair is suddenly lost, regrowth may not occur. The cause of this type of hair loss is unknown.
• toxic alopecia
  Toxic alopecia may occur following a high fever or severe illness. Certain medications, especially thallium, high doses of vitamin A, and retinoids, may cause toxic alopecia. Medical conditions, such as thyroid disease, and after giving birth may also trigger toxic alopecia. The condition is characterized by temporary hair loss. Also, some cancer medications can cause hair loss.
• scarring alopecia
  Scarred areas may prevent the hair from growing back. Scarring may occur from burns, injury, or x-ray therapy. However, other types of scarring that may cause hair loss can be caused by diseases such as lupus, bacterial or fungal skin infections, lichen planus, sarcoidosis, tuberculosis, or skin cancer.
• trichotillomania (hair pulling)
  Hair pulling, a habit most common among children, may cause hair loss.

How is the type of baldness diagnosed?

In addition to a medical history and physical examination, a biopsy of the skin area may help to identify the type of baldness and/or its cause.

Treatment for baldness:

Specific treatment for baldness will be determined by your physician based on:

• your age, overall health, and medical history
• extent of the condition
• your tolerance for specific medications, procedures, and therapies
• expectation for the course of the disease
• your opinion or preference

Most forms of baldness have no cure. Some types of baldness will disappear on their own. Treatment may include:

• certain medications to promote hair growth (such as minoxidil and finasteride)
• corticosteroid injections (when treating alopecia areata)
• treating any underlying condition or disease
• hair transplants
• scalp reduction
• skin lifts and grafts

What is hair replacement surgery?

The interest in hair replacement has significantly increased over the past 10 years. Two out of every three men, and one in five women, suffer from hair loss. For men, the main cause of a diminishing hairline is heredity. Hormonal changes such as menopause can cause both thinning and hair loss in women.

There are a number of hair replacement techniques that are available, although hair replacement surgery cannot help those who suffer from total baldness. Candidates for hair replacement must have a healthy growth of hair at the back and sides of the head. The hair on the back and sides of the head will serve as hair donor areas where grafts and flaps will be taken.

There are four primary different types of hair replacement methods, including the following:

• hair transplantation
  During hair transplantation, the surgeon removes small pieces of hair-bearing scalp grafts from the back or sides of the head. These grafts are then relocated to a bald or thinning area.
• tissue expansion
  In this procedure, a device called a tissue expander is placed underneath a hair-bearing area that is located next to a bald area. After several weeks, the tissue expander causes the skin to grow new skin cells. Another operation is then required to place the newly expanded skin over the adjacent bald spot.
• flap surgery
  Flap surgery is ideal for covering large balding areas. During this procedure a portion of the bald area is removed and a flap of the hair-bearing skin is placed on to the bald area while still attached at one end to its original blood supply.
• scalp reduction
  Scalp reduction is done in order to cover the bald areas at the top and back of the head. This technique involves the removal of the bald scalp with sections of the hair-bearing scalp pulled together filling in the bald area.

Possible complications associated with hair transplantation procedures:

Possible complications associated with hair transplantation procedures may include, but are not limited to, the following:

• patchy hair growth
  Sometimes, the growth of newly placed hair has a patchy look, especially if it is placed next to a thinning area. This can often be corrected by additional surgery.
• bleeding and/or wide scars
  Tension on the scalp from some of the scalp reduction techniques can result in wide scars and/or bleeding.
• grafts not taking
  Occasionally, there is a chance that the graft may not "take." If this is the case, surgery must be repeated.
• infection
  As with any surgical procedure, there is the risk of infection.

Traction alopecia may look similar to trichotillomania, but it is often the result of hair styles which involve pulling and securing hair into shape such as braiding or corn rows. The over use of hair stylers such as sponge hair rollers or curling irons may also promote traction alopecia. Traction alopecia often shows as distinct patches of hair loss in those areas where the hair and hair follicles have been put under excessive strain. The hair loss may occur anywhere on the scalp depending on the nature of the hair style or process that is causing the traction alopecia.

Traction alopecia is a very common cause of temporary hair loss. Typically, traction alopecia in the early stages involves affected hair follicles being pushed into the telogen resting state along with localized trauma to the hair follicles as a result of hair fibres being forcibly pulled out.

As with trichotillomania, traction alopecia is generally a non-scarring, non-inflammatory form of hair loss although long term use of hair styles involving traction over 3 or more years may result in a mild immune cell infiltrate and irreversible scarring damage to some hair follicles. Any form of chronic traction alopecia will eventually lead to fibrosis around hair follicles and total destruction of some hair follicles. Once destroyed the hair follicles will not regrow under any circumstances hence chronic traction alopecia can be described as a scarring cicatricial alopecia.

Traction alopecia is reversible if diagnosed in the early stages. An effective treatment is to simply avoid hair styling that puts excessive strain on the hair. Even with removal of the cause of traction alopecia it may take up to three months for the hair to recover. Areas of scalp subjected to chronic traction alopecia may never fully recover. Chronic traction alopecia may be treated by hair transplants.

Los Angeles, California, June 21^st, 2008 –Richard Farrell, owner of Farrell Hair Replacement announced today that he is adding an extra stop on his personal design tour. Richard will be at his Hair Salon & Production Center Los Angeles, CA on June 27^th and 28^th.

The Farrell Los Angeles location (which is conveniently located at 5059 W. Pico Boulevard, Los Angeles, CA 90019) has an artistic factory/loft type atmosphere dedicated to hair system perfection. The trendy location is dedicated to making Farrell Hair clients feel comfortable and cared for, Richard went on to say that “along with our very private salon rooms and our plush consultation area, one just can’t help but feel relaxed when they come in for a no cost/no obligation consultation”.

Richard Farrell who is always striving for completely undetectable and natural looking hair systems says: “Hair systems need to be produced under watchful eyes.” And no one is more precise in Hair system making than Richard Farrell himself.

The Farrell Los Angeles personal design tour is scheduled for June 27^th and June 28^th, since this is only a 2 day tour Richard has added a free registration page on his website where anyone can set their own appointment to see Richard in person. All of this and the Los Angeles appointment page are all posted on Richard’s website at: http://www.farrellhair.com/meetrichardcut.asp.

Watch the videos and become a believer!
At Farrell Hair Replacement, you can expect to receive close to perfect duplication of the hair you used to grow naturally. Watch our client testimonial video and see for yourself! And when you visit us at one of our worldwide locations, we will prove to you in person that our hair systems are totally undetectable! But before you come in, study our website and view Richard Farrell's performances at Live Cut-Ins, TV Appearances and Makeover Shows. All of these projects offer further proof that Farrell Hair Replacement is the Best in the World.

Research into young people’s experiences of hair loss during cancer treatment has found it is a mistake to assume women will be more affected than men. Scientists analysing interviews with recovered young adult cancer patients enrolled in the DIPEx project found that young men were just as affected by chemotherapy-induced hair loss as young women. However until now, men’s experiences of hair loss have been largely ignored.

Hair loss can be a distressing side-effect of chemotherapy affecting patients’ body-image, self-esteem, confidence and social interaction. It is often feared by patients, yet little is done to talk young men through what to expect. Scientists at the MRC’s Social and Public Health Sciences Unit in Glasgow carefully analysed interviews from young cancer patients from all over Britain to find out what impact this aspect of the illness had had on them. Of the 37 people aged between 18 and 38 that took part in the study, only three (one woman and two men) said their experience of hair loss had been unproblematic.

“It became clear that though these young people had been told to expect hair loss, few had any idea of what to expect, both in terms of the manner in which this would occur, and the likely emotional impact this would have on them,” said Professor Kate Hunt, who led the study.

The researchers found young men in particular had not been prepared for the impact of hair loss. One of the most distressing aspects described was the loss of privacy and control over who knew about their diagnosis. Many people also described how, in addition to the difficulties they faced after being diagnosed with cancer at a relatively young age, they also had to cope with some very negative and upsetting reactions to their hair loss from other people.

One big difference between the way that the young men and women talked about their hair loss was that it was only the men who talked about losing hair from other parts of their body as well as their scalp. Some men found this more disturbing than losing the hair on their head:

“You lose all your arm hair, you lose your pubic hair and then your body hair and your leg hair and your toe hair, everything is completely gone,” said one respondent. Another likened himself to a “plucked chicken”.

These differences are particularly interesting because in most societies hair length and style are taken for granted as a way in which people express their identity, but also as an important way in which distinctions between men and women can be emphasised.

Summing up the implications of their findings, Professor Hunt concluded:

“What we found is that young men appear to have as much difficulty adjusting to hair loss as young women and it’s important that health professionals are aware of how distressing this can be for men as well as women. The loss of their body hair in particular makes them feel even more vulnerable at a time when they are suffering from losing control over their lives. It’s also really important for all of us in society to try and be more sensitive about not adding to people’s problems when they are coming to terms with a cancer diagnosis and treatment by being insensitive to changes in people’s physical appearance at this time”.

Hair does not really serve any important function since a person can certainly live without it! Yet, our hair and how it looks is a very important part of our self-image. So when a child loses their hair, it is a disturbing event for both youngster and their parents.

The life cycle of a single hair can be divided into a period of active growth, lasting several years, and a resting stage, which last 60 to 90 days. Of the normal scalp's 100,000 hairs, as many as 15 percent are in the resting mode, soon to be lost at the rate of about 75 hairs per day (hardly noticeable to the child or parents). The rate of hair loss does increase dramatically when the growing hair follicle is subjected to different types of internal stress, such as high fever, severe flu, surgery, crash diets, and certain medications.

Almost all newborns lose some if not all of their hair. This is normal and is expected for the first six months, since the first hairs made by the infant's hair follicles are usually silky and fragile. Occasionally, an infant will lose more hair on the back of the head from constantly moving their head from side to side or spending too much time on their backs.

Most abnormal hair loss in children is caused by one of five conditions: alopecia areata, tinea capitis, traction alopecia, trichotillomania, and telogen effluvium (Dermatologists love fancy names for their diseases!)

Tinea capitis or "ringworm" is a common cause of hair loss in children. The condition is caused by a fungus (not a worm!) that invades the hair shaft and causes the hairs to break. The bare patch of hair loss is often round and the scalp takes on a black-dot stubble appearance from hair shafts broken off at the surface. There may also be mild scalp itching and scaling. The condition is transmitted by contact from one infected child to another by sharing combs, brushes, hats, barrettes, pillows and bath towels. Minor bruising of the scalp occasionally provides an entry for the microscopic fungus. Children three to ten years of are more susceptible and boys are more than girls. Ringworm of the scalp is not dangerous. Without treatment, however, the hair loss can be considerable and some children will develop a boggy tender swelling of the scalp known as a kerion.

Tinea capitis is treated with an oral antifungal medication called griseofulvin, usually taken for up to eight weeks. Selenium sulfide shampoo, used twice a week, has been shorn to shorten the course of tinea capitis. Topical antifungal creams usually do not help in killing the fungus and shaving the hair or giving the child a close haircut is unnecessary. Even though the infection is still visible, a child with tinea capitis may return to school after oral medication is started and the scalp receives at least one washing with shampoo.

Alopecia areata (alopecia means "hair loss," areata means "in patches") is another common form of patchy hair loss in children. The typical story is the sudden appearance of one or more totally bald areas in the scalp. The child with this condition loses hair in circular patches sometimes up to two inches in diameter. The hair at the borders of these patches is loose, but the peach-colored scalp looks and feels normal, without scaling or inflammation. There may be just a few patches of hair loss or a total absence of body hair. Alopecia areata is not life-threatening, and children who have it are otherwise healthy. Why the hair falls out from the roots is still a mystery. What is known is that the condition is not contagious, caused by foods, or the result of nervousness or psychological stress. In 20% of cases another family member has been affected. Some patients with this condition will also develop a grid-like pitting of the nails.

Fortunately, over 80% children with alopecia areata grow new hair back within twelve months. Oddly, the new hair may temporarily be white, but eventually the hair returns to its natural color. Because the hair loss can sometimes be psychologically devasting for the child, dermatologists have tried many different medications in an attempt to stimulate new hair growth. Treatments sometimes involve cortisone injections into the hair follicles.

Traction alopecia, or physical damage to the hair, is another common cause of hair loss, particularly in girls. The human hair is quite fragile and really does not respond well to the many physical and chemical assaults it has to endure in the name of beauty. Constant teasing, fluffing, combing, washing, curling, blow drying, hot combing, straightening and bleaching can do a number on the fragile hairs, causing them to fall out, especially those by the hair line and along the front and sides. Styles that apply tension to the hair, such as tight ponytails, braiding, barrettes, and permanent waving can also damage the hair.

Treatment is to handle the hair gently, as little as possible, and use natural hair styles. The hair will usually return, but regrowth can be slow. Injured hair follicles do not heal quickly and often take three or more months before they are back to their growing phase.

Trichotillomania is the compulsion to pull out one's own hair. It results in irregular patches of incomplete hair loss, mainly on the scalp, but may involve the eyebrows and eyelashes as well. The habit of pulling out one's hair is usually practiced in bed before falling asleep or when the child is studying or watching television. Interestingly, parents are usually not aware of the habit and frequently find it hard to believe that their child would pull out their own hair. Affected areas of hair loss often appear on the left side of right-handed children and on the right side of left-handed youngsters. Most cases of trichotillomania resolve spontaneously. The best treatment is to ignore the hair pulling and concentrate on why the child is anxious, nervous or frustrated.

Another less common form of hair loss in children is called telogen effluvium. Following a high fever, crash diet, flu, or emotional stress, hairs that were in their growth phase suddenly are converted into the resting phase. Two to four months later, when the child is otherwise fine and the stress is forgotten, these hairs begin to shed and do so for about six weeks. The hair loss is not total or in patches- the hair appears thin throughout the scalp. Unless the initial cause is repeated, all the hairs normally return (telogen effluvium explains why many mothers lose so much hair weeks after childbirth). Most parents who bring their child to the physician for this condition are worried that the youngster has cancer or another bad disease.

Remember, hair loss in children is not caused from vitamin deficiencies (at least in the United States), poor scalp circulation, headbands, hats, or helmets. When children lose their hair, parents can probably make the diagnosis themselves. If they have any doubts, they should consult with their child's physician.

Baldness or hair loss is usually something only adults need to worry about. But in a few cases, teens lose their hair, too — and it may be a sign that something's going on.

Hair loss during adolescence can mean a person may be sick or just not eating right. Some medications or medical treatments, like chemotherapy treatment for cancer, also cause hair loss. People can even lose their hair if they wear a hairstyle that pulls on the hair for a long time, such as braids.

Losing hair can be stressful during a time when you're already concerned about appearance. Most of the time, hair loss during the teen years is temporary. With temporary hair loss, the hair usually grows back after the problem that causes it is corrected.

Hair Basics

Our hair is made of a type of protein called keratin. A single hair consists of a hair shaft (the part that shows), a root below the skin, and a follicle, from which the hair root grows. At the lower end of the follicle is the hair bulb, where the hair's color pigment, or melanin, is produced.

Most people lose about 50 to 100 head hairs a day. These hairs are replaced — they grow back in the same follicle on your head. This amount of hair loss is totally normal and no cause for worry. If you're losing more than that, though, something might be wrong.

If you have hair loss and don't know what's causing it, talk to your doctor. A doctor can determine why the hair is falling out and suggest a treatment that will correct the underlying problem, if necessary.

What Causes Hair Loss?

Here are some of the things that can cause hair loss in teens:

• Illnesses or medical conditions. Endocrine (hormonal) conditions, such as uncontrolled diabetes or thyroid disease, can interfere with hair production and cause hair loss. People with lupus can also lose hair. The hormone imbalance that occurs in polycystic ovary syndrome can cause hair loss in teen girls as well as adult women.
• Medications. Some medications that have hair loss as a side effect may be prescribed for teens. These include acne medicines like isotretinoin, and lithium, which is used to treat bipolar disorder. Diet pills that contain amphetamines also can cause hair loss. Chemotherapy drugs for cancer are probably the most well-known medications that cause hair loss
• Alopecia areata . This skin disease causes hair loss on the scalp and sometimes elsewhere on the body. It affects 1.7% of the population, including more than 5 million people in the United States. Alopecia areata (pronounced: al-uh-pee-shuh air-ee-ah-tuh) is thought to be an autoimmune disease, in which the hair follicles are damaged by a person's own immune system. (In autoimmune diseases, the immune system mistakenly attacks healthy cells, tissues, and organs in a person's body.) Alopecia areata usually starts as one or more small, round bald patches on the scalp. These can get bigger, and in a small number of cases, can progress to total hair loss. Both guys and girls can get it, and it often begins in childhood. The hair usually grows back within a year, but not always. Sometimes people with alopecia areata lose their hair again.
• Trichotillomania (pronounced: trik-o-til-uh-may-nee-uh). Trichotillomania is a psychological disorder in which people repeatedly pull their hair out, often leaving bald patches. It results in areas of baldness and damaged hairs of different lengths. People with trichotillomania usually need professional help from a therapist or other mental health professional before they are able to stop pulling their hair out.
• Hair treatments and styling. Having your hair chemically treated, such as getting your hair colored, bleached, straightened, or permed, can cause damage that may make the hair break off or fall out temporarily. Another type of baldness that results from hair styling actually can be permanent: Wearing hair pulled so tightly that it places tension on the scalp can result in a condition called traction alopecia. Traction alopecia can be permanent if the style is worn for a long enough time that it damages the hair follicles.
• Poor nutrition. Poor eating can contribute to hair loss. This is why some people with eating disorders like anorexia and bulimia lose their hair: The body isn't getting enough protein, vitamins, and minerals to sustain hair growth. Some teens who are vegetarians also lose their hair if they don't get enough protein from non-meat sources. And some athletes are at higher risk for hair loss because they may be more likely to develop iron-deficiency anemia.
• Disruption of the hair growth cycle. Some major events can alter the hair's growth cycle temporarily. For example, delivering a baby, having surgery, or going through a traumatic event can temporarily cause shedding of large amounts of hair. Because the hair we see on our heads has actually taken months to grow, a person might not notice any disruption of the hair growth cycle until months after the event that caused it. This type of hair loss corrects itself.
• Androgenetic alopecia. Among adults, the most common cause of hair loss is androgenetic (pronounced: an-druh-juh-neh-tik) alopecia, sometimes called male-pattern baldness. This condition is caused by a combination of factors, including hormones called androgens and genetics. Sometimes, the hair loss can start as early as the mid-teen years. It also can occur in people who take steroids like testosterone to build their bodies.

What Can Doctors Do?

If you see a doctor about hair loss, he or she will ask questions about your health and family health (called a medical history) and check your scalp. In some cases, the doctor might take hair samples and test for certain medical conditions that can cause hair loss.

If medication is causing hair loss, ask the doctor if you can take a different drug. If your hair loss is due to an endocrine condition, like diabetes or thyroid disease, proper treatment and control of the underlying disorder is important to reduce or prevent hair loss.

If your doctor recommends it, a product like minoxidil that can speed up hair growth also might be helpful. Alopecia areata can be helped by treatment with corticosteroids. If nutritional deficiencies are found to be causing your hair loss, the doctor might refer you to a dietitian or other nutrition expert.

Catastrophic Hair Loss

Hair loss can be the first outward sign that a person is sick, so it may feel scary. Teens who have cancer and lose their hair because of chemotherapy treatments (especially girls) might go through a difficult time.

It can help to feel like you have some control over your appearance when you're losing your hair. When getting chemotherapy, some people like to cut their hair or shave their heads before the hair falls out. Some even take the hair they cut off and have it made into a wig. Many options can help disguise hair loss — such as wearing wigs, hair wraps, hats, and baseball caps. For most teens who lose their hair, the hair does return — including after chemotherapy.

Taking Care of Your Hair

Eating a balanced, healthy diet is important for a lot of reasons, and it really benefits your hair.

If you're losing hair, some doctors recommend using baby shampoo, shampooing no more than once a day, and lathering gently. Don't rub your hair too vigorously with a towel, either. Many hair experts suggest you consider putting away the blow dryer and air drying your hair instead. If you can't live without your blow dryer, try using it on a low heat setting.

Style your hair when it's dry or damp. Styling your hair while it's wet can cause it to stretch and break. And try to avoid teasing your hair, which can cause damage. Finally, be careful when using chemicals — such as straighteners or color — on your hair, and avoid frequent use of chemical treatments.

•   Have you experienced a decrease in your self-esteem since noticing your hair loss?
  
•   Do you experience feelings of depression (or symptoms such as difficulty concentrating, eating too much or too little, sleeping too much or too little, and loss of interest in things you used to enjoy) related to losing your hair?
  
•   Do you socialize less than you used to?
  
•   Do you worry that your hair loss is all that others notice about you?
  
•   Do you feel unattractive?
  
•   Do you worry about your hair loss often enough that it interferes with other areas of your life?

•  Identify Your Thoughts and Feelings: Write down your negative thoughts about hair loss and baldness so you can keep track of them.
  
  
•  Examine the Evidence: Instead of assuming that a negative thought is true, examine the actual evidence for it. For example, if you think all bald people are unattractive, ask several people if they have ever been attracted to a bald person.
  
  
•  The Double Standard: Instead of harshly telling yourself to "just get over it," talk to yourself in the same compassionate way you would talk to a friend who is upset about his or her hair loss.
  
  
•  The Experimental Technique: Do an experiment to test the validity of your negative thoughts about hair loss. If you think it is impossible for a balding person to get a date, approach several people who seem interested in you and ask them to a movie, coffee, or lunch.
  
  
•  Thinking in Shades of Gray: Rather than thinking it's "all or nothing," evaluate things on a scale of 1-100. For example, just because you aren't the most attractive person in the world, doesn't make you the least attractive one either. Find yourself in the middle ground rather than at the extremes.
  
  
•  The Survey Method: Ask people questions to find out whether your thoughts and attitudes about hair loss and baldness are realistic. For example, if you believe all balding people are miserable, talk to people who are losing their hair. Test your assumption by asking them how they are feeling and how their lives are going.
  
  
•  Define Terms: When you label yourself "ugly" or "inferior" or "a loser," ask yourself the definition of these terms. You may find that you used such labels on yourself automatically, without thinking about what they really mean. In fact, you may find that you don't at all match some of the labels you've given yourself.
  
  
•  The Semantic Method: Substitute language that is less emotionally loaded. Instead of saying, "I shouldn't have to lose my hair; it's totally unfair," say "I would have preferred not to lose my hair, but since I have, what can I do to feel better about it?"
  
  
•  Re-attribution: Instead of automatically assuming that you are to blame for a problem, think about the many factors that may have contributed to it. Some people may believe that they have lost their hair because they are destined to be second rate. But consider that baldness is controlled genetically, like the color of your eyes. Would you call yourself a loser because your eyes were blue instead of brown?
  
  
•  Cost Benefit Analysis: List the advantages and disadvantages of negative feelings about baldness, thinking negatively about baldness, or changing the way you live because you are losing your hair. What do you gain from seeing your hair loss negatively? What might you have to gain from a more positive outlook?

•   Counseling can help you to clarify your attitudes toward hair loss and baldness.
  
•   Counseling can help you understand how your life has been affected by your hair loss.
  
•   Counseling can help you to create strategies for feeling better about your hair loss and yourself.
  
•   Counseling can help you to explore your definitions and attitudes toward attractiveness and self-image.
  
•   Counseling can help you to become less isolated and start socializing.
  
•   Counseling can provide support during difficult periods of adjustment.

• Tinea capitis: is a scalp infection that is caused by a fungus. It can cause patches of hair loss, with broken off hairs (black dot ringworm), scales, enlarged lymph glands, or the formation of a kerion, a large, red, boggy nodule on the scalp. Your doctor may do a KOH examination of the hairs, have a fungal culture done, or he may just treat your child with an antifungal agent, such as griseofulvin. These medicines are taken for at least 6 weeks, usually with fatty meals which can help it to be absorbed better. You can also wash your child's hair with a shampoo that contains selenium sulfide at least twice a week to make him less contagious.
• Trichotillomania: this is a condition in which a child actually pulls the hair out, leaving an irregular patch of hair loss with broken off hairs of different sizes. It can be a habit, especially in times of stress.
• Traction alopecia: this occurs when hair is braided too tight, or other tight hairstyles.
• Alopecia areata: children with this condition have a complete loss of hair in one to three areas of the scalp, without scalp redness or scaling. Another finding can be pitting of the nails in children with this condition. Although there is no reliable treatment for this condition, most children will have regrowth of the hair on their own within a year.
• Telogen effluvium: this usually occurs in young infants as a part of the normal process in which mature hair replaces baby hair. It can also occur in older children, usually a few months after an illness, and it is caused by the hair growth cycle being interrupted, with many hairs moving from a growing state to a resting state. As many hairs are shed, you may notice diffuse hair loss and it may seem like all of your child's hair is falling out, but there should be no other signs of infection or inflammation. The hair usually grows back in about 6 months.
• Congenital alopecia: newborns can have small areas of hair loss that are present from birth from a few different conditions, including aplasia cutis congenita and nevus sebaceous, a yellow-orange birthmark.
• Scarring alopecia: some conditions, including trauma or inflammatory reactions on the scalp can lead to scar formation, inside which hair does not grow, causing a bald spot on the scalp.

Wigs for Kids is a cooperative effort among Certified Cosmetic Therapists™ throughout North America who share a common goal. “Children shouldn’t have to worry about how they look, especially when they’re in the middle of a health crisis,” says Jeffrey Paul. “We want to give these kids the opportunity to feel good about themselves again.”

The value of each individually designed hair system is $1,500. “These are custom-made hair replacements,” says Jeffrey Paul. “Each prosthesis is hand-tied and is made completely from human hair. We make sure they look just like a child’s own hair.

“They won’t come off on the baseball field or in the playground,” he adds. “Kids can count on them. And because kids look just the way they did before, they feel better about themselves. They look in the mirror and their eyes light up. To see that light in their eyes — that’s priceless.”

"Corn rows" and other styles, like extensions, which pull the hair are to blame, particularly if combined with hair straightening chemicals.

The South African research, published in the British Journal of Dermatology, looked at almost 2,000 adults and children.

A UK dermatologist said that affected hair follicles may never recover.

Specialist braided hairstyles are increasingly popular in the UK, particularly among young people from the Afro-Caribbean community.

Short cuts

The Cape Town-based researchers wanted to find out if they, and other popular cuts such as short "brush-cut" haircuts could cause skin problems.

They found that nearly one in seven children and a third of women suffered from "traction alopecia", a type of hair loss directly linked to the hair being constantly under tension.

The problem was even more common if chemical "relaxers" had been used to straighten the hair, with one in five children who had used the chemicals suffering hair loss.

The research also found that very short haircuts made men much more prone to developing severe acne on the scalp, thought to be caused by the hair clippers damaging the scalp when pressed hard against the head.

They pointed out that the risk of catching a disease such as HIV or hepatitis could be increased by this type of haircut.

No growth

Dr Nonhlanhla Khumalo, who led the research, said: "Traction alopecia is common in women and girls and is significantly linked to hairstyles, particularly when relaxed hair has braids, extensions or weaves attached.

"This can cause unsightly hair loss which is distressing."

In the UK, dermatologists are reporting similar problems, both due to braiding, and to other popular hairstyles where the fringe is dragged backwards and tied.

Dr Andrew McDonagh, from the Royal Hallamshire Hospital in Sheffield, said: "The best thing is to try to identify the problem early - if this happens for a long time, the hair follicles may be permanently damaged, and hair will not grow back."

A spokesman for the British Association of Dermatologists added: "Some of these hairstyles might be fashionable, but they can lead to permanent hair loss, which is difficult to cover up and can have a huge impact on a person's confidence."

The emotional effects of hair loss are often significantly more distressing on children than on adults. The child suffering from this condition often doesn’t understand the cause as an adult does and tends to think that there’s just something wrong with him/her. Additionally, other children will often subject the child to teasing for looking different.

Some myths about children’s hair loss are that vitamin deficiency, poor scalp circulation, headbands, hats, or cold weather can bring it on. The causes of hair loss in children are unfortunately not quite that simple.

Besides trauma, the most common cause of hair loss in children is alopecia areata. This is an autoimmune condition in which the body mistakenly forms antibodies against its own hair follicles. This condition commonly begins with the rapid onset of bald spots over the scalp. Although one smooth bald spot is most common, many may be seen, and every hair on the body may be lost in some patients.

Current treatments attempt to stop the hair loss process, but this condition has a propensity to recur again and again. The most common approaches to treating this distressing problem include injections of cortisone, UVA light in combination with a topical photosensitizing medicine, Rogaine®, and anthralin.

Other causes of hair loss in children are

• telogen effluvium (a condition brought on by a high fever or excess stress)
• tinea capitis (a fungal infection)
• trichotillomania (a compulsive disorder in which the child pulls his/her hair out)
• traction allopecia (hair being damaged and pulled out by ponytails, braiding, etc.)
• scarring from trauma or surgical procedures

While surgical methods, such as microscope-assisted follicular grafting, are often chosen for those with baldness due to trauma, a non-surgical approach should always be selected for children with alopecia areata or other disorders.

Eyebrow transplants and eyelash transplants were originally introduced to patients who had suffered from burns or congenital malformations of the eye. However, since this procedure has been perfected, people suffering from either complete or partial eyelash or eyebrow loss now have an available medical alternative. In the past, some people opted for eyebrow tattoos to recreate lost eyebrow hair, but tattoos can be obvious and look unnatural. This procedure will restore natural looking eyebrows and eyelashes that will last a lifetime. This procedure can also be used simply to thicken existing eyebrows or to lengthen existing eyelashes for cosmetic reasons.

Causes
Many reasons can cause both men and women to lose eyebrow or eyelash hair. These include:

• burns;
• scars;
• diseases;
• congenital inability;
• self-inflicted obsessive plucking;
• medical or surgical treatments such as radiation therapy and chemotherapy.

Procedure
Transplanting eyebrows or eyelashes involves extracting “donor” hair one follicle at a time.. Dr Jones matches up hair form other parts of your body for the desired thickness and curl. Eyelash hair, for example, is coarser than eyebrow hair. The eyebrow or eyelash hair is placed in the same direction as native eyebrow hair or eyelashes to create a natural look. The direction of the curl is also chosen when inserting the follicles to imitate the regular curl of your lashes and the hole to receive the new follicle can be made with a slight arc to promote a curl. Density varies with gender: women often have more eyelashes than men. Patients feel no pain or discomfort during the procedure, as local anesthetic is used. The entire procedure takes a few hours to perform and usually requires only one session.

With careful attention to the direction and angle of the growth of the new hairs, we can successfully transform patchy or absent eyebrows and/or eyelashes into natural-looking ones.

Results
The eyelashes and eyebrows are your own naturally growing hair. Unfortunately, hair grows in cycles so you will have to be patient. It usually takes a few months before the new hair starts to grow. Both eyelash and eyebrow transplant surgeries yield very positive results.

Post-operation
Few patients experience complications following the procedure. The most common are a small area of purplish discoloration under the eyelids for a few days, minor itching, pain and possibly swelling in some patients. The results yield no visible scarring or tufting and appear quite natural. Patients should avoid scratching the area. For 4 to 5 days following the procedure, tiny scabs appear like dots of sand on the skin, but these fall off. Once the new eyebrow or eyelash hair grows in, it is indistinguishable from natural looking eyelashes and eyebrows. They will require regular trimming as they will continue growing like hair on the scalp.

Eligibility and Cost
Not everyone is a candidate for this procedure. For example, victims of trauma or burns may require reconstructive surgery before eyebrow or eyelash restoration. The degree of hair loss must also be taken into consideration before effectively evaluating the feasibility and complexity of individual cases. In addition, it is difficult to estimate the cost of the procedure since cases vary from one patient to another. Please call for a consultation.

Dr Jones is a skilled hair transplant surgeon and is now regularly seeing patients for eyelash transplants and eyebrow transplants. After this procedure, patients will enjoy their beautifully shaped and contoured eyelashes and eyebrows for life.

An unusual disorder leaves its sufferers with bare eyebrows, bare eyelashes, a ragged scalp that even a wig might not cover, and a very damaged self-esteem.

Trichotillomania, a psychiatric disorder that drives people to compulsively pull their hair, leaves behind scars worse than bald patches.

Video

Trichotillomania: A Hair Pulling Gene

"Those who suffer with 'trich' suffer twice," said Dr. Tamar Chansky, director of the Children's Center for Obsessive Compulsive Disorder and Anxiety in Philadelphia.

"Not only because they have this condition that interferes with their freedom -- how to wear their hair, whether they can swim or ride a bike. It also wreaks havoc on their self-esteem."

Between 3 percent and 5 percent of the population suffer this compulsive hair-pulling, but they often hide their habit.

As a result, the disorder often goes undiagnosed and untreated, researchers said.

Trich patients feel like they have a terrible secret that they need to keep private, for fear that no one will understand why they "do this" to themselves, Chansky said.

Trich Cause Uncertain

Experts aren't certain what causes trich.

It usually starts during early adolescence, but scientists at Duke University have recently found that the disorder might sometimes be due to a genetic mutation.

This finding is preliminary, but very exciting, experts say.

To the patients who suffer from this painful disorder, this discovery says, "It's not your fault," experts say.

"This is an important first in understanding the genetics of not only trichotillomania but any disorder where people have unwanted behaviors that they can't control," said Dr. Allison Ashley-Koch, the study's author and a researcher at the Duke University Center for Human Genetics.

"This opens the door and tells us that genes can be associated with this and other impulse-control disorders."

The scientists studied 44 families where one or more family members suffered from trich.

They looked specifically at a gene known as SLITRK1.

Scientists already know that SLITRK1 is linked to another impulse-control disorder that doctors think is related to trich, Tourette's syndrome.

CAUSES OF HAIR LOSS

Locks of Love is devoted to helping every child suffering from medical hair loss, thus we do not discriminate as to the cause of hair loss. We list the following information in an attempt to explain types of hair loss and specific needs of individual recipients.

Alopecia

Our largest number of children live with alopecia. Alopecia is an auto-immune disorder that causes the hair follicles to shut down. This disease has varying degrees and affects 4.7 million people in the United States alone. Alopecia areata affects both sexes equally and may, but does not always, progress to significant hair loss. Currently, there is no known cause or cure for alopecia. The degrees of alopecia are as follows:

• Alopecia Areata Ophiasis-loss in bands along the scalp margins
• Alopecia Areata Sisaipho-loss of all scalp hair except along the scalp margins
• Alopecia Totalis-loss of all scalp hair
• Alopecia Universalis-loss of all scalp and body hair

Cancer

Cancer constitutes the second highest percentage of our recipients. Every year approximately 2,200 children under age 20 are diagnosed with brain tumors. Radiation treatment to the brain stem as a treatment for cancer can cause permanent hair loss. Chemotherapy may also cause hair loss to be long-term depending on the length of treatment needed.

Other causes of hair loss account for a small percentage of our recipients.

• Ectodermal Dysplasia-A heritable disorder that affects the formation of the ectoderm. Extremely sparse hair can be a result of ectoderm abnormality.
• Loose Anagen Syndrome-An abnormality where hair is thin and normally does not grow beyond the nape of the neck.
• Trichotillomania-Compulsive and repetitive hair pulling.
• Telogen Effluvium-Diffuse but excessive shedding related to sudden stress.
• Trauma-burns, accidents, dog attacks, etc.

Baldness or hair loss is usually something only adults need to worry about. But in a few cases, teens lose their hair, too — and it may be a sign that something's going on.

Hair loss during adolescence can mean a person may be sick or just not eating right. Some medications or medical treatments, like chemotherapy treatment for cancer, also cause hair loss. People can even lose their hair if they wear a hairstyle that pulls on the hair for a long time, such as braids.

Losing hair can be stressful during a time when you're already concerned about appearance. Most of the time, hair loss during the teen years is temporary. With temporary hair loss, the hair usually grows back after the problem that causes it is corrected.

Hair Basics

Our hair is made of a type of protein called keratin. A single hair consists of a hair shaft (the part that shows), a root below the skin, and a follicle, from which the hair root grows. At the lower end of the follicle is the hair bulb, where the hair's color pigment, or melanin, is produced.

Most people lose about 50 to 100 head hairs a day. These hairs are replaced — they grow back in the same follicle on your head. This amount of hair loss is totally normal and no cause for worry. If you're losing more than that, though, something might be wrong.

If you have hair loss and don't know what's causing it, talk to your doctor. A doctor can determine why the hair is falling out and suggest a treatment that will correct the underlying problem, if necessary.

What Causes Hair Loss?

Here are some of the things that can cause hair loss in teens:

• Illnesses or medical conditions. Endocrine (hormonal) conditions, such as uncontrolled diabetes or thyroid disease, can interfere with hair production and cause hair loss. People with lupus can also lose hair. The hormone imbalance that occurs in polycystic ovary syndrome can cause hair loss in teen girls as well as adult women.
• Medications. Some medications that have hair loss as a side effect may be prescribed for teens. These include acne medicines like isotretinoin, and lithium, which is used to treat bipolar disorder. Diet pills that contain amphetamines also can cause hair loss. Chemotherapy drugs for cancer are probably the most well-known medications that cause hair loss
• Alopecia areata . This skin disease causes hair loss on the scalp and sometimes elsewhere on the body. It affects 1.7% of the population, including more than 5 million people in the United States. Alopecia areata (pronounced: al-uh-pee-shuh air-ee-ah-tuh) is thought to be an autoimmune disease, in which the hair follicles are damaged by a person's own immune system. (In autoimmune diseases, the immune system mistakenly attacks healthy cells, tissues, and organs in a person's body.) Alopecia areata usually starts as one or more small, round bald patches on the scalp. These can get bigger, and in a small number of cases, can progress to total hair loss. Both guys and girls can get it, and it often begins in childhood. The hair usually grows back within a year, but not always. Sometimes people with alopecia areata lose their hair again.
• Trichotillomania (pronounced: trik-o-til-uh-may-nee-uh). Trichotillomania is a psychological disorder in which people repeatedly pull their hair out, often leaving bald patches. It results in areas of baldness and damaged hairs of different lengths. People with trichotillomania usually need professional help from a therapist or other mental health professional before they are able to stop pulling their hair out.
• Hair treatments and styling. Having your hair chemically treated, such as getting your hair colored, bleached, straightened, or permed, can cause damage that may make the hair break off or fall out temporarily. Another type of baldness that results from hair styling actually can be permanent: Wearing hair pulled so tightly that it places tension on the scalp can result in a condition called traction alopecia. Traction alopecia can be permanent if the style is worn for a long enough time that it damages the hair follicles.
• Poor nutrition. Poor eating can contribute to hair loss. This is why some people with eating disorders like anorexia and bulimia lose their hair: The body isn't getting enough protein, vitamins, and minerals to sustain hair growth. Some teens who are vegetarians also lose their hair if they don't get enough protein from non-meat sources. And some athletes are at higher risk for hair loss because they may be more likely to develop iron-deficiency anemia.
• Disruption of the hair growth cycle. Some major events can alter the hair's growth cycle temporarily. For example, delivering a baby, having surgery, or going through a traumatic event can temporarily cause shedding of large amounts of hair. Because the hair we see on our heads has actually taken months to grow, a person might not notice any disruption of the hair growth cycle until months after the event that caused it. This type of hair loss corrects itself.
• Androgenetic alopecia. Among adults, the most common cause of hair loss is androgenetic (pronounced: an-druh-juh-neh-tik) alopecia, sometimes called male-pattern baldness. This condition is caused by a combination of factors, including hormones called androgens and genetics. Sometimes, the hair loss can start as early as the mid-teen years. It also can occur in people who take steroids like testosterone to build their bodies.

What Can Doctors Do?

If you see a doctor about hair loss, he or she will ask questions about your health and family health (called a medical history) and check your scalp. In some cases, the doctor might take hair samples and test for certain medical conditions that can cause hair loss.

If medication is causing hair loss, ask the doctor if you can take a different drug. If your hair loss is due to an endocrine condition, like diabetes or thyroid disease, proper treatment and control of the underlying disorder is important to reduce or prevent hair loss.

If your doctor recommends it, a product like minoxidil that can speed up hair growth also might be helpful. Alopecia areata can be helped by treatment with corticosteroids. If nutritional deficiencies are found to be causing your hair loss, the doctor might refer you to a dietitian or other nutrition expert.

Catastrophic Hair Loss

Hair loss can be the first outward sign that a person is sick, so it may feel scary. Teens who have cancer and lose their hair because of chemotherapy treatments (especially girls) might go through a difficult time.

It can help to feel like you have some control over your appearance when you're losing your hair. When getting chemotherapy, some people like to cut their hair or shave their heads before the hair falls out. Some even take the hair they cut off and have it made into a wig. Many options can help disguise hair loss — such as wearing wigs, hair wraps, hats, and baseball caps. For most teens who lose their hair, the hair does return — including after chemotherapy.

Taking Care of Your Hair

Eating a balanced, healthy diet is important for a lot of reasons, and it really benefits your hair.

If you're losing hair, some doctors recommend using baby shampoo, shampooing no more than once a day, and lathering gently. Don't rub your hair too vigorously with a towel, either. Many hair experts suggest you consider putting away the blow dryer and air drying your hair instead. If you can't live without your blow dryer, try using it on a low heat setting.

Style your hair when it's dry or damp. Styling your hair while it's wet can cause it to stretch and break. And try to avoid teasing your hair, which can cause damage. Finally, be careful when using chemicals — such as straighteners or color — on your hair, and avoid frequent use of chemical treatments.

Reviewed by: Larissa Hirsch, MD
Date reviewed: January 2008
Originally reviewed by: Eliot N. Mostow, MD, MPH