Good things come in threes, it’s said, and so does hair. It occurs in three layers and three growth cycles.

Hair’s a special form of protein called keratin, which also constitutes the nails on our toes and fingers. Its outer layer is called the cuticle, and it protects the middle layer called the cortex, the really interesting layer, which determines the color of your hair and whether it is straight or curly. The innermost layer, the medulla, causes hair to look different in the sunshine because it reflects light.

Hair grows in three cycles — the growth stage, the transition or hair loss stage and the resting stage. The follicle produces both the terminal hair, which grows longer and can be seen easily, as well as vellus hair, usually referred to as “peach fuzz.”

CAUSES OF HAIR LOSS

It is normal to lose 50 to 100 hairs per day. There are several types or forms of alopecia (the medical term for hair loss). One is androgenetic alopecia, which can happen even to teenagers and for which you can thank either side of your family for passing the genes along to you. Heredity can also predispose you to the speed and pattern and extent of your baldness.

Alopecia areata is blamed on your immune system. What causes your system to periodically attack your hair is not known. Small, round and smooth patches of hair loss are the pattern of this type of alopecia. However, sometimes all of the body hair is lost, a condition called alopecia totalis. This condition is treatable, and most of the time the hair grows back between bouts.

Other causes of hair loss include iron deficiency, particularly in athletes and women with heavy menstrual periods, and protein deficiency caused by certain fad or low-protein diets, eating disorders such as bulimia, and just plain not getting the proper nutrition. Surgery, anesthesia and diseases such as diabetes, lupus and thyroid disorders as well as medications such as some of those used for gout, arthritis, depression, heart problems, high blood pressure and acne can be blamed for hair loss.

High fever, illnesses such as flu, and chemotherapy and radiation treatments are also culprits. Hormonal changes resulting from birth control pills, childbirth, menopause and thyroid are major causes of hair loss. And, finally, STRESS. Hair loss is just one more problem among the many the body undergoes when stressed, for whatever reason.

But there’s more. Let’s call it hair abuse. Pulling and twisting the hair by some individuals is just an unconscious, nervous habit. For others, this behavior could be part of an illness requiring the help of a mental health professional.

Those chemicals we use to make us so beautiful — the dyes or tints, bleaches, straighteners, relaxers and perms — can cause problems with hair. Here’s a rule of twos: not too often, not for too long, and no two procedures in one day. By going only to hair professionals who use top-of-the-line products, you can most likely avoid these problems.

Finally, tight braids, hair weaves and ponytails or other styles that constantly pull on the hair can be hair loss culprits, causing traction alopecia.

THE PSYCHOLOGY OF
HAIR LOSS IN WOMEN

When women suffer hair loss, it can be emotionally devastating. After all, women aren’t supposed to go bald. Just look around — in books and book covers and descriptions in the writing, billboards, magazines, TV and movies — women are depicted with long, flowing, shiny and, yes, thick hair.

Hair loss in a woman can affect every area of her life as she tries to hide the problem. Activities can wither away as she tries to avoid water, heat and wind and even her sexuality. Many women become depressed, as their self-esteem takes a dive, and they almost become reclusive. Some may even question their sexuality.

WHAT CAN BE DONE
ABOUT HAIR LOSS?

Right now, the choices you have are to do nothing and accept it, to seek nondrug or drug therapy, to use wigs or hair “systems,” or to have surgery to restore your hair. Since education is clearly important, let’s address each of these choices. If you can accept your hair loss without sustaining emotional or psychological damage, good for you!

There are many products on the market making claims of a cure for hair loss. These non-drug products are not controlled by the FDA, so they can make claims that may not be true. The overthe- counter product, Rogaine, or the prescription product, Propecia, may cause a little “peach fuzz” to grow or slow the hair loss, but neither will cause permanent hair to grow. They must be used continually, as any benefits gained by these products will be reversed when you stop using them. Note: Use of Propecia is very dangerous to women, especially pregnant women.

Dermatologists and other physicians have access to some prescription creams, shampoos, shots and other methods to try to help your situation, depending on what is causing the baldness.

Wigs and hair “systems” can be made of synthetic materials or from real human hair. The quality of the wig can vary from the less expensive and mass-produced to the custommade and extremely expensive. With custom-made and custom- fitted wigs, the construction of the foundation and the wig is important so that the hairs appear to be growing from a human scalp. There are, of course, maintenance costs associated with wigs, such as cleaning, styling and replacing.

There are several ways a wig or hairpiece can be attached to your head. Clips, although quick and easy, can be so tight that they can cause traction alopecia. Adhesive tape leaves the hairpiece sticky. Some systems are actually semi-permanently bonded to the hair. As the name implies, hair weaves are actually woven into your own hair. These weaves need to be tightened frequently as your real hair grows. The maintenance can be quite expensive.

SURGICAL PROCEDURES

In 1959, a dermatologist in New York was the first to successfully transplant hair from the back of the head to the balding areas. The procedure is known as “donor dominance,” the theory being that by using hair from a more permanent area, it will prevail over the bald area and grow.

Other procedures have been developed over the years, including one using larger, round plugs of hair that were grafted onto the scalp. Problems arose when the hair in the middle of the transplant died, leaving a hole in the middle. This became known as “donutting.” Other problems included raised areas at the base of the graft and the famous “doll’s hair” appearance where the grafts were round clumps of hair placed in the middle of bald areas in little rows. Unfortunately, they stayed that way! Scalp reduction and the flap are other techniques used and are pretty much self-explanatory.

In San Antonio, several doctors perform hair transplantation. As a matter of fact, we have father and son physicians who practice state-of-the-art hair transplantation surgery. The father, Dr. B. L. Limmer, is recognized as one of the premier hair transplant surgeons worldwide, having developed and perfected a technique referred to as the “gold standard of hair transplantation” — microscopically magnified micrografting. His son, Dr. Bradley Limmer, has been involved in the development of follicular unit micrografting. This technique can also be used for eyebrows, eyelashes, beards, mustaches and to cover scars.

SOME THINGS YOU CAN
DO FOR YOUR HAIR:

Take care of what you have. Use mild shampoos, air dry if possible, go easy on the chemicals, and curtail ponytails, weaves, braiding and similar restricting techniques so as not to stretch your hair.

When you do have hair loss, consult with a physician to determine the actual cause of the loss, whether it’s treatable and if the condition is temporary or permanent.

Make sure the physician is board certified, experienced at transplanting and has some aesthetic vision for your transplant results. Don’t hesitate to ask to talk to other patients who have had these procedures. The physician should be open to discuss any concerns you might have.

Hair loss affects so many millions of people, there is ongoing research to develop new drugs that might restore hair and even a “buzz” about cloning of individual hairs in the future.

Author: Anne Moore