Scientific Area

Hair loss: manifestation, causes and prevention

CATEGORIES SCIENTIFIC AREA

Scientific collaboration between Professor Marco Toscani and Dr. Pasquale Fino, Chair of Plastic, Reconstructive and Aesthetic Surgery, Umberto I Health Center – “Sapienza” University of Rome.

A shedding of hair is considered physiologically normal when hair loss is limited to around one hundred hairs per day. During an individual’s life hair grows, falls out and regrows around twenty times. Each cycle, especially for females, may last up to six years and if hair loss is found within this time frame, it is considered absolutely physiological.

PHYSIOLOGY AND PATHOLOGY OF THE LOSS

With the Cesare Ragazzi Laboratories trichological research program, thanks to the Tricotest® and a dermatological visit, it is possible to examine the hair loss and understand whether it is a normal loss or a different type of problem.

An increase in the number of hairs that fall out, especially during the spring and autumn, should not indicate anything pathological and therefore be a cause for worrying, so long as the quantity of hair lost is proportional to its usual density.

One may start to think he/she is facing an irregularity in the hair loss when the amount of hair falling out is visibly greater than the amount of hair in the growth phase. This irregular loss of hair is often caused by temporary factors – which may be environmental or related to stress or to a poor diet – but if one realizes that the loss lasts beyond a limited amount of time, it is best to start searching for a deeper cause.

Except in the case of situations in which the hair loss issues are due to medical causes, verified with clinical exams, undergoing a hair exam such as the one performed by Cesare Ragazzi Laboratories is useful for discovering the presence of scalp irregularities (such as dandruff or seborrhea, which influence hair health and hair loss and, as such, may be important for indicating how to act with targeted treatments that bring hair loss back within physiological limits).

Recognizing hair loss and preventing it

The nature of the different types of hair loss is not easy to identify: it may differ on the basis of the affected areas of the scalp or of the causes that triggered it. Thus, various types of hair loss can be identified, each presenting different degrees of severity, different causes and specific remedies.

– Hair loss occurs in different ways in men and women: the receding hairline is typical of the hair loss and thinning in men, while in women thinning occurs over the entire scalp.

– Hair loss may be reversible (temporary) or permanent, with the death of the hair follicles (scarring)

– When the hair loss, although anomalous, is reversible, it is known as telogen effluvium

– Instead, Telogen Defluvium is a definitive loss of hair, which involves the progressive loss of hair follicles

– When hair falls out more abundantly but physiologically in the spring or autumn, we are talking about seasonal hair loss

– A growing number of young people are afflicted by premature baldness, making the phenomenon of young hair loss a truly common one

– The loss of hair may be a source of psychological problems, which may cause depression

– We can also include itchiness of the scalp among the possible causes of hair loss, when this is symptomatic of particular illnesses

– Male hair loss is assessed with the Hamilton-Norwood Scale, which measures the progressive hairline recession and thinning

– Female hair loss is assessed with the Ludwig Scale, which measures the thinning

– When hair loss is hereditary, it is called androgenetic alopecia (pattern hair loss) or baldness

– If hair loss is caused by excess sebum deposited on the scalp, we are talking about seborrheic hair loss.

– Periods of high and prolonged stress may also destabilize hair, causing hair loss due to stress (psychogenic alopecia)

– Trichotillomania alopecia occurs when hair falls out following the continuous traction and tearing due to the habit of continuously pulling one’s hair

– Intervention with the right remedies within the right time frames is fundamental for resolving (or at least limiting) the consequences of hair loss.
There are different degrees of solutions and treatments, which go from aesthetic hair replacement remedies to pharmaceutical and trichological treatments such as that offered by the CRLab line.

– Our experts are available to answer all doubts and questions on hair loss and on how to avoid it by maintaining healthy skin and hair.

SEASONAL HAIR LOSS

The term seasonal hair loss indicates the increased loss of hair during the spring (months of April and May) and autumn (months between September and November).
This affects both sexes in equal measure.
The causes that lead to seasonal hair loss are not yet completely clear.

Origini e cause della caduta dei capelli stagionale

Three different origins can be identified:
1) Many of those who study trichology recognize a genetic heredity combined with the seasonal change of the hair that is characteristic in mammals;
2) Other scholars believe that it is due to the change in the relationship between the hours of light and dark that cause the hair loss by influencing the hormonal balance;
3) Finally, other trichologists provide an explanation more closely related to psycho-sociological factors of the phenomenon and associate the increase in hair loss with the return to polluted city life after summer vacations, characterized by stress, returning to work, frenetic rhythms of life and the presence of atmospheric pollution.

Furthermore, we can confirm that some scientific studies claim to have found the cause for seasonal hair loss. Considering that after 3 months any damage or benefit at the level of the scalp translates into a loss or improvement, the autumn hair loss would apparently refer to excessive exposure of the head to sun during the hot summer months (the rays of the sun cause free radicals to accumulate, and these damage the hair bulbs and are therefore responsible for the hair loss after approximately 3 months, thus in autumn); with regards to the spring loss the theory states that excessive exposure of the head to cold during the winter leads to vasoconstriction at the level of the scalp, thus damaging the hair bulbs and resulting in a loss after approximately 3 months, thus in the spring. Regardless of the cause of seasonal hair loss, its increase in the spring and autumn is considered to be a physiological phenomenon of natural “renewal”.

It is well known that human hair has a growth cycle that may last between two to six years. Hair, in fact, is renewed around twenty times in the arc of your entire life. This means that each hair falls out and regrows around twenty times before definitively dying following aging of the hair follicle. The spring and autumn periods do not do anything other than accelerate, due to changes in climate, the life cycle of hair and its physiological renewal. 
That said, a distinction must be made between seasonal hair loss and irregular or pathological hair loss. 

For the majority of people losing hair is a condition experienced with anxiety and depression. What happens in the spring and autumn periods is natural. In these seasons even for people with full heads of hair, hair loss can greatly exceed one hundred hairs per day. In these cases, only hair in the telogen phase falls out (in fact, we are talking about seasonal telogen effluvium), meaning that which has by now reached the end of its growth cycle. 
In fact, its follicles are already working to produce new hair. There are, however, also those clinical cases in which the natural increase in seasonal hair loss hides a real hair growth problem, thereby making it difficult to distinguish between normal and irregular hair loss. In fact, during the autumn period the renewal of psycho-physical tensions due to the beginning of the work year is reflected in hair health. If this stress is inserted into a situation of already weak hair, the risk is very high that a process of excessive and abnormal hair loss will be activated. 

There are also some signs that indicate that the hair loss has pathological characteristics, such as the presence of scalp itchiness and pain. It should be noted that often in the months in which hair loss increases in many people it tends to lead to an increase in pre-existing hair loss. 
In these situations it is always necessary to consult a trichologist who, by studying the individual case, will determine the causes responsible for the excessive hair loss and will establish a proper therapy to remedy it.


HAIR LOSS DUE TO STRESS

Even if today there isn’t experimental proof that attests to hair loss due to stress, many patients often complain about this situation. 
Psychogenic hair loss is nothing more than a disturbance of psychosomatic origin resulting from stress and nervous tension.Hair loss due to stress is differentiated clearly from trichotillomania alopecia, which though both are due to psychological causes, is a disturbance in behavior and thus not of psychosomatic origin. 
Recent studies have shown that the important and repeated roll of stress induces both the hypothalamus and the pituitary gland to release corticotropins which enter circulation, reaching the keratinocytes, fibroblasts, cells of the immune system and the sebocytes, cells responsible for hair growth. 



Any stress or stressful event, both of an endogenous (internal) and exogenous (external) nature, leads to a psychological and physical reaction which manifests in hair loss.
Hair loss due to stress in women manifests as hair thinning over the whole scalp and especially in the center which connects the hairline to the top of the head. 
Instead, hair loss due to stress in men, in addition to thinning that involves the entire scalp, is characterized by a receding hairline that proceeds quickly with the continuation or aggravation of the factors that led to it.


The symptoms of hair loss from stress (both for women and men) is often confused with androgenetic alopecia (pattern hair loss). The latter is excluded only when it is demonstrated that the patient in question does not have a family history with regards to this illness. 

Also the differential diagnosis between seborrheic hair loss and hair loss from stress is not simple. 
In both cases an excessive production of sebum is noted, but while in seborrheic hair loss, seborrhea is the direct cause of hair loss, in hair loss due to stress, seborrhea, if present, is an indirect cause triggered by the stress. 
The symptoms of psychogenic hair loss are: hair loss, seborrhea or hypersecretion of sebum, seborrheic dermatitis, scalp itchiness and trichodynia. 
An important therapy in the cases of hair loss due to stress is eliminating any source of stress that causes the hair loss by: staying away from the cause if it is external or through psychotherapy if the source is an internal distress.


The treatments and therapies for hair that falls out or is damaged (telogen effluvium and defluvium) may last a long time and require a great deal of determination and consistency. 

We can confirm that hair loss due to stress is not irreversible, but it is very difficult to cure. In fact, it is unlikely that those who are particularly anxious will be become calm and will reduce the stress that is the source and origin of the hair loss. 
In addition to trying to reduce or stop the psychological causes of stress, medical and trichological anti-hair loss therapies and cures can be prescribed which contrast the symptoms and indirect causes. For example, anti-seborrhea therapies help to reduce the secretions that would otherwise block the hair bulbs, facilitating hair loss. 
Laser and infrared ray hair therapies are also very useful for hair regrowth.


They stimulate the hair follicle facilitating the transfer of nourishing substances from the hair bulbs to the hair, thereby strengthening and protecting them from premature loss. A trichological visit, hair exam and trichogram are nevertheless important.


Hyperhidrosis

Excess sweat production on the entire surface of the body or just in some areas (especially the scalp, palms of the hands, soles of the feet) is called hyperhidrosis.
Some of the causes that may lead to temporary hyperhidrosis are physical hyperactivity, fevers, saunas, vomiting and dysentery. Causes that may instead lead to a repeated state of hyperhidrosis are hyperthyroidism, hypoglycemia and alcoholism

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Dry hair

Both men and women of any age may have dry hair. This situation is endured not only as an aesthetic problem, but in time may represent a problem concerning hair health. Dry hair often appears weak, fragile and tends to become brittle and to break.
Dry hair often has split ends and other forms of damage to the shaft.

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Hair follicles and bulbs

A hair follicle is a formation of epidermal origin, anchored in the dermis and consisting of a hair and its sheath.
The formation of hair follicles occurs early. They begin to appear as early as the second month of gestation. These follicles will continue to form for the entire duration of the pregnancy. At birth, the baby will indeed have the entire supply of follicles with which it was genetically equipped and from this moment on, no others will form.

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Seborrheic dermatitis

Seborrheic dermatitis is a very common scalp condition characterized by the presence of yellow and oily flakes on the skin.

It is associated with erythema, small scaly, and intense itching.
Seborrheic dermatitis is a well-known condition but is still not easily identifiable. Many men and women starting from puberty have oily, greasy, shiny and thickened skin with large hair follicles, especially noticeable around the nose and mouth, forehead, torso, scalp (affected by so-called oily dandruff).

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Premature hair loss

Recent studies have demonstrated that around one in five young men tend to lose their hair prematurely over time.
This problem does not affect only young men but also young women.

In the majority of cases, it is androgenetic alopecia (pattern hair loss) and therefore is hereditary/genetic. However, it is important to remember that often factors of psychological origin like performance anxiety, trauma and emotional stress take over, thereby becoming a source and cause of hair loss from stress.

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