Scientific Area

Hair loss (telogen defluvium)

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.

What does Telogen Defluvium (or Defluvium) mean?

With the term Telogen Defluvium we mean a modest, not excessive, loss of hair in the telogen phase, but which tends to often be irreversible, with the precise characteristics of hair in decay or involution. The hair that falls out is usually short and fine, with bulbs that are undeveloped and reduced in size.

Terapie efficaci del Telogen Effluvio acuto

Telogen Defluvium is nothing other than Androgenetic Defluvium (pattern hair loss).
With Telogen Defluvium the number of hairs lost does not exceed 100. With the pull test only two or three hairs at most are usually obtained. This means that due to the defluvium, the anagen phase has become temporally shorter (compared to its usually length), thus reducing the ability of hair follicles to sustain hair growth.
An alteration of the trichogram is almost non-existent with a number of hair in the anagen phase at around 80% due to a temporal reduction of the anagen phase of the hair follicle.

Due to a very short anagen phase, between 10% and 60% of fallen hair are short, thin and with bulbs that have a very thin diameter. They are moreover located on the surface of the dermis compared to hair that has a normal growth cycle. This hair is in between terminal hair and vellus hair.
It is included among hair in the involution phase with a short anagen phase and therefore is considered like hair in the premature telogen phase which falls out before its time. It is short and thin because it does not have time to develop (short anagen phase), it appears small and involute after a very short anagen phase and is characteristic of this form of hair loss. The follicle remains histologically present for a long time, even if it is not as deep and contains a hair that is increasingly involute. Only very late does this hair go towards hyalinosis.

This is a pathological process that may manifest in various bodily structures, characterized by the intra- and extra-cellular accumulation of material, called hyaliane, which damages the structure and function of the affected areas, resulting in progressive atrophy. The hair loss resulting from this is similar to a scarring form with loss of the skin adnexa.
We can distinguish between an acute form of Telogen Defluvium (very intense and characterized by a temporary loss of hair) and a chronic form of Telogen Defluvium (a modest type with a constant loss of hair).
In men common causes of Telogen Defluvium are both pattern hair loss (chronic telogen defluvium) and male frontoparietal alopecia (chronic telogen defluvium).
Instead, in women common causes of Telogen Defluvium are more numerous. Among them we note: pattern hair loss from drugs (acute telogen defluvium), post-menopause hair loss (acute telogen defluvium), hair loss from androgen secreting tumors (acute telogen defluvium), hereditary hair loss (chronic telogen defluvium), polycystic ovary hair loss, congenital adrenal hyperplasia hair loss (acute telogen defluvium), hair loss from anorexia nervosa (acute telogen defluvium) and lastly hair loss from hyperprolactinemia (acute telogen defluvium).

Seborrheic alopecia (seborrheic hair loss)

Seborrheic hair loss is a form of premature hair loss that generally afflicts men in their youth (onset between 20 and 30 years of age), mainly affecting the frontal region and the crown. The cause, as the name of the condition suggests, is related to an excess production of sebum that provokes or accelerates hair loss.

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Sebaceous glands

The sebaceous glands are glands that secrete sebum, an oily, acidic substance with a pH of 3.5. They are connected laterally to the hair follicle. Sebaceous glands are found with a density of approximately 100/cm2 throughout all areas of the skin. In the human body, they are located across the entire surface of the skin, except for the palms of the hands and the soles of the feet.

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Grey hair

In the trichological field, with the passing of age hair whitening is seen to follow the greying process of the hair on the scalp (called grey hair). Hair becomes grey (white) following a natural biological aging process of the melanocytes, which are the cells tasked with coloring hair.
In the majority of people, the first grey hairs appear around 35/40 years of age in women and around 30/35 in men.

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Scalp pain

Scalp pain and irritation (or trichodynia) are pathological conditions that affect both women (in a greater percentage) and men (in a lower percentage). The pain felt on the scalp, spontaneous or caused by treatment, and in particular around the roots of the hair, may be more or less intense, alternating at times between periods of disappearance, associated with burning, tingling or itching.

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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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PRPHT: the last frontier against hair loss

The acronym PRPHT stands for “Platelet Rich Plasma Hair Therapy”. It is a therapeutic medical technique that falls within the field of “regenerative medicine”; it is based on the principle that stem cells, which have been demonstrated to be present in the hair bulb, are equipped with growth factor receptors.

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