Hair Loss- Private room
Vancouver Hair Loss Specialist- Private room
Anyone who are going through hair loss, thinning, and baldness, Psoriasis hair loss, Chemotherapy, pattern Alopecia, Trichotillomania, or a different medical reasons
I will do my very best to find a non surgical solution for you. Prior to booking an appoitment with me please see a dermatologist for your hair loss concerns. I recommend Dr. Jerry Shapiro or Dr. Sunil Kalia.
Department of Dermatology & Skin Science
Faculty of Medicine
835 West 10th Avenue
Vancouver, BC Canada V5Z 4E8
Tel 604 875 4747 | Patient Information 604 875 5151
Here is a bit more information on hair loss
Hair loss occurs due to many possible causes related to an individual’s genetic makeup or other factors. Through this discussion, hair restoration. I hope to help you better understand the causes of your hair loss.
Normal Hair Loss. We can lose about 50-150 hairs per day from normal shedding, as part of the normal hair growth cycle. On average, hair on the scalp grows about 6 inches per year. We all have random growth and shedding cycles. The number of hairs lost or gained also vary.
Causes for Hair Loss
Telogen Effluvium (Stress-induced hair loss)
Severe stress can affect normal hair growth. As a result, excessive shedding can occur, which in turn can cause bald patches. This effect, however, is temporary given that the stress is properly managed.
Significant changes in hormone levels can have a drastic effect on hair. For example, estrogen levels increase during pregnancy, so it is normal to have thicker hair during that time. However, during the postpartum period, estrogen levels decrease, which results in more hair going into the catagen and telogen phases. Hair loss that occurs during this time, though, is normal. Similarly, women going through menopause also experience a decrease in estrogen and progesterone levels, which can also cause a hormonal imbalance that leads to hair loss.
Some medicines for heart conditions, blood pressure, birth control, acne and depression have been known to cause temporary hair loss. Cancer treatments like chemotherapy and radiation also commonly cause hair loss.
Infection and Disease
If left unchecked, fungal and viral skin infections and serious diseases such as lupus, thyroid disease and diabetes can thin out hair or cause hair loss altogether. Proper diagnosis and medical treatment is advised immediately.
Genetics and Age
Hair loss is a genetic issue, as people with family members who suffer from hair loss are likely to have it as well. The chances of experiencing hair loss also increases with age, and this can be predicted using the Rule of Decades. According to this rule, 30% of men in their 30s will start to experience hair loss, and 40% of men in their 40s will already be experiencing hair loss. This rule changes in women — only 30% of women under the age of 50 experience hair loss, while 50% of women over the age of 50 will experience hair loss.
Other Hair Loss Syndromes
Androgenetic Alopecia / Pattern Hair Loss
Androgenetic alopecia is the scientific name for the genetic predisposition to pattern baldness in both men and women. Androgenetic alopecia is the cause of over 95% of all pattern hair loss, including baldness in men and thinning hair in women. Pattern hair loss occurs in somewhat predictable stages, and is relentlessly progressive. Usually the earlier in life pattern hair loss begins, the more advanced the pattern will ultimately become.
In male pattern baldness, the hairs on the top of the scalp have a genetic sensitivity to the male hormone testosterone (DHT). The hairs on the sides and back of the scalp do not possess this genetic trait and is usually unaffected. For this reason, hairs removed from the sides and the back of the head will maintain their genetic predisposition when transplanted and continue to grow even when moved to the top of the scalp where hair loss initially occurred.
Alopecia areata is an immune system disorder which causes hair follicles to stop producing hairs. Sudden loss of hair in small patches on the head is a common symptom. Advanced forms of the disorder include alopecia totalis, where all hair on the head is lost, and alopecia universalis, which results in the absence of all body hair.
Traction / Scarring Alopecia
Scarring alopecia occurs when hair strands experience consistent pulling that is usually caused by wearing hair in very tight braids, corn rows or ponytails. Because of such hairstyles, the hair follicles undergo a lot of stress, which ultimately leads to damage and hair loss.
Anagen effluvium is the sudden loss of growing hairs as a result of chemicals or radiation. Cancer treatments such as chemotherapy and radiation therapy halt the growth phase of hair follicles, and result in the sudden shedding of hair. Some medications (i.e. diuretics, blood thinners, acne medications and birth control pills.) can also cause hair loss as a side effect.
Lichen planopilaris is a rare inflammatory condition where smooth hairless patches occur on the scalp. It affects mostly young women, although it can affect men as well, and can have wide age range. These smooth patches on the scalp can grow larger and cause aggressive hair loss. Common sites for lichen planopilaris are usually seen on the sides, front, and lower back of the scalp.
This syndrome is characterized by the development of fraying and swelling nodes on the hair shaft that cause it to easily break. This is said to occur from repeated trauma to the hair such as excessive application of hair chemicals and hair styling.
Folliculitis is the infection of the hair follicles by bacteria, fungus, or yeast and can be caused by exposure to unhygienic hot tubs and swimming pools. Folliculitis can also occur when the skin or hair follicles becomes irritated by tight clothing, chemicals, or anything that can cause blockages in the hair follicle. Infection can also occur from cuts, scrapes and wounds that directly affect the hair follicles. With so many possible causes, folliculitis is common, but can be readily treated with over-the-counter, prescription, and even common homemade remedies like white vinegar.
What is Alopecia Areata?
Alopecia Areata is a highly predictable, autoimmune skin disease resulting in the loss of hair on the scalp and elsewhere on the body. This common but very challenging and capricious disease affects approximately 1.7 percent of the population overall, including more than 4.7 million people in the United States alone. Due to the fact that much of the public is still not familiar with alopecia areata, the disease can have a profound impact on one’s life and functional status, both at work and at school.
How Does Alopecia Areata Occur?
In alopecia areata, the affected hair follicles are mistakenly attacked by a person’s own immune system (white blood cells), resulting in the arrest of the hair growth stage. Alopecia areata usually starts with one or more small, round, smooth bald patches on the scalp and can progress to total scalp hair loss (alopecia totalis) or complete body hair loss (alopecia universalis).
Alopecia areata occurs in both males and females of all ages and races; however, onset most often begins in childhood and can be psychologically devastating. Although not life-threatening, alopecia areata is most certainly life-altering, and its sudden onset, recurrent episodes, and unpredictable course have a profound psychological impact on the lives of those disrupted by this disease.
ACell Enhanced PRP Hair Rescue Therapy Treatment
Patient with Severe Alopecia Areata for over 1 year with no response to corticosteriod therapy with no results and area expanding. Injected with ACell/Enhanced PRP Hair Regeneration Therapy. (L) Pre-injections, Second photo Post-Injection follow-up 7 weeks , third photo (R) 8 months post injection therapy.
Causes of Alopecia Areata
The causes of alopecia areata are not exactly known, or why only specific areas of the scalp are affected by the hereditary disease. It is believed that the immune system has an inherited factor that triggers it to react against particular tissues of its own body — in this case, hair follicles. These “triggers” can range from infection, medicines, to environmental factors. Interestingly, this disease does not actually destroy the hair follicles, but only “halts” normal growth. The growth of hair normalizes when the immune reaction goes away.
For more information, visit The National Alopecia Areata Foundation Website.
What is Trichotillomania?
Trichotillomania was first identified in 1889 by French dermatologist François Henri Hallopeau. Since then, numerous medical reports have been published from both dermatologists and psychologists regarding the condition.
As the name suggests, trichotillomania is based on an obsession with hair. People with trichotillomania tug and pluck their hair making bald patches or sometimes areas of diffuse hair loss. The hair for plucking is selected from other hair based on it being different in some way, perhaps feeling rough to the touch or more curly than other fibers. Once a bald area has been made it becomes even more enticing to pull at the hair around it making the alopecia patch larger. Sometimes the hair plucking is more generalized and looks like a diffuse alopecia.
This is generally a non-scarring non-inflammatory form of hair loss although long term repeated plucking over several years may result in a mild immune cell infiltrate and irreversible scarring damage to some hair follicles (Olsen, 1993).
Trichotillomania in Numbers
Trichotillomania affects 2-3% of all people with hair loss, making it a fairly common condition. Trichotillomania can affect both children and adults although the mean age of first onset is 13 years. Both boys and girls are affected in childhood but the adult version of trichotillomania almost always affects women (Jaspers, 1996).
Studies have identified the scalp as being the most commonly affected area. Approximately 70% of cases involve scalp hair loss, 50% involve eyebrows and or eyelashes, 30% include pubic hair, 20% body hair, and about 10% involve facial hair. As well as plucking the hair, affected individuals may then chew or eat the hair.
Hair eating is known as trichophagia, while hair chewing may result in hair balls (trichobezoars). About 40% of cases involve hair chewing while 10% of affected individuals eat their hair. Eating hair is rather unwise as it is very irritating to the stomach and may lead to digestion problems and ulcers.
The Psychology Behind Trichotillomania
Trichotillomania is a neuro-biological condition and may develop in people with anxiety disorders or mood problems. This form of hair loss is seen in many species, not just humans. In mice the condition is called barbering and mice housed together under stressful conditions may pull each other’s hair out. Certain mouse species are much more prone to barbering than others which suggests genetics play a part in this condition. Parrots are a well known example where a distressed parrot separated from its owner will start to pluck its own feathers.
The affected individual is most often unaware of what they are doing and arrive at the dermatology clinic complaining of hair loss from an unknown cause. Dermatologists have been known to resort to making a video of the individual to prove to them that they are unconsciously plucking their hair.
Treatment for Trichotillomania
There are two treatment approaches for Trichotillomania: one from a psychiatric perspective and one from dermatological perspective. There is a degree a friction between the two groups as psychiatrists regard hair pulling as a disorder and dermatologists regard it as an alopecia and subsequently, their “domain”.
Psychiatrists will naturally focus on psychology and exploring why the child might have developed this habit. Treatment may involve therapy and in adults can involve drugs.
Dermatologists take a more direct approach. Children with trichotillomania may be made to wear gloves. The gloves stop the sensation of touch and this makes it impossible for the person to identify suitable hairs for plucking. Sometimes a child’s hair may be covered with Vaseline which makes it difficult to get hold of and unpleasant to the touch. In extreme cases the scalp may be bandaged so the child can’t get at the bald area.
The prognosis for children is generally good — with treatment they usually grow out of it. There is some importance in obtaining successful treatment as repeated plucking of hair will gradually destroy hair follicles to the degree that they will not grow properly and may not even grow at all. However, to reach this stage would take several years of continuous hair pulling. At this stage the condition becomes traumatic/traction alopecia and involves scar tissue development in the hair follicle. Adults who develop trichotillomania have a poor prognosis and are much less likely to respond to treatment.