Hair and Scalp Conditions

Alopecia is a vast subject – its definition is purely ‘hair loss’ and can be applied to all types of hair loss, so if you hear the word alopecia it does not always mean you will result in total hair loss.

Is it more than just hair? If you are reading this then there is a good chance that you understand how life and self esteem can be affected by the top of our heads. In todays society, there is much importance placed upon our looks, but as hair is the second fastest growing cell in the body, it can quickly become the earliest signs of important underlying issues and illness. Hair loss may be genetic, immune related, hormonal or dietary and a Trichologist is able to spend time to ‘join up the dots’  to establish factors, symptoms and signs to look at the full picture of your health.

Unfortunately not all hair and scalp conditions can be ‘cured’, in many cases treatments will only work for the time you use them and these may need reviewing and altering. However taking positive action to understand your condition, whatever it may be and discussing the next steps and options, can bring peace of mind and reassurance about what the future may hold.

Below, you will find brief descriptions of common hair and scalp problems, however as with any condition, there are often other subcategories that exist and these descriptions are intended for general guidance only.

To buy the products recommended during your consultation, I have partnered with Lifestyle Pharmacy to offer a selection of products. I do not advocate buying these products without a consultation as they may be incorrect or contra-indicated for your individual hair condition and the conditions described below can co-exist; it is important to evaluate all factors before considering treatment.

Following this link will open to the separate secure website of Lifestyle Pharmacy.

The Hair Growth Cycle: Understanding the action of hair growth (anagen), transitioning (catagen) and resting (telogen), prior to the release of the hair and the start of a new anagen phase is key to understanding many types of alopecia.
Alopecia Areata and Alopecia Totalis

These types of alopecia are perhaps the ones that many people commonly think of when we hear the word ‘alopecia’. Areata can take different forms but with the same autoimmune cause. Commonly it will cause distinct patches of loss in different areas of the head, but can also be a more diffuse loss where the hair thins rather than causing patches, and either can extend to a complete loss of scalp hair known as ‘totalis’. The autoimmune nature of this disorder makes it very unpredictable. Itching and scalp irritation are commonly reported along side an increase in hair shedding and noticeable patches of loss. 

A quick diagnosis is key at the onset to get you the correct treatment as these are often more effective the sooner they are started, whether this is dermatology referral for medical intervention or addressing any underlying causes through a trichology consultation and electrotherapy treatments. 

 

Androgenetic Alopecia
Androgenetic alopecia is the name given to a type of hair loss that is related to the androgen hormone, more commonly known as male pattern hair loss or female pattern hair loss. Both male and female types present differently, however the both types have the same cause. Male pattern hair loss presents with thinning to the frontal recession areas, followed by thinning to the crown. This type of hair loss is progressive and over time, the two separate areas merge across the top of the head. Female pattern hair loss is a more diffuse thinning, with patients noting a wider parting but usually retaining the front hairline.

Testosterone is the androgen hormone implicated and is naturally present in both men and women in differing amounts. It is the conversion of testosterone to a more potent type, called dihydrotestosterone that causes the miniaturisation of hair follicles in sensitive individuals.

Excess Hair Shedding (Telogen Effluvium)
As the hair is reflective of our bodies health, there are a huge range of factors that can lead to an excess of hair follicles, sometimes up to 50% compared to just 10% normally, to enter the telogen phase prematurely. This causes you to experience thinner hair and more noticeable hair shedding. There are many factors to consider when diagnosing telogen effluvium, which an in-depth trichological consultation will take into account.
Scarring Alopecias
In recent years, there has been an increase in a type of alopecia that attacks the hair follicles and results in scarring, meaning that the hair follicle no longer exists resulting in smooth shiny, scarred skin.

Scarring hair loss falls into three categories:

  • Autoimmune scarring; such as frontal fibrosing alopecia, lichen planopilaris, discoid lupus erythematosus, pseudopelade, and folliculititis decalvens
  • Bacterial scarring; such as acne necrotica miliaris and folliculitis keloidalis.
  • Traumatic scarring from an injury to the scalp, or over time, excessive tension placed on the follicles, such as from poorly applied hair extensions or trichotillomania (compulsive pulling) causing atrophy.
Hair Shaft Disorders
There are a number of disorders (many inherited) that affect the successful production of a healthy hair shaft with irregularities and fractures making the hair very brittle and easily breakable. Such conditions may exist within other syndromes such as Ichthyosis and Nethertons Syndrome, and are monilethrix, pili torti, trichorhexis invaginata (bamboo hair), pili annulati (spangled hair)

Two more commonly seen conditions can also be caused by external weathering and damage to the hair shaft. Trichoptilosis or fragilitas crinium is more commonly known as split ends and trichorrhexis nodosa describes fractured nodes along the hair shaft that easily break away when pulled.

Loss of hair condition
Loss of hair condition can arise from the weathering of incorrect treatment of your hair, including excessive heat use, the incorrect use of shampoos, conditioners, products and oils, poorly applied hairdressing chemicals, to internal causes such as medication, mineral and vitamin deficiencies and protein deficiency.

Any and all of these combined can leave the hair feeling brittle, dull, dry, prone to breakage from loss of tensile strength and elasticity, more split ends (trichoptilosis/fragilitas crinium), fractured nodules (trichorrhexis nodosa), loss of moisture and knotty, tangled matting hair from open, raised cuticles.

Advice in the correct hair care regime and reconditioning treatments can help to prevent reoccurrence in the future.

Itching and Scalp Irritation
While itching can also exist entirely on its own, it can also be a symptom of other disorders with a multitude of causes; from infection, infestation, systemic disorder or reaction to a hairdressing chemical or sensitising product.

On examination I will be able to distinguish any contributing factors and offer advice and treatments to reduce the feeling of irritation and soothe the area.

Dandruff and Scalp Scaling
Pityriasis Capitis is the full name given to common dandruff and it exists within a family of conditions, all with the same persistent cause; a sensitivity a yeast found on everyone’s scalp, Malassezia farfur. M. farfur is also known as Pityrosporum Ovale, which lends its name to the condition. Treatment with the correct products and identifying factors that can cause the condition to flare up offers an effective way of managing the condition.

• Pitryiasis Capitis (dandruff): small, loose, white flakes
• Infantile seborrhoeic dermatitis (Cradle cap): adherent build up of skin cells
• Seborrhoeic dermatitis: commonly itchy with more pronounced flaking, but these symptoms can appear individually.
• Pityriasis Amiantacea: Thick adherent patches of skin cells, often in small patches and can be itchy and sore. Can co-exist with other forms.

Oily Scalp (seborrhoea oleosa)
Excess oil production is caused by an over-active sebaceous gland, which produces sebum to lubricate and give natural moisture to the skin. Sufferers may also experience acne and scalp scaling as described above. The production of sebum is controlled by hormone function and with the correct advice and treatments, the condition can be bought under control.
Psoriasis
Psoriasis is recognised by adherent, silvery plaques, seen over a reddened area of skin, feelings of itching and ‘tightness’ are reported but not experience by everyone. It commonly occurs in only in patches on the scalp, and is also seen in other areas of the body such as the tops of the knees and outside of the elbows. Psoriasis is an autoimmune disorder, that treatments and the use of the correct products can manage successfully bringing relief to sufferers.

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Clinics:
Surrey Trichology Clinic @ Body Tonic, 58 The Street, Ashtead, Surrey, KT21 1AW

Surrey Trichology Clinic @ 10 Harley Street, London, W1G 9PF

Opening hours:
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Evening appointments available by request.

 

For enquiries please email stephanie@surreytrichologyclinic.co.uk 07751 553234 or use the contact form.

 

For appointments please contact the Body Tonic Reception on 01372 270790