diseases

HAIR LOSS

Hair arises from epithelial follicles distributed universally over the surface of the body except on the palms and the soles. There are three phases of the hair growth cycle.

a) Growth (Anagen)
b) Regression (Catagen)
c) Rest (Telogen)

In man above phases are not synchronous and are independent. The scalp hair grows at a rate of 0.35mm per day and the rest of the body hair grows at a rate of 0.1-0.4mm per day. The anagen lasts on the scalp for a period of 2-6 years.

Hair has no functional importance in human beings but it is important from the cosmetic point of view. A severe hair loss might cause a tremendous impact on the personality of and individual.

Alopecia (hair loss)
The patient suffering from hair loss has to be evaluated and this must include examination of the hair bearing areas as well as the hair itself. Few congenital varieties of alopecia are known but they are of very rare occurrence. The acquired hair loss is more common and can be sub classified into:
a) Scarring alopecia
b) Non scarring alopecia

Scarring alopecia or cicatricle alopecia is not common they may represent genetic acquired inflammatory of neoplastic diseases.

Non scarring alopecia occurs mostly in women after several moths following delivery. It is also seen in both the sexes after a severe illness. This process is known as Telogen effluvium and is related to the hair cycles which have become synchronized during such periods. In other species who she their hair seasonally this is a common phenomenon but is rare in human beings.

Diffuse alopecia
Androgenetic alopecia is the most common cause of diffuse hair loss (Common baldness, Male pattern baldness).It starts with recession of hair from the temporal region and thinning of the hair at the vertex ( Hamilton's pattern). It is genetically determined hair loss. In women a more diffuse form of hair loss is seen (Ludwig pattern).

In androgenetic alopecia there is physiological change which involves a shortening of the anagen phase and consequent increase in the portion of the Telogen hairs. Structurally the terminal hair follicles transform into progressively smaller follicles (Miniaturisation phenomenon)

Genetic basis an autosomal dominant inheritance has been suggested a multifactorial inheritance is possible.

Other causes of diffuse hair loss are Telogen effluvium, thyroid disease, severe protein and iron deficiency. In this type there is thinning of the hair on the whole scalp.

Androgens:
Men with syndrome of androgen insensitivity fail to develop temporal recession after puberty. In women the baldness may be associated with elevated levels of circulating androgens changes in hair pattern mostly occur after menopause.

Assessment of diffuse hair loss
Examination of scalp is important to rule out any inflammatory disease or scarring alopecia.
. A detailed medical history is a must
. Full blood count
. Serum iron and ferritinin measurement
. Liver function test
. Thyroid function test
. Renal function tests
. Microscopy of the hair has to be done to look for weathering of the hair caused by cytotoxic injury and any congenital abnormalities that have made the shaft of hair more susceptible

Assessment of women with androgenic alopecia
. To rule out polycystic ovarian disease
. Enquiry about galactorrhoea (elevated prolactin levels)
. Examination of hirsutism and cutaneous virilism and the following investigations have to be done
. Prolactin
. Luteninzing hormone (LH)
. Follicle stimulating hormone(FSH)
. Testosterone.

Alopecia areata:
It is an acute problem of hair loss which is more common in the age group below 25 years of age. The hair loss is complete in small patches in one place or in multiple patches which are non inflammatory. The patch is several centimeters in diameter.

This condition can be associated with emotional trauma or some systemic diseases like auto immune thyroid disease. IT is a non scarring auto immune disorder affecting any hair bearing area.

It starts suddenly and there is complete loss of hair in patch or patches in the affected area the patch is smooth and is well defined. There can be a spontaneous hair growth but sometimes it spreads peripherally and develops in total loss of hair (Alopecia totalis).

Alopecia in atopic individuals has a worse outcome.

Causes:
Genetic predisposition if there is a family history then the chances of the person suffering from alopecia are increased.

Association with autoimmune diseases (thyroid disease, Vitiligo, Addison's disease) suggests the autoimmune origin.

Alopecia differs from other auto immune diseases as it does not result in total loss of the function of the target organ but it is temporarily affected which can return to normal.

Treatment:
After a careful study of the case the indicated homeopathic remedy should be given.

Tinea capitis:
It is a sort of fungal infection which results in irregular patches of alopecia with scaling and broken stubs of hair within the patch. Multiple patches may develop. There can be inflammation of the affected area sometimes.

Lichen planopilaris:
When the hair follicles are affected by lichen planus it produces patchy scarring alopecia. Minute purple papules may be seen around the hair follicles at the edges of the patches.

Folliculitis decalvans

This is a rare disease which leads to pustules around the hair follicles which heal with scarring and destruction of the hair follicles.

Skin diseases that produce alopecia are discoid lupus erythematosus and morphea

Trichhotillomania

It is a psychiatric illness where the patient plucks her hair.

Traction alopecia

It is produced by tying a tight pony tail it is prominent along the hair margins as the distant hair is subject to most traction.

Role of Homeopathy:
The role of homeopathy lies in the fact that it can bring back the lost balance in the human body when it is in a diseased state.

Homeopathic remedies act at the psycho neuro endocrinal axis. In other words it stimulates the human body which in turn will take care of the disease.

The right homeopathic remedy prescribed on the totality of the symptoms will help in reducing the hair loss and will also achieve the new hair growth by stimulating the body. It will also improve the overall health of the person.

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