Absolique Hair Health Clinic at Zash Fine Hairdressing Brisbane

THE HAIR CYCLE

To help you understand the mechanism of Hair Loss and the different types, it is important that you have some knowledge of your 'Hair Cycle'.

All Hair follicles grow in cycles. Each cycle consists of a long growing phase - Anagen, a short transitional phase – Catagen, and a short resting phase - Telogen.

At the end of the Telogen resting phase, the hair falls out and a new Anagen hair is supposed to start growing in the follicle beginning the hair cycle again.

ANAGEN PHASE: 

Anagen is the active growth phase of the hair follicles. In the Anagen phase, the cells in the root of the hair are dividing rapidly, adding to the hair shaft.

In a normal Anagen phase the hair grows about 1 cm every month. Anagen phase lasts from 2–8 years. The amount of time the hair follicle stays in the Anagen phase is genetically determined.

The longer the length you can grow your hair indicates a longer Anagen phase of 5 to 8 years. If you have never been able to grow long hair, you have a short Anagen phase of 2-4 years.

Normally up to 90% of the hair follicles on the scalp are in Anagen phase.

Under a microscope, Anagen hairs have a straight, well defined pigmented bulb and may be encompassed by the inner root sheath.

At the end of the Anagen phase an unknown signal causes the follicle to go into the Catagen phase.

Anagen Effluvium is a disruption of the growing phase that causes abnormal loss of anagen hairs.

CATAGEN Phase:

Catagen is the short transition phase that occurs at the end of the Anagen phase. Catagen signals the end of the active growth of a hair.

Catagen phase lasts for about 2–3 weeks. Normally 1-2% of hair follicles are in the Catagen phase.

Under a microscope, Catagen hairs have pointed, frayed looking bulb with a drooped root sheath if present, and no pigment activity.

TELOGEN Phase:

Telogen phase is the resting/falling phase of the hair follicle and lasts for 2-3 months. A Telogen hair is the final product of a hair follicle cycle, and is a dead, fully keratinized hair. 10-14% of hair follicles are in the Telogen phase. Normally 70-100 hairs reach the end of their resting phase each day and fall out.

Under a microscope, Telogen hairs have a club like bulb with the root sheath leaving a thin tail like projection from the base of the bulb, and no pigment activity.Telogen Effluvium is clinical hair loss, when more than 100 hairs fall per day.

SO HOW DO YOU KNOW IF YOU HAVE HAIR LOSS?

Common complaints that indicate you may have ‘Diffuse’ Hair Loss:

"My hair is falling out in handfuls!"

"My bathroom floor is covered with hair!"

"My brush is full of hair!"

"My pillow case is covered with hair in the mornings!"

"My hands are covered with hair when I style my hair or use styling product!"

"My hair falls out more when I Shampoo and Condition it!"

DIFFUSE HAIR LOSS:   

Diffuse Hair Loss is a loss of hair or generalized hair thinning that affects the entire scalp and is a common type of hair loss in both females and males of all ages.

Diffuse Hair Loss is not a patchy type of hair loss nor is it hair loss in localized areas or typical patterns associated with hereditary male and female pattern hair loss and Alopecia Areata.

With Diffuse Hair Loss, much of the hair remains, but the diameter of the hair shaft is smaller than normal hair 'Diffuse Damaged', or the hair follicle is left empty until the hair cycle resumes.

Diffuse Hair Loss is a sign that the normal hair cycle has been disturbed which results in the premature loss of Anagen 'growing' hairs and a higher count of Telogen 'falling' hairs lost on a daily basis.

Total hair loss or complete baldness will never result from diffuse hair loss alone.

The medical term for this type of hair loss and hair thinning is "Diffuse Un-patterned Alopecia".

The difference between hair loss and Diffuse Hair Loss can be quickly identified with a 'Hair Health Check',  developed by Absolique Hair Health Clinic.

Hair Health Check will assesses the population of miniaturized diffuse damaged hairs and or empty follicles over the scalp using a microscope.

Miniaturization is the process by which hairs shrink in length and diameter from the effects of Diffuse Hair Loss.

Early detection of diffuse hair loss can minimise the extent of the damage and assist in a positive future plan in the recovery and hair regrowth after diffuse hair loss.

In most cases, the diffuse hair loss has stopped by the time help is sought. Treatment focus is on ensuring the hair cycle is functioning correctly.

In cases where the diffuse hair loss is current, the cause for the hair loss must be found and corrected where possible.

Either way, the best thing you can do is seek professional help from your Trichologist as soon as possible if you think you have hair loss.

CAUSES OF DIFFUSE HAIR LOSS:  
Diffuse hair loss is your body's response to changes and can be caused by a variety of conditions OTHER than "hereditary hair thinning and hair loss".

Anything that interrupts the normal hair cycle can trigger diffuse hair loss.

Diffuse Hair Loss triggers can include a wide variety of physiologic and emotional stresses, nutritional deficiencies, endocrine imbalances, shock, high fever, operations, stopping and starting certain medications, food poisoning, or having a baby, for example.

Loss of Telogen-phase hairs is the most common type of diffuse hair loss. Hair loss during the Anagen phase is usually caused by chemotherapy or radiation therapy.

Loose Anagen Syndrome is an increasingly common type of diffuse hair loss with the premature loss of the Anagen or 'growing' hairs.

Finding the cause, or trigger, of active hair loss requires a thorough history and examination and will enable appropriate treatment.

The cause of Diffuse Hair Loss triggers Anagen 'growing' hairs to prematurely pass to the Catagen 'resting' and then Telogen 'falling' hair cycle stages.

The scalp hairs effected by Diffuse Hair Loss will remain are in these stages for 2-3 months before you see the effect and notice hair falling from the scalp.

Diffuse Hair Loss begins 2 to 3 months AFTER whatever triggered it. The amount of hair loss depends on the length and severity of the trigger and your individual sensitivity.

Diffuse Hair Loss that occurs gradually and continues for OVER 3 months indicates an underlying 'health' problem that will require correction of the health problem for the hair loss to stop.

Medical intervention may be required for this longer term diffuse hair loss.

Diffuse Hair Loss that increases quickly but subsides within 3 months indicates that the trigger has been removed and won't require any health treatment.

Up to 25% of hair may be lost from the scalp before the hair loss is noticed.

Prompt diagnosis and treatment for diffuse hair loss can minimise the extent of damage and encourage normal hair regrowth, as the hair cycle resumes to normal.

Hair shaft damage is a common effect following diffuse hair loss and responds well to treatment. In most cases full recovery is achieved with professional treatment available from your Trichologist.

To ensure full recovery from diffuse hair loss, have your hair cycle evaluated by Absolique Trichologist with a 'Hair Health Check'.

If left unchecked, you may find yourself with diffuse damaged hairs replacing your normal growing hairs. Diffuse damaged hairs are mostly wiry, fine and frizzy.

These diffuse damaged hairs are also very weak and will break easily during simple hair styling practises.

Diffuse damaged hairs will not hold colour resulting in poor colour retention, colour fade and hard to style hair.

Popular straightening and de-frizzing treatments will not fix diffuse damaged hairs, and will most likely break them adding to the hair loss.

If you are experiencing hard to manage or frizzy hair, that you have not had all your life, then you most likely have diffuse damaged hairs and you should consult your trichologist prior to any straightening or de-frizzing treatments, to be safe. You may save money, and your hair!

DIAGNOSIS OF DIFFUSE HAIR LOSS:  
Microscopic examination of the scalp through a Hair Health Check will quickly and clearly show the distribution of hair loss, presence or absence of empty follicles, presence or absence and characteristics of hairs growing from the scalp, and the presence or absence of scarring.

Once the microscopic examination is complete, your Trichologist can provide a clinical evaluation of your hair cycle and possible causative factors based on clinical symptoms, or lack thereof.

In some cases, further testing to determine the extent, type and duration of the diffuse hair loss, may be required.

Hair Pull Test: this test helps to identify current diffuse hair loss.

Gentle traction is exerted on hair over the entire area of the scalp after the client has NOT washed or manipulated the hair in any way for 48 hours.

The numbers of individual extracted hairs are counted and may be examined under a microscope.

Normal hair loss is around 100 hairs per day. Hair pull test count over 100 is considered positive.

Daily Hair Counts: This is normally done when the pull test is negative. It is done by counting the number of hairs lost.

The hairs that should be counted are those lost in the first morning combing or washing. The hair is collected and stored separately for 14 days.

The strands are counted and recorded. If the hair count is over 100 each day and empty follicles are present under the microscope, diffuse hair loss is current.

Hair Pluck Test: In this test, the Trichologist will carefully extract up to 40 hairs from the scalp “by the roots.”

The root of the plucked hair is examined under a microscope to determine the phase.

In a sample of 40 plucked hairs 34 hairs should normally be in the Anagen phase with 6 hairs in either the Catagen or Telogen phase.

Results of a hair pluck test assist in clarification of current diffuse hair loss.

Scalp biopsy: This test can be done when Alopecia is present, but the diagnosis is unsure. The biopsy can allow for differing between scarring and non scarring forms of hair loss.

Scalp biopsy is minor surgery and is not commonly required for diagnosis.

Modern microscopic technology allows Trichologists to detect if a hair bulb is living, scarred or damaged without the need for minor surgery.

In a scalp biopsy, hair and scalp samples are taken from areas of inflammation or hair loss, usually around the border of a bald patch.

OTHER TYPES OF DIFFUSE HAIR LOSS:

Hair Breakage:

Sometimes what seems to be diffuse hair loss is actually hair breakage.

Microscopic and physical examination of hair bulbs and shafts can assist diagnosis of hair breakage from hair shaft defects and disturbances such as:
Protein Deficiency - poor diet or digestion can result in structural changes in the hair shaft. It only takes 15 days for a hair bulb to be impacted by a low protein diet as hair is 97% protein.

Blood Sugar Fluctuations - associated with diabetes commonly shows in the hair shaft as a disturbance.

Monilethrix - inherited hair shaft disorder characterized by a beaded appearance of the hair due to periodic thinning of the shaft. Typically results in hair fragility.

Trichorrhexis Nodosa - a defect in the hair shaft characterized by thickening or weak points (nodes) that cause the hair to break off easily.

The breakage contributes to the appearance of hair loss, lack of growth, and damaged-looking hair. Also often appears on hair with split ends.

The result of all hair shaft disturbances is narrowing or swelling of the hair shaft leaving a weakened area on the hair strand which will be easily broken with simple daily hairstyling.

Over processing of the hair from chemicals such as straightening, bleaching and tinting can cause breakage of normal healthy hair, so imagine what they will do to a defective hair shaft!

IMPORTANT - Early detection of Diffuse Hair Loss is the key.

Diffuse hair loss is a sign something is out of balance in your body.

DON’T IGNORE IT!

Early detection of Diffuse Hair Loss can minimise the extent and duration of the hair loss and promote normal hair regrowth when the hair cycle resumes

Absolique Trichologist Hair Health Check is the best way to diagnose current and past diffuse loss and damage.

Don't wait another day; book your Hair Health Check today!

This work is copyright 2011. Apart from any use permitted under the Copyright Act 1968, no part may be reproduced by any process, nor may any other exclusive right be exercised, without the permission of Carolyn Evans Absolique Hair Health Clinic Trichologist at Zash Fine Hairdressing 23-26 Gallery Level Brisbane Arcade 160 Queen St Mall Brisbane 07 3229 3242