The hair follicle, hair thickness and number of hairs are genetically determined. Protein intake is very important for hair health because the hair shaft is entirely composed of proteins.
Energy intake: The mitosis rate is sensitive to the caloric value of the diet, provided mainly by carbohydrates. Adequate intake of vitamins and trace metals is essential for the biosynthetic and energy metabolism of the follicle.
REASONS FOR HAIR LOSS AND PREVENTION
Hair loss is a common problem that can affect 50% of men and women throughout their lives. There are an average of 150,000 hairs on our scalp.
- There are an average of 50 to 125 hairs per day
- It grows on average 1 to 1.5 cm per month
- Faster in summer and slower in winter
HAIR CYCLE
Anagen: active growth phase, protein synthesis and keratinization, lasts 5 years Catagen: resting phase, Extension slows down, takes 3 weeks
Telogen: shedding phase, lasts 3 months, 85% of scalp hair is in the anagen phase, 13% in the telogen phase and 2% in the catagen.
Hair loss occurs when this cycle is interrupted becomes!
- The causes of hair loss are
- Genetic predisposition,
- Hair development disorders,
- Systemic diseases and autoimmune diseases,
- Scalp diseases
- Medications
THE REASONS FOR HAIR DIFFUSERS
LOSS DIFFUSERS HAIR LOSS.
1-ALOPECIA ANDROGENETIC
From puberty, androgens shorten the anagen phase and cause follicles to shrink. Gradual hair thinning begins. If women have problems such as hirsutism, menstrual disorders, acne or infertility, a laboratory test is required. Type M hair loss in men is characteristic.
2-TELOGEN EFFLUVIUM
This occurs when the hair that enters the telogen phase increases. About 25% of hair enters the telogen phase. Significant hair loss is observed approximately 3 to 4 months after the triggering event. Acute: less than 6 months, longer than 1 month chronic
Causes of telogen effluvium
PHYSIOLOGICAL
- Postpartum
- Mechanical or psychological trauma
- Persistent fever (malaria, etc.)
- Serious infections
- Serious systemic diseases
- Major surgical procedures
- Hypothyroidism/other endocrinopathies
- Unhealthy diets/malnutrition
DRUGS AND TOXIC AGENTS
- Retinoids
- Anticoagulants (heparin, warfarin)
- Antithyroid drugs
- Anticonvulsants
- Hormonal preparations
2-LOCAL HAIR LOSS (Alopesia areata)
A condition characterized by focal hair loss is an autoimmune disease. It is often accompanied by other autoimmune diseases. It can also show a genetic transition. The development of spontaneous regression is common in 6 to 12 months. The prognosis is poor for those that last more than a year and begin in childhood.
TRICHOTILLOMANIA: This is a psychiatric illness. It begins at the age of 8-10 years. Some patients eat the hair they have pulled out. Patients usually do not admit the situation. Erythema and pustules may be observed on the scalp. Diagnosis is made by shaving the bald area. Treatment is psychiatric.
TRACTIONALOPEZIA: commonly occurs in people who tie their hair tightly. It can cause permanent hair loss.
TINEA CAPITIS It occurs especially in prepubescent people. And occurs more often in people who have close contact with infected cats, dogs or children. Oral antifungal medication is required (terbinafine).
3- SCARFING HAIR LOSS
It causes permanent hair loss. It can be seen in diseases such as chronic discoid lupus erythematosus (CDLE), lichen planopilaris, folliculitis decalvans. Patients with hair loss should also be screened for iron deficiency, goiter, menstrual disorders, syphilis, diabetes, and hormone, D, and Ca levels determined.
TREATMENT
MEDICAL TREATMENT Biotin deficiency is rare and is seen in congenital biotinidase or carboxylase deficiency. Deficiency can result from the use of antibiotics that disrupt the gastrointestinal flora or from excessive ingestion of raw egg whites. The use of antiepileptic drugs can also lead to biotin deficiency. Biotin deficiency can cause changes in hair and nails. Hair loss is accompanied by greasy yellow crusts on the scalp. Although no clinical trials have shown efficacy in treating hair loss with biotin supplementation in the absence of deficiency, biotin may be helpful for hair loss and nails. Recommended daily dose: 30 mg
Vit B12: Deficiency can be seen in atrophic gastritis and vegetarians. It causes whitening of hair. Recommended daily dose: 2.4 mg.
ZINC: Deficiency is not usually seen in people with a normal diet, however, it can be seen in people from developing countries. Zinc deficiency can lead to telogen effluvium, thin, white and brittle hair, nail dystrophy, cheilitis and perioral dermatitis. Low zinc levels are sometimes seen in the elderly, alcoholics, people with anorexia, people with pancreatitis, those using ACE inhibitors, long-term breastfeeding mothers and those using iron supplements for a long time. Serum levels should be monitored when administering zinc as toxicity may occur. The daily dose is 11 mg for men and pregnant women, 8 mg for women. The recommended dose for adults with deficiency is 25-50 mg of elemental zinc. It is 0.5-1 mg/kg for children.
Niacin B3: Its deficiency can cause pellagra (dementia, diarrhea, dermatitis, death). Hair loss may be observed in the early stages of deficiency. • The daily dose is 16 mg for men and 14 mg for women.
ESSENTIAL FATTY ACIDS: Linoleic acid and alpha-linolenic acid are essential for normal health. They are also vital for the cell membrane and the stratum corneum. It can be seen in malnourished children or those with biliary atresia and cystic fibrosis. Its deficiency can lead to hair loss on the scalp and eyebrows.
IRON: Even without anemia, diffuse hair loss, glossitis, cheilitis, and koilonychia can be seen. Impaired keratin production causes thinning of anagen hair. The effects of iron deficiency and replacement on hair loss are still a major topic of discussion. However, according to many authors, the ferritin level must be higher than 40 mg/L for healthy hair.
Treatment: 50 – 60 mg of elemental iron = 325 mg of ferrous sulfate 2×1 for 3 months
COPPER: its deficiency can rarely lead to malabsorption syndrome.
Menkes disease: hypopigmented hair and pili torti (frizzy hair), brain degeneration, etc. can occur. Prolonged use of zinc can lead to deficiency. Hypopigmented hair, anemia, leukopenia can occur. Daily dose: 900 mg
SELENIUM: A deficiency can be observed in regions where the soil is insufficient in selenium. Although it mainly presents with symptoms of the muscular and cardiac systems, hypopigmented hair and skin are not uncommon. Excessive consumption can lead to toxicity. Daily Dose: 55 mg
Vit A: Hair loss occurs in excess amounts, not deficiency. It can be seen in people receiving retinoid therapy. Maximum Daily Dose: 10,000 IU
Vit D: The role of vitamin D in hair loss is still under investigation. Its role in hair growth has been demonstrated in animal studies. However, its role has not been demonstrated in alopecia areata and AGA. Nevertheless, it may be advisable to examine the Vit D level in patients with telogen effluvium, and to replace if deficient. Daily dose: 5-10 mg (1 mg calciferol = 40 IU vitamin D)
HAIR LOSS AND NUTRITIONAL SUPPLEMENTS
There are many products on the market, but no sufficient evidence to prove their effectiveness. Antioxidants may play a role in hair aging, but it is difficult to prove. Taurine has been shown to extend the life of hair follicle cells. L-carnitine has been shown to stimulate hair follicle cells. Soy ingredients may be effective for hair growth due to their anti-inflammatory and estrogen-like effects.
Orthosilicic acid increases hair strength and prevents breakage.
ANDROGENIC ALOPECIA
- Minoxidil 5%: 5 sprays 2 times daily on dry scalp
- Finasteride: – 5-α-reductase inhibitor: DHT ↓ – 1 mg/day orally
- Ketaconazole shampoo
- Zincpitrion shampoo
LOCAL HAIR LOSS
- Topical steroid: – 2 times daily on scalp hairy
- Minoxidil 5%: 5 sprays 2 times a day on dry scalp
- Topical immunotherapy with DNCB or SADBE:
- Oral steroids
- Intralesional steroids
- Antralin cream: