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| Medical Information: Hair Loss is Frequently Due to Reversible Factors |
| Nicholas V. Costrini, M.D. Medical Director Georgia Gastroenterology Group |
| My dogs are very insensitive beasts. They prance around the house flaunting their rich, thick, white, tan, and black hair as they watch me comb my hair, which is beginning to thin a bit. Hamlet is the worst. If one hair from my head hits the floor, he raises his big black eyes toward the ceiling as if he is counting my remaining hair. He stands four feet tall at the shoulders and has a carpet of fur that nearly reaches the floor from his chest. He has been known to whisper to the other dogs, Here comes the Master Cue ball. Fortunately, I am neither sensitive nor paranoid about my thinning hair. The other pups Russell, Gabriel, and Roxanne have told Hamlet not to talk behind my back, but I know that they are all grooming their long locks and restraining their laughter. These dogs have so much fur that shedding is nearly a continuous process. It is a miracle of canine physiology that dogs can shed enough fur in a day to cause any vacuum cleaner to beg for mercy and still begin each day unchanged as happy, hirsute hounds. As long as they remain healthy, there is little chance they will develop partial or complete baldness. Thus I will not have that opportunity to get even with my hairy hounds. As I count the hairs falling from my head, I will consider what to do with my insensitive, barking carpets. I will also provide some insight into the process of hair growth and hair loss, i.e. thinning and shedding. In medical parlance, thinning is the slow, gradual process of hair loss most common in men but certainly seen in post-menopausal females. This form of male pattern or androgenic balding is frequently hereditary and occurs over a period of years. Shedding is a different process characterized by a relatively sudden onset of hair loss. Acute shedding episodes may last 2-6 months. Chronic shedding of hair is less common and is considered if the problems continue for more than six months. In either situation, shedding is a consequence of a sudden disruption of the normal cycle of hair growth and hair rest. At any one time 85% of hair follicles are in various stages of new hair growth and 15% are in a rest phase during which the strand of hair falls out of the follicle and the scalp. In this normal cycle of hair growth, about 100 follicles enter the resting phase each day and an equal number of follicles begin new growth during the same period. In an event of acute shedding, the balance of new growth and resting follicles is altered in such a way as to cause a severalfold increase in the number of resting or shedding follicles. Women notice the problem sooner than men. They may notice hair on the pillow or clothing and soon thereafter thinning of the hair of the scalp. The cause of acute shedding is frequently due to common and reversible trigger factors. When no trigger factors can be defined the problem usually is self-limited and resolves within four to six months. The trigger factors for acute hair loss include: acute or chronic illness, medications, emotional stress, hormonal changes, and vitamin deficiencies. The list of drugs that may cause hair loss is endless, but the following are frequent culprits: aspirin, Amiodarone (Cordarone), anti-depressants (Prozac, Elavil), beta blockers (Inderal, Corgard), ibuprofen, lipid-lowering drugs, and oral contraceptives to name a few. Iron and vitamin deficiency, particularly of the B-complex group, are easily reversed causes of hair loss. If sudden hair loss occurs, consult your physician. The cause is frequently one of these trigger factors; the process will not cause baldness; and the problem usually resolves in a matter of months. Your physician will address the trigger factors and may prescribe a topical hair growth agent such as minoxidil for a few months. As for my furry friend Hamlet, I have agreed not to laugh at his long nose if he will not kid me about my hair.
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