Understanding Alopecia

26th Feb 2019

Understanding Alopecia

Did You Know?

Alopecia, aka the medical term for hair loss, is a problem that will affect most men and up to 50% of women within their lifetime.

No matter your background, race or gender, it is likely that you will experience some form of alopecia, be it permanent or temporary, at some stage in your life.

Hair is very important to our psyche, contributing to our confidence, enhancing our well being and central to our social interactions. They didn’t coin the phrase “having a bad hair day” when everything goes wrong, for nothing!

So, what is it exactly that causes alopecia and what can we do about it? Scientists at heart, we believe that the better people understand the hair growth cycle, the easier it is to tell the difference between regular shedding and problem hair loss or alopecia.

Understanding Hair Growth

There’s far more to hair growth than many people realise. The hair growth process occurs in a cycle, with hair follicles going through four different stages as they grow, regress, rest and shed over the course of around seven years. Our primary focus at évolis is to extend the hair cycle, keeping hair in the growth phase for longer, resulting in less hair resting and less hair fall.

Understanding how hair grows is crucial for understanding why your hair thins and falls out and whether it is part of the natural hair cycle process or the beginning of more problematic alopecia.

Believe it or not, the human scalp contains about 100,000 follicles that each have their own muscle. Ever had your hair stand on end? That’s your follicle muscles hard at work contracting and giving you goose bumps!

The hair shaft, or strand, is the visible part of the hair and is made up of a hard protein called keratin and a scaly outer protective layer called the cuticle. Hair shafts are actually dead, which is why it doesn’t hurt to get a haircut, and why it’s so important to look after the health of your scalp and roots as well as the actual hair itself. Here’s how hair growth happens:

It’s important to note that not all hair follicles are growing new hair at the same time. As hair grows in a cycle, different follicles are in different phases, which is fortunate, otherwise we would shed all our hair at once! Here is the breakdown:

Anagen (Growth) Phase
The anagen, or growing, phase is the first part of the hair growth cycle. During the anagen phase, cells of the bulb divide rapidly, resulting in new hair growth. The length of the anagen phase determines the maximum hair length. For example, people who have very long hair have a very long anagen phase. There are numerous factors that play a part in the length of the anagen phase, including genetics, nutrition, age and general health.

Catagen (Transition) Phase

After the hair growth phase enters the catagen phase. This short, transitional phase only lasts a few weeks, where the cells that make up the control centre for the hair, called the dermal papilla, detach from the follicle. The hair becomes what is known as a club hair.

Telogen (Resting) Phase

The telogen, or resting, phase follows the catagen phase. During the telogen phase, the club hair rests while a new hair begins to grow beneath it. This new hair will eventually take the place of the club hair. The telogen phase lasts for around three months.

Exogen (Shedding) Phase

The exogen, or hair shedding, phase is the last part of the hair cycle. During the exogen phase, the resting club hair detaches and falls out. Every hair eventually sheds, and it’s completely normal to lose up to 100 hairs per day. In fact, the exogen phase is why you’ll frequently see hairs in your shower drain or on your hair brush.

After the exogen phase, the follicle then returns to the anagen phase and the cycle repeats.

So, now that you understand the phases hair goes through to grow, you will be able to get a clearer picture of whether you are experiencing a natural shed or one you need to investigate.

Different Types of Alopecia

There are many types of alopecia, some of which are more concerning than others. The most common include:

  • Androgenetic Alopecia
    The most common form of alopecia is pattern hair loss, sometimes referred to as androgenetic alopecia. A common feature of pattern hair loss is a gradual loss of hair on the head occurring over many years or months. The factors underlying hair loss are still not well understood, but it is thought stress, diet, hormones, genes, aging and environmental factors contribute, causing a shortening of the anagen phase in the hair growth cycle. Hair loss in men follows a distinct pattern of receding hairline, often at the temples, with additional loss at the crown of the head. Men with pattern hair loss rarely lose hair at the sides or back of the head. The hair loss is progressive and so predictable that it can be defined with a specific classification scale known as the Hamilton-Norwood scale.

Androgenetic alopecia in women tends to not form a pattern, but rather, is distributed across the entire scalp as diffuse hair loss. This is most visible at the part in women with a centre parting or at the temples in women with hair pulled back. In a similar manner to male pattern hair loss female pattern hair loss can be classified along a progressive scale that describes the stage of hair loss – the Ludwig scale.

  • Telogen Effluvium 

Stress, illness, change in diet, and even pregnancy/childbirth can have profound effects on the human body. One of the ways this can manifest is that large numbers of the hair follicles will prematurely enter telogen and stop growing. This phenomenon, known as telogen effluvium appears as diffuse thinning all over the scalp and shedding of larger amounts of hair than usual. Telogen effluvium is normally fully reversible and those affected will recover after several months. However, prolonged stresses may mean that an individual will take longer to recover unless the stress is removed.

  • Anagen Effluvium

Anagen effluvium is a sudden and rapid shedding of anagen hair follicles as a result of a serious systemic insult such as cancer chemotherapy or poisoning. This can result in diffuse or total hair loss. This form of hair loss is most often completely reversible and follicles will regenerate after the poison or medication is removed. If there is no recent history of chemotherapy or severe sickness, any person with rapid unexplained hair loss should be referred immediately to a doctor.

  • Alopecia Areata

Alopecia areata is a type of hair loss that results in local patches of hair loss on the scalp, usually round and sometimes associated with inflammation. Alopecia areata is an autoimmune problem where the body attacks the hair follicles. Sometimes this can progress to total scalp hair loss (alopecia totalis) or complete body hair loss (alopecia universalis).

  • Traction alopecia

Traction alopecia results from the extended hairstyling in very tight ponytails, pigtails or from long braided hair, cornrows or dreadlocks. It can also occur as the result of long hair extensions. Traction alopecia is often seen in African American women and those with very curly or kinky hair and the popular hairstyles used to keep this kind of hair contained. If not treated, traction alopecia can lead to permanent hair loss.

How can évolis help?

The évolis Reverse 3 Step System was designed specifically to help improve pattern hair loss, restoring the hair cycle and increasing hair growth rate in both men and women. A common feature of both male and female pattern hair loss is the shortening of the hair cycle. évolis products, specifically Reverse Activator act to increase the length of the anagen phase, which extend the hair cycle to a more natural length. Dysfunction in hair cycling can also occur after recovery from other forms of hair loss such as telogen effluvium, so évolis can help with recovery of other less common forms of hair loss as well. The companion shampoo and conditioner promote a healthy scalp and resilient, voluminous hair.



About the Author

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Dr Dominic Burg
PhD, Chief Scientist

Dr Dominic Burg is a biochemist and systems biologist with expertise in hair and scalp biology, particularly hair cycle signalling. An accomplished science communicator with a career spanning academic research and the private sector, Dr Burg is the Chief Scientist for pioneering hair and scalp health leaders évolis.

 

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