August 2006 - Posts
Monilethrix is a genetic disorder characterized by a beaded appearance to the hair from periodic thinning and swelling of the hair shaft. It is a type of dysplasia, which refers to the abnormal growth of tissue, that affects the hair and that may result in hair loss.
The condition presents itself at birth or shortly thereafter as alopecia in the occipital area (back) of the scalp that gradually extends to the rest of the scalp. It is accompanied by erythema (a reddening of the skin) and follicular hyperkeratosis (the thickening of the outer sheaths of the follicles) that results in a rough feeling on the scalp. The condition may also affect other hairy areas, including the eyebrows, eyelashes, pubic areas, armpits and body hair. Affected hairs may appear beaded and constricted to a length of a few millimeters, though this varies from patient to patient.
A variation of monilethrix, called moniliform hair syndrome, may also include nail alterations as well as other possible ectodermal (pertaining to the outermost layers of cells) defects with neurological, dental or ophthalmologic alterations.
Drug treatment is possible for cases of monilethrix, though the best treatment is found in avoiding the mechanical actions of combing and brushing. As always, symptoms seeming to pertain to this condition should be discussed with a medical professional.
This is another example of a case of alopecia where the hair loss is related to irregularities of the hair shaft. Intermittent hair follicle dystrophy involves the dystrophy (the weakening and eventual wasting away) of the hairs. The hair shafts become breakable and present irregular losses of cuticles, horizontal and vertical cracks and vertical ridges. There is also abnormal keratinization (the process by which keratin, the protein that makes up hair, is produced) as well as an accumulation of fluid in the outer root sheath of the hair shaft.
Intermittent hair follicle dystrophy usually occurs among the hairs of the scalp and is unlikely to affect the eyebrows or the eyelashes. It was first described in 1986 in a six-year-old girl who experienced an important loss of hair with periods of partial remission.
Cases of intermittent hair follicle dystrophy, or symptoms that appear to be indicative of the condition, should be reported to a medical professional as soon as possible.
Irregularities of the hair shaft, such as those associated with the condition trichomalacia, can result in various types and degrees of hair loss. Another such condition is the presence of ‘bubble hairs’, which is the appearance of accumulated bubbles on the interior of the hair which may cause swelling or tension within the strand. This can result from exposure to high temperatures, particularly from the use of hair dryers or curlers, but it can also result from swimming in chlorinated pools or from whitening or lightening the hair.
The result is plaques of slight hair loss along the parietal and occipital areas of the scalp due to the hair breaking at one to four centimeters after emerging. The hair loss should, however, cease when the trauma (usually from the aforementioned cosmetic procedures) is eliminated.
Among the types of alopecia that can occur, many are associated with irregularities with the hair shaft. For example, cases of trichomalacia are characterized by plaques of hair loss with follicles consisting of deformed hairs. It can be caused by such traumatic causes as tics or trichotillomania, which is a psychological condition that involves the uncontrollable pulling of hair.
A scalp biopsy may reveal partially pulled out hair roots as a result of the traumatic causes that are deformed and twisted. There may also be evidence of fissures or grooves between the cells around and within the hair roots and the connective tissue.
While neither the traumatic causes of trichomalacia nor the resulting deformities result in any inflammatory reactions, many of the scalp’s hairs enter the resting, or telogen, phase of the hair cycle prematurely and result in excessive, diffuse hair loss some months later. The alopecia is similar in its effects to cases of telogenic alopecia that can result from nutritional deficiencies, traction or stress.
Hair loss may sometimes affect otherwise completely healthy people, with good eating habits, no notable diseases or any injuries to the scalp that can explain such a loss of hair. When this occurs, it is referred to as alopecia areata. This unpredictable but common disease affects 1.7 per cent of the world population.
Although it can affect men and women of all ages, onset most often begins in childhood. In most cases the hair falls out leaving round patches of baldness spread out over the scalp and body. In some extreme and rare cases this unexplained hair loss can lead to a complete loss of hair all over the head and body. Alopecia areata that causes complete hair loss over the head is called ‘alopecia totalis’ and when it causes hair loss over the whole body it is called ‘alopecia universalis’.
Hair loss that fits this description usually re-grows on its own and never reappears. If sudden, unexplained hair loss persists, however, medical treatment is a possibility. The drugs that have been found to be somewhat effective in combating alopecia areata are various types of steroids, Propecia, Rogaine, and various immunogens (drugs that interfere with the immune system). The longer the hair loss persists, the more unlikely it becomes that re-growth will recur. Although the hair follicles remain intact during the onset of alopecia areata, the longer they are inactive, the harder it will be to produce hairs.
It is believed that alopecia areata is caused by the immune system unexpectedly and temporarily attacking the hair follicles, causing them to fall out and preventing re-growth in some cases. However, it is not known why this occurs. Because alopecia areata is mainly asymptomatic (meaning that it does not present any symptoms other than the hair loss) a medical doctor can only diagnose alopecia areata by eliminating other possibilities for the hair loss.
Although sudden, unexplained hair loss is not life threatening, it is so dramatic in the severity and abruptness of the hair loss that it often affects the mental and emotional states of its victims. Individuals who suffer from alopecia areata are likely to develop high levels of stress. For this reason, many support groups have been established in many places. If you have this type of hair loss it is a good idea to contact your local support group by contacting the National Alopecia Areata Foundation. The foundation maintains a support network that operates in countries all over the world. You can contact the foundation by visiting their website at www.alopeciaareata.com.
Alopecia areata is an unfortunate and usually psychologically devastating disease with no sure cure to date. If you think you may be suffering from this condition, you should see a medical doctor immediately to rule out any other possibilities for the hair loss. If you find that you are suffering from alopecia areata, remember that there are many research foundations trying to find a cure, just as there are many support groups that are available to you who are there to help you cope with this sudden, unexplained hair loss.
The use of many drugs can result in some degree of hair loss. This includes the use of oral anovulatory drugs, commonly known as birth control pills. The hair loss that occurs is similar to that seen in post-partum cases of alopecia. It manifests as a slight shedding of the hair due to a disturbance in the woman’s hair cycles and is usually minor and temporary.
Similarly, it has also been noted that androgen-dominant (androgens are male hormones like testosterone) contraceptives have caused hair loss in women who were genetically predisposed to androgenic alopecia (also known as female pattern baldness). Cases such as these are usually easily taken care of by switching to an estrogen-dominant contraceptive, as androgens are known to be associated with genetic hair loss in both men and women.
Before taking any drug, you should always discuss the possible short-term and long-term side effects with a medical professional, and weigh the risks and advantages yourself.