Dr. Antonio Alvi Armani

Moniliform hair syndrome

dr_antonio_alvi_armani — Mon, 28 Aug 2006 21:46:00 GMT

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.

Intermittent hair follicle dystrophy

dr_antonio_alvi_armani — Fri, 25 Aug 2006 21:52:00 GMT

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.

Alopecia resulting from ‘bubble hairs’

dr_antonio_alvi_armani — Mon, 21 Aug 2006 18:49:00 GMT

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.

Trichomalacia

dr_antonio_alvi_armani — Fri, 18 Aug 2006 17:37:00 GMT

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.

Alopecia Areata

dr_antonio_alvi_armani — Fri, 11 Aug 2006 20:44:00 GMT

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.

Hair loss associated with birth control pills

dr_antonio_alvi_armani — Tue, 08 Aug 2006 16:11:00 GMT

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.

Diet-related hair loss

dr_antonio_alvi_armani — Fri, 28 Jul 2006 17:32:00 GMT

You probably understand that a poor diet that lacks in essential nutrients can negatively affect your overall health. What you may not know is that deficiencies of particular vitamins or other substances can cause you to lose your hair.

Hair loss that is caused by a nutritional deficiency is usually slight and temporary, with the exception of some extreme cases where the hair loss becomes chronic and results in permanent damage to the density and strength of the hair. These kinds of hair loss occur because your hair’s structure or hair cycles are affected.

Protein deficiency is one of the most common causes of diet-related hair loss. Your hair is composed mostly of proteins, the same materials that your nails are composed of. If your food does not provide you with enough protein then both your nails and your hair may be negatively affected. Proteins are found in common foods like meats, poultry, fish, beans and dairy products. If a protein-deficient diet persists than your hair will go into a premature resting stage and will start to fall out within a few months.

Another possible cause of diet-related hair loss is low levels of iron in your blood, which might result from an inadequate amount of iron in your diet. Foods that are common sources of iron include potatoes, dried beans, liver, beef, fortified cereals, raisins, spinach and broccoli. An inadequate amount of iron in your blood may also result from some difficulty your body has in absorbing iron, which is commonly associated with the condition anemia.

Vitamin A can also affect your hair. But both an inadequate and an excessive amount of vitamin A can cause hair loss. Too little of this vitamin can result in a condition called hyperkeratosis. It occurs in your hair follicles and in the sebaceous glands (the small glands in your skin that secrete oil into your hair) and it can complicate hair growth. Conversely, too much vitamin A can prevent proper keratinisation (the process by which a protein called keratin builds your hair and nails), resulting in a kind of hair loss referred to as ‘toxic alopecia’. Vitamin A can be found in whole eggs, milk and liver.

Other nutritional deficiencies that can affect your hair growth include deficiencies of: essential fatty acids, zinc, copper and vitamin C.

Fortunately, the damage done to hair by this type of diet-related hair loss is only temporary and can be corrected by simply improving your diet. It is important to maintain a balance of vitamins, minerals and other nutrients in your diet for the betterment of your hair’s health as well as your overall health. If you allow poor dietary habits to persist, your body may suffer many possible consequences including varying degrees of hair loss.

Trichodental syndrome

dr_antonio_alvi_armani — Thu, 27 Jul 2006 19:46:00 GMT

There are many cases of hypotrichosis (the less than normal growth of hair on the head or body) that occurs due to genetic skin diseases, which are called genodermatoses. One of these is the condition referred to as ‘trichodental syndrome’. This syndrome is characterized by hypotrichosis, as already mentioned, and fine, dry and lusterless hair that grows slowly. It is also accompanied by a condition called hypodontia, where the patient is born with less than the normal number of teeth. Incidentally, the external halves of the eyebrows are also missing.

The condition falls into the category of telogenic alopecias. This means that with trichodental syndrome, more than 50 per cent of the scalp’s hairs are in the telogen, or resting, phase of the hair cycle at any given time. This is the amount of hair that will routinely fall out. The percentage for the average individual is only 10 per cent.

There are many conditions and means by which any person can have less hair than should be expected. Many cases of hair loss are due to androgenic alopecia (male or female pattern baldness), but some are the result of more serious and life-altering conditions. All cases of hair loss that seem abnormal should be discussed with a medical professional.

Hair loss due to ultraviolet radiation

dr_antonio_alvi_armani — Tue, 25 Jul 2006 20:10:00 GMT

It is not uncommon to see men and women who have experienced some slight hair loss due to prolonged exposure to the sun and its ultraviolet radiation. Some 3 to 4 months after vacationing in a very sunny place, an individual of either sex may notice that they are excessively shedding hair from their frontal regions and along the hairline. He or she may also notice some slightly increased shedding in other areas as well.

This hair loss may be due to the temperature increase similar to that seen in cases of hair loss that occur after a severe fever or it may be related to the inflammatory phenomena caused by sunburn, if there is evidence of such.

In most cases, hair loss from too much exposure to the sun is not permanent and should resolve itself. But this kind of hair loss can be avoided by keeping your scalp properly covered while out in the sun for long periods of time.

Female Androgenic Alopecia

dr_antonio_alvi_armani — Fri, 21 Jul 2006 17:53:00 GMT

There is a common misconception that only men suffer from genetic hair loss. In actuality, however, almost 40 per cent of all females will experience some degree of female androgenic alopecia (FAGA) as they age. Like male pattern baldness, FAGA also goes by the name female pattern baldness, because of the common pattern that the hair loss usually follows.

Women with FAGA tend to experience a progressive thinning of the scalp hair only around the crown area. It is also usually more diffuse and central than male genetic hair loss; and it is often referred to as a ‘widened part’. Less commonly, women may have a receding hairline similar to that seen in balding men. It is unlikely that female genetic hair loss will result in total baldness, though it does occur.

FAGA is caused by similar chemical causes to male pattern baldness. Both are related to the action of androgens (male hormones). In fact, many cases of hyperandrogenism (the excessive production of male hormones) that are due to other factors trigger the onset of female genetic hair loss. Treatment for both types of genetic hair loss may focus on this chemical cause, however, the current leading drug treatment for female hair loss is Rogaine, which does not target the action of androgens.

There are other ways that women can suffer from hair loss, including the influence of hormones, disease, diet or drug usage. But FAGA continues to be the most common type of hair loss among women. Fortunately, many treatment options are available, including the use of Rogaine, as well as surgical treatment, which offers a permanent, effective solution to almost any kind of hair loss including female androgenic alopecia.

Cancer-related hair loss

dr_antonio_alvi_armani — Thu, 20 Jul 2006 17:37:00 GMT

There are a variety of ways that cancer or the treatment of cancer can affect your hair and may result in some degree of hair loss. Like most hair loss that accompanies a disease or drug usage, the hair loss should only last as long as the cause of the loss.

There is a rare type of hair loss that occurs when a cancer spreads from somewhere else in the body to the scalp. It is called neoplasic alopecia because the word neoplasic comes from the word ‘neoplasm’, which means tumor, but it may also go by the name metastatic alopecia because the word metastatic comes from the word metastasis, which refers to the spread of cancer.

The susceptibility of the scalp to neoplasic alopecia is higher for women with breast cancer and for men with lung cancer in particular, as opposed to other types of cancer. It is believed that mucines, a certain kind of protein created by breast and lung carcinoma, degenerate the cells of the outer root sheath of the hair follicle. There are cases, however, of cancer spreading from the breast to the scalp without any evidence of hair loss.

Ovarian and adrenal tumors are also likely to cause hair loss. Both types of tumors can cause hyperandrogenism, which is the excessive production of androgens (male hormones). Androgens are known to play a key role in male and female pattern baldness. Once the tumor has been removed, however, the hair loss should go away.

Finally, all cancer-fighting drugs attack the body in order to destroy the cancer cells. This means that any cancer-fighting drug, like chemotherapy, will also attack the body’s hair follicles and cause them to fall out and result in considerable hair loss. Fortunately, when the treatment ends, so should the hair loss.

A general philosophy to do smaller number of grafts per session.

dr_antonio_alvi_armani — Mon, 17 Jul 2006 21:15:00 GMT

In the past, there has been a general philosophy to do smaller number of grafts per session. I have found, as in one of my repair cases today from London, UK, that after 800 or so grafts, the patient has almost no outcome that he is happy with. The donor scar is usually not just superficial, but goes down much deeper. The fibrosis extends both vertically and horizontally. The need to repair him is obvious in the front. However, the tissue now is tougher to work with both in the recipient area and the donor area.

Therefore, it’s better to do larger sessions for many reasons.

The three obvious reasons are:

Better cosmetic results; more pleasing to the patient.
Lesser scarring, and therefore, less damage to his donor area. In this way, he or she has greater donor reserve.
Lesser number of procedures needed.

This new philosophy will eventually overtake the smaller session surgeries. It is in the interest of the patient to obtain the best results with the least damage.

Loose Anagen Syndrome

dr_antonio_alvi_armani — Mon, 17 Jul 2006 19:47:00 GMT

First described in 1984, loose anagen syndrome affects an unknown number of people and usually goes undetected. It remains one of the many varied and generally unexpected forms of hair loss. It is a disease of the hair that predominantly affects young, Caucasian, blonde girls, although anyone is susceptible to this type of hair loss. There may be some genetic susceptibility as well.

The characterizing symptom of loose anagen syndrome is the ability of anagen hair (hair that grows during the anagen, or growth, phase of the hair) to be pulled easily and painlessly out of the scalp. A microscopic examination of this type of easily extracted hair shows several key characteristics: there is a marked distortion of the anagen bulb on the hair follicle, ruffling of the cuticle distal to the bulb and absent sheaths. There is a structural abnormality to the inner root sheath of the hair follicle that disturbs its anchoring function and thus makes it easier for the hair follicle to be pulled out. Diagnosis of loose anagen syndrome consists of a review of patient’s history, a clinical examination and a light microscopic examination of the easily extracted hair.

It has also been found that there is an association between loose anagen syndrome and other developmental defects, which may include: Noonan’s syndrome, Nail-patella syndrome, Tricho-rhino-phalangeal syndrome or Hypohidrotic ectodermal dysplasia.

In children ages 2 to 5 years with loose anagen syndrome, the condition is usually identified by the inability of the hair to grow past the ears, though the density is usually unremarkable and the hair is not particularly fragile otherwise. If one were to pull at a cluster of hairs, 15 to 20 hairs are likely to be painlessly extracted. Hair loss as a result of loose anagen syndrome can be distinguished from alopecia areata (unexplained hair loss) by the fact that hair lost from loose anagen syndrome grows back very quickly.

Treatment for loose anagen syndrome is usually unnecessary, as even loose anagen hair will grow, albeit slowly, and if it is accidentally pulled out it grows back very quickly. However, a topical minoxidil solution, like that found in Rogaine, may be used to hasten hair quality if desired. If the syndrome does not seem to be accompanied by any other developmental defects, there is no need for further extensive hormonal and metabolic studies to be done.

Female Androgenic Alopecia

dr_antonio_alvi_armani — Thu, 13 Jul 2006 19:05:00 GMT

Hair loss related to cancer

dr_antonio_alvi_armani — Thu, 13 Jul 2006 19:03:00 GMT

Hair loss can result from the onset of various types of cancer or as a side effect of a tumor and even the treatment of cancer with drugs like chemotherapy can cause you to lose hair. Like most hair loss that accompanies a disease or drug usage, the hair loss should only last as long as the cause of the loss.

Hair loss as neoplasic alopecias: This is a rare type of hair loss that occurs when a cancer spreads from somewhere else in the body to the scalp. It is called neoplasic alopecia because the word neoplasic comes from the word ‘neoplasm’, which means tumor, but it may also go by the name metastatic alopecia because the word metastatic comes from the word metastasis, which refers to the spread of cancer.

Neoplasic alopecia is considered to be so closely related to signs of breast cancer that it is common practice for women over the age of 40 who show signs of alopecia areata (sudden unexplained hair loss) to undergo a breast examination. In these cases the hair loss could be a sign of carcinoma before the cancer is clinically detected.

Hair loss from tumors: Ovarian and adrenal tumors are also likely to cause hair loss. Both types of tumors can cause hyperandrogenism, which is the excessive production of androgens (male hormones). Androgens are known to play a key role in male and female pattern baldness. Once the tumor has been removed, however, the hair loss should go away.

Scalp tumors are another possibility of tumors affecting your hair. Although slow growing scalp tumors are a rare cause of hair loss, they can still affect the hair and scalp in other ways. Benign scalp tumors can result in growths on and around your scalp in relation to any number of the various components of the hair follicle, the sebaceous gland (the small glands in your scalp that secrete oil and fatty substances) or the skin of the scalp itself. Any of these kinds of growths can affect the growth of your hair and the structure and health of your scalp in many ways, including bald patches or diffuse shedding of the hair.

Hair loss due to cancer-fighting drugs: All cancer-fighting drugs attack the body in order to destroy the cancer cells. This means that any cancer-fighting drug, like chemotherapy, will also attack the body’s hair follicles and cause them to fall out and result in considerable hair loss. Fortunately, when the treatment ends, so should the hair loss.