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Hair Loss Profile Image

Hair Loss

Hair loss is also known as alopecia or baldness. The severity of hair loss can vary from a small area to the entire body. 

Overview

Symptoms of hair loss include hair loss in patches usually in circular patterns, dandruff, skin lesions, and scarring.

People have between 100,000 and 150,000 hairs on their head. The number of strands normally lost in a day varies but on average is 100.

In order to maintain a normal volume, hair must be replaced at the same rate at which it is lost. The first signs of hair thinning that people will often notice are more hairs than usual left in the hairbrush after brushing or in the basin after shampooing.

In male-pattern hair loss, loss and thinning begin at the temples and the crown and hair either thins out or falls out. Female-pattern hair loss occurs at the frontal and parietal. 

Diagnosis

There are 2 types of identification tests for female pattern baldness: the Ludwig Scale and the Savin Scale. Both track the progress of diffused thinning, which typically begins on the crown of the head behind the hairline, and becomes gradually more pronounced.

For male pattern baldness, the Hamilton–Norwood scale tracks the progress of a receding hairline and/or a thinning crown, through to a horseshoe-shaped ring of hair around the head and on to total baldness.

  • The pull test helps to evaluate diffuse scalp hair loss. Gentle traction is exerted on a group of hairs (about 40–60) on three different areas of the scalp. The number of extracted hairs is counted and examined under a microscope. Normally, fewer than three hairs per area should come out with each pull. If more than ten hairs are obtained, the pull test is considered positive.

  • The pluck test is conducted by pulling hair out "by the roots". The root of the plucked hair is examined under a microscope to determine the phase of growth, and is used to diagnose a defect of telogen, anagen, or systemic disease. Telogen hairs have tiny bulbs without sheaths at their roots. Telogen effluvium shows an increased percentage of hairs upon examination. Anagen hairs have sheaths attached to their roots. Anagen effluvium shows a decrease in telogen-phase hairs and an increased number of broken hairs.

  • Scalp biopsy is used when the diagnosis is unsure; a biopsy allows for differing between scarring and nonscarring forms. Hair samples are taken from areas of inflammation, usually around the border of the bald patch.
  • Daily hair counts are normally done when the pull test is negative. It is done by counting the number of hairs lost. The hair from the first morning combing or during washing should be counted. The hair is collected in a clear plastic bag for 14 days. The strands are recorded. If the hair count is >100/day, it is considered abnormal except after shampooing, where hair counts will be up to 250 and be normal.
  • Trichoscopy is a noninvasive method of examining hair and scalp. The test may be performed with the use of a handheld dermoscope or a video dermoscope. It allows differential diagnosis of hair loss in most cases.

In almost all cases of thinning, and especially in cases of severe hair loss, it is recommended to seek advice from a doctor or dermatologist. Many types of thinning have an underlying genetic or health-related cause, which a qualified professional will be able to diagnose.

Read this post for more information on treating hair loss in Singapore.

Thank you for the question. A common cause of progressive thin ning of the hair includes female pattern hairloss. Scalp dermatitis can cause the scalp to be itchy and painful. You can see your doctor or dermatologist for assessment and treatment of your hair problem. It is di...
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There are various types of hair loss that will require different treatment approaches. You should consult a dermatologist, plastic surgeon or aesthetic doctor with special interest in hair to help you with your concern. They should provide you with a detailed consultation, examination, necessary t...
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Sorry to hear about your plight. Don't worry, there are proven hair loss treatments that work. I diagnose hair loss through a detailed medical consultation involving your personal medical history and medical history. After that, I will examine your scalp for the causes of hair...
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Thanks for your question. I see two issues at hand: You are now having red patches on your scalp that are itchy You have noticed hair loss for some time, for which minoxidil did not work. The problem is I don’t know the timeline of both, and whether the 2 issues are...
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Thank you for your question and please bear with my lengthy reply. PART 1: The likely diagnosis What you are describing does sound like female pattern hair loss. This condition can typically start as early as puberty and is progressive in nature i.e. gets worse over time, ...
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Hi Dianne Rose, Based on your story, I can immediately pinpoint possible causes of your hair loss. They are: 1. Scalp Dermatitis (inflammation of scalp) 2. Tinea Capitis (fungal infection of scalp) 3. Nutritional Deficiencies 4. Female Pattern Hair Loss(multi facto...
26 Jan 2018
Hair fall of 50-100 hairs/day is normal. If your hair is getting thin and your hairline is receding , it is most likely Male Pattern Hair Loss (aka Androgenetic Alopecia). It is the most common form of hair loss in men. Please refer to the attached chart for classification of t...
26 Jan 2018
You are most likely suffering from Male Pattern Hair Loss. It is due to Dihydrotestosterone hormone wreaking havoc on the front and top hair follicles on your head. There’s 2 ways to restore hair in your case (and for many other men). 1. Hair Transplantion Its the...
26 Jan 2018
Thank you for the question. The diagnosis of hair loss and thinning is often made after thorough history and physical examination, and blood tests to rule out underlying medical diseases may need to be ordered. Dermatologists are specialists in skin, nails and hair diseases an...
7 May 2018
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