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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. 

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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.


Ultimate Guide To Regenera Activa: Hair Loss Treatment Without Medication Or Surgery

Thinning hair stems from many reasons and it can be really distressing. Patients who come to me are eager to seek ways to reverse thinning hair.

However, despite their eagerness, many of them are still not keen on trying the traditional hair growth methods. Hair growth medicines comes with quite number of undesirable side-effects while hair transplant surgery is costly, and carries some risks. 

Thus, I wanted to write this article to share my knowledge on a new hair-loss treatment: Regenera Activa. 

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Ask Dr Kelvin Chua: Hair Loss & Hair Transplant

Hair loss issues are indeed frustrating and may make one feel self-conscious. It’s no coincidence that hair transplant-related queries is also one of the most popular treatments that Singaporeans send in a request for.

If you're facing hair loss issues or are looking for ways to prevent it, join Dr Kelvin Chua, as he hosts a QnA session where he answers all your questions on hair loss and hair transplant.

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The Ultimate Guide To Getting A Hair Transplant In Singapore (2018)

“Hair transplant Singapore” is one of the most Googled terms locally, with over 1,000 searches each month. It’s no coincidence that hair transplant-related queries is also one of the most popular treatments that Singaporeans send in a request for.  

This guide will address everything you need to know about getting a hair transplant in Singapore.

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13 Key Facts About Hair Transplants In Singapore

This post addresses the common questions from readers about hair transplants in Singapore.

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The Doctor's Guide To Hair Loss Treatment In Singapore (Non-Celebrity Endorsed)

About 99% of hair loss treatments in Singapore that you see advertised on local media do NOT work at all. You probably know exactly which adverts I'm talking about - they often feature a Mediacorp artiste. Just how much money is wasted on these ineffective treatments? A lot. Hair loss treatment is a whooping $3.5 billion industry.

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Dear Diane, Good question. I receive this question a lot from my patients too. Platelet Rich Plasma (PRP) is not allowed for Aesthetic treatments in Singapore Unfortunately, Platelet Rich Plasma (PRP) is not allowed for Aesthetic treatments in Singapore. Hence, PRP is ...
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Dear CT, Cohort studies done on patients taking isotretinoin (accutane) have shown may develop hair abnormalities. This is attributed to Vitamin A toxicitiy, of which, accutane is a potent derivative of. The types of hair disorders that are associated with isotretinoin u...
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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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Dear JM, 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 caus...
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Dear kandycanecarinn, Lengthy reply alert: 1. Biotin as a hair growth supplement: I would like to clarify a few points regarding biotin - firstly, biotin IS vital in the normal development of normal hair and nails (believed to be due to biotin's role in controlling ke...
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Dear Lyndy, The best treatment for receding hairline/female pattern hair loss (FPHL) for women in Singapore are: 1. Regenera Activa - a minimally invasive regenerative medical treatment to strengthen your hair using micro-grafts extracted from your own scalp. Price of Re...
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Dear Hairlossyouth, While I acknowledge that Turkey and India (as well as some other countries) do offer more affordable hair transplantation rates, do be aware that hair restoration surgery is, after all, a surgical procedure. All surgical procedures have risks involved - th...
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Dear Hairlossyouth, The cost of a hair restoration procedure depends on a few factors: 1. The surface area where hair needs to be restored: this will affect the number of grafts that are required for the procedure, in order to achieve a good aesthetic result. Most centres in S...
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Dear Haziq, At 17 years of age, a receding hair line is likely due to a genetic cause of hair loss. Male pattern hair loss can occur from any age after puberty, with some patients experiencing it earlier than others. It would be ideal to first consult a doctor familiar with h...
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Dear Marie, As you have correctly done, stopping the hair pulling is the first step in controlling the permanent follicle damage that can be caused by mechanical traction trauma. Do continue to be mindful to avoid pulling out more hair! If there are areas of scalp that have ...
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Dear Hairlossyouth, It is indeed distressing to face hair loss at a young age. I would not rush into PRP injections as the first option since: 1. It is not legally available in Singapore 2. There is only scant evidence of its efficacy for hair loss 3. So far the scant evi...
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Dear Kalai, 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...
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Dear Clylotte, 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 proble...
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Dear Rach, Firstly, let me address your concern about the dry and itchy scalp. The scale that you showed a picture of could represent a range of possible 'flaky skin conditions' - commonly, on the scalp, pityriasis capitis and seborrheic dermatitis are likely diagnoses. A thorou...
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Hi A, It appears you have male pattern hair loss. The main cause of this is high DHT (dihydrotestosterone) levels, a type of male hormone. Oral finasteride helps to reduce the amount of DHT. Other options include minoxidil and hair supplements such as viviscal. However these m...
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