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HAIR GROWTH CYCLEHair is made of a protein called "Keratin". Hair has 2 parts i.e. hair shaft (visible on the scalp) & root (underneath the scalp) which are responsible for the growth of hair. Our hair is attached to scalp at the base of the follicle by the hair root. This is the area where hair growth takes place and are continuously nourished by blood vessels providing oxygen and nutrients to the cells. If talking about the thickness of hair, it depends upon the size of the hair follicle from which it grows.There are approximately 100000 – 150000 strands of hair on a person’s scalp. The constant hair growth pace is half-inch a month and normally, a person sheds between 50 - 100 hairs every day, as part of the natural hair growth cycle. Also, every person has different kind of hair like some have thick hair or thin hair, some have curly hair and these factors also affect the hair growth cycle.Hair growth cycle follows an independent 3 phase cycle as given below.ANAGENIt is the active hair growth phase where 90% of hair is in active growth at any one time.Here pigment (melanin) is produced in the hair bulb throughout the Anagen cycle.It is the longest phase that lasts for approximately 2-6 years.This phase determines the length of the hair.CATAGENThis is the transition phase of hair growth where follicle shrinks up to 1/6 of its normal length and hair stop growing.Here no pigment is produced which led the follicle stops producing hair. This phase just lasts for a very short period of 2-3 weeks.TELOGENThis is the resting phase where hair has reached to its full extent of growth and falls out.The shedding of hair is normal, as old hair is replaced with the new hair.Approximately 14% of the hair is in the resting phase that you lose while combing, shampooing, oil massaging.This phase lasts for 2-3 months & once it is over, the hair follicle re-enters the Anagen (growing) phase.HAIR LOSSHair Loss can occur due to several reasons which affect more than 90% of men/women. Usually, hair loss begins from the forehead and recedes to hairline which concludes bald patches at back and crown areas. Nothing to worry if you are losing 50-100 hairs a day, but if the count increases then it is definitely an alarming signal. In case you are losing more hairs on regular basis or you are seeing your hair everywhere- including your pillow & towel; then this situation can move you towards baldness. Losing hair in juvenescence means that there is the deficiency of essential proteins and nutrients in the diet or can be due to some other reasons such as using chemicals to look good like hair gels and hair colors, medications etc.Is Hair Fall & Hair Loss a same thing?Hair loss is not the same condition as that of hair fall. There is difference between both the hair problems- Hair Loss & Hair Fall. In case of hair fall, new hairs take place of falling hairs. But hair loss is a more serious concern; because in this, hair does not grow in place of fallen hair. Thus hair loss can result in thinning hairline and causing baldness.Causes of Hair LossThe hair loss/baldness concerns can demolish the self-confidence of a person. Following are the various causes of hair loss/hair fall or baldness problems:1) GeneticIt is a very common cause of hair loss and practically there is lack of evidence to substantiate this. So, if your organic parents, closed relatives or other family members have baldness or thin hair, you may also become prone to hair loss/hair fall.2) Malnutrition/Diet DeficienciesAs other cells in our body need good care, hair cells in our scalp also need proper nourishment and nutrition. Deficiency of vitamins, minerals and other nutrients can be one of the reasons for hair loss/baldness.3) Certain Drugs or MedicationsHair loss can also be caused by drugs, medicines or treatments used to treat severe conditions like arthritis, depression, cancer, heart problems, high blood pressure etc. Normally cancer patients subjected to radiation and chemotherapy are much susceptible to the hair loss or rapid thinning of hair.4) Hormonal FactorsHormonal imbalances and changes can cause temporary hair fall/loss. These changes can occur due to pregnancy, childbirth, the onset of menopause, cessation of birth control pills. Pregnancy or giving childbirth is one of the major causes of hair loss due to mineral deficiencies.5) Stress, Physical or Emotional TraumaStress is the root for every disease; it also has subversive effects which led to hair loss. Like other body cells, hair cells also need pause, relaxation and refreshment; and your stress can be a major reason for non-responsive re-growth of hairs. Also sudden or excessive weight loss, death in the family or high fever can be a reason.6) Fever & Viral DiseasesHigh fever for a long period and other viral diseases like thyroid problems, scalp infections, alopecia areata and skin disorders are said to be the contributing factors to hair loss.7) Harsh Hairstyles and Cosmetic UsageHair loss can also occur due to tight hairstyles such as cornrows and pigtails. Also, some chemically treated cosmetics lead to hair loss. These include hair gels, hair straightening chemicals, hair colours, shampoos etc.8) AgingAgeing is a natural factor that can slow down the hair growth, causing hair loss or baldness on the top of the head or in the crown area.9) Hair Pulling DisorderSometimes mental illness causes people to have an irresistible exhort to pull out their hair which often leaves uneven bald spots on the head.Effects of Hair LossThe hair loss effects are not only restricted to the hair and scalp; but it can also become the reason for Psychological, Physical or Emotional issues. It becomes difficult for some people to digest their progressive hair loss or balding problems; and because of not getting the appropriate treatment at early stages, these concerns can have devastating impacts on the lives of people.Physical Effects: Degrading Personality or Less Attractive Look More aged/older appearancePsychological/Emotional Effects: Losing self-confidence Depression or Chronic StressThe appearance of Hair Loss and EtiologiesEvaluation of Hair Loss at NHTA physical diagnosis and directed history is must for the evaluation of hair loss and for this purpose, you need to visit and consult to an experienced Dermatologist. The NHT experts will determine the severity and progression of your problem during the evaluation phase. They will appropriately analyze or diagnose the various aspects related to your hair loss. The aspects include when your hair loss started, the pattern of hair loss and the causes behind it. This diagnosis is then followed by invasive and non-invasive tests.Here are the several tests & methods that are used for the evaluation of hair loss: Medical History Physical Examination Hair Pull TestMedical HistoryIn this, the patients need to talk freely with the consultant about his medical problems or stressful events. In order to prepare an appropriate treatment plan, the physician may ask the patients about their severe illness (if any), medications, hairstyling habits, family history of hair loss etc.Physical ExaminationIt involves the inspection of a patient’s entire scalp and hair to identify the pattern of baldness and other physical clues like scales, erosions, pustules, excoriations etc. It also involves the assessment of hairline, frontal area, crown area and back of the scalp. This analysis is performed with the patient sitting on a chair; in good lighting.Hair Pull TestThe hair pull test is generally performed on the patients who have a complaint about intense hair loss. It identifies the active hair loss and with the help of the microscopic tool, the specialist will also determine the type of hairs removed during this test.

" Onam " 10- Sardarnagar, B/h Boss Colour Lab, Opp. Jain Upashray, Astron Cinema Road, Gujarat

Types of HAIR LOSS IN MENMALE PATTERN BALDNESS/ANDROGENIC ALOPECIAAs men grow older, they start losing hair to some extent due to different reasons. A big percentage of men have to suffer from some sort of hair loss in their lifetime. Male Pattern Baldness or commonly known as Androgenic Alopecia is the foremost reason of men hair loss. • WHAT CAUSES MALE PATTERN BALDNESS?Male Pattern Baldness occurs due to progressive thinning of hair. In this, the hairs generally begin to lose at the temples with the hairline receding gradually. Then it causes bald patches over the crown area (back of the head). Eventually, it results into making the ‘M’ from the forehead and the person is left with a horseshoe pattern of hair i.e. the hairs will be available on both sides (above the ears) and back of the head. The loss will be greater if it starts at a younger age.It has been estimated recently that male pattern baldness affects more than 40% of men in India by the age of 50. It does not signify any medical disorder, but it may alienate the person with low self-esteem or cause anxiety.• WHAT ARE THE CAUSES OF MALE PATTERN BALDNESS?The main cause of Male pattern baldness is the genes predisposing and sex hormones. It usually follows the pattern of receding hairline and hair thinning on the crown.Other causes may include: Diseases like thyroid, anaemia etc. Blood-thinning medications or anabolic steroids Inappropriate Diet (fewer intakes of iron or high doses of Vitamin A) Stress/Depression Treatments such as radiation, chemotherapy Scalp Infections• DIAGNOSIS & TREATMENTIf you feel that you are losing more count of hair, then you need to be very attentive and keep track of the pattern. You can visit the experienced doctors/specialists who will definitely guide you with proper diagnosis and treatment; so as to eliminate your hair loss problem permanently.Alopecia AreataAlopecia areata is a common autoimmune disorder that results in unpredictable hair loss from the head, beard, or any part of the body. It affects regardless of age and gender, though most cases occur before the age of 30.It is genetic and passes down in the family. One in five people suddenly over a course of just a few days start to lose tremendous amounts of hair. People with alopecia areata who have only a few patches of hair loss soon recover their hair without treatment.The condition occurs when white blood cells attack the hair follicles, causing them to shrink which dramatically slows down hair production. It is not known why hair follicles fall in this way, but it progresses rapidly and can cause large patches, thus causing social awkwardness. It is often conjectured that stress could be a probable cause of Alopecia Areata but there aren't many researches to validate the claim.Further, it can develop into complete loss of hair on the scalp termed alopecia totalis or in extreme cases the entire body called alopecia Universalis. Corticosteroids, powerful anti-inflammatory drugs that can suppress the immune system can stop white blood cells from attacking the hair follicles.Traction AlopeciaTraction Alopecia is a form of acquired hair loss that results from prolonged or repetitive tension to the scalp hair. It was first described in 1907 in patients hailing from Greenland who had been diagnosed with hair loss after wearing hair in tight ponytails for longer periods.This issue can develop due to:1. Regularly wearing your hair in tight ponytails, buns, braids, dreadlocks.2. Using relaxers and rollers on hair.3. Having longer beard and hair and twisting and braiding it, increases its weight and causes submandibular traction alopecia.The likelihood of traction alopecia increases with age and also from what age you started to put pressure on your hair. There are different phases in this type of hair fall and only getting a consultancy from the best hair transplant clinic in India will provide you with the best solution.The different stages in Traction Alopecia:A. Early stages: There is thinning of hair and you start to notice hair growth cycle change slowly but gradually and the amount of Telogen (resting) hair increase.B. Later stages: Sebaceous glands and terminable hair follicles reduce and are replaced by fibrous tracts (scars). Inflammation is mild to absent.Anagen EffluviumAnagen Effluvium refers to hair shedding that commences during the growth stage of the hair growth cycle. Anagen effluvium has shown to cause diffuse non-scarring alopecia. This is in stark contrast to telogen effluvium where hair shedding onsets during the resting phase of the hair growth cycle.It is generally associated to be caused by infections, toxins, autoimmune diseases, drugs, or radiations. Patients who are undergoing chemotherapy also have hair loss due to anagen effluvium.Usually, in anagen effluvium, the end of the hair that is scraped from the scalp is tapered, irregular, or broken off. Anagen hairs have long roots covered with the inner and outer root sheaths and they get pigmented. Telogen EffluviumTelogen effluvium or hair shedding which arises during the telogen or resting phase of hair growth cycle. It is in complete opposition to anagen effluvium where hair shedding happens during the growth stages. It is usually caused due to hormonal imbalance but consuming medicines that misbalance hormones can also cause hair loss.Usually, hair starts to recover on its own because this type of hair loss is temporary. But if there is a pattern found in hair loss, then the hair fall will increase and you will be required to consult a Hair specialist.Cicatricial AlopeciaCicatricial or scarring alopecia comprises of diverse groups of scalp disorders that result in permanent hair loss. This destructive process can occur as a primary or secondary cicatricial alopecia.Primary cicatricial alopecia refers to a group of idiopathic inflammatory processes that cause follicle inflammation destroying the hair follicle. Secondary cicatricial alopecia can be caused by almost any cutaneous inflammatory process of the scalp skin or by physical trauma, which injures the skin and skin appendages. Regardless of Cicatricial alopecia being primary or secondary, it causes replacement of hair follicle with fibrous tissue, thus hair can't grow here. But Cicatricial Alopecia is just about 3% of the overall cases of hair fall complaints. Bald patches, in this case, are due to inflammation thus anti-inflammatory medications are suggested. Minoxidil 2% solution has shown to be effective, but a hair transplant is the best treatment.FolliculitisFolliculitis is the name given to a group of skin conditions in which there are inflamed hair follicles. There is always a red spot with a pustule on the skin.Folliculitis may be superficial or deep. It can affect any place where there is a presence of hair, including chest, buttocks, back, arms, and legs. Acne and its variants are also types of folliculitis. Folliculitis can be due to infection, occlusion (blockage), irritation, and various skin diseases. Folliculitis can be due to bacteria, yeasts, fungi, viral infections, parasitic infections, and many others. Taking medications to curb down the folliculitis and suppress the cause of irritation can lead to a stoppage of hair loss. Eosinophils are present whenever there is an inflammation in the body thus treatment may also include immunosuppressants.Hair Loss by Folliculitis isn't a lot but it can lead to major hair loss if you allow it to stay and ignore it.Dandruff, Dry & Flaky ScalpItchiness due to dandruff often causes irritability and embarrassment. Dandruff does make your scalp itchy and flaky. That white flake which you scratch off from the scalp is nothing but itchy dead skin. Males are more prone to dandruff concerns compared to females. It can be observed with the onset of adolescence which then continues till adulthood. You may try to get rid of it by maintaining a good hair wash routine, but that is not a sustainable solution.The scalp skin constantly renews itself. That is when the old skin drops off and a new one replaces it. This cycle is not visible when it is in the initial phase. But when the process accelerates, many more old skin cells shed in the form of visible clumps or flakes. The moment you brush your hair or rub through it, you will notice these flakes fallen on the shoulders or against any dark-coloured clothing.In terms of severity, itching and flaking are equally alarming. The common form of dandruff affects the entire scalp, but not the skin over the face or neck. Severe dandruff concern means quick shedding of old skin, which can lead to uncontrollable itchiness.Apart from drying of the scalp skin, there are many other reasons for dandruff. If your scalp skin is sensitive to hair products, it can also lead to dandruff. Also, environmental factors such as heat and humidity can aggravate dandruff. The concern can be observed either throughout the year or can vary as per season.Dandruff, if not treated at the right time, can cause hair loss and scalp inflammation. If your skin is suffering from acne or oily skin, the condition can worsen because of the flakes.

" Onam " 10- Sardarnagar, B/h Boss Colour Lab, Opp. Jain Upashray, Astron Cinema Road, Gujarat

About Hair Loss In WomenNoticing strands of hair in your comb often these days? Every day we lose around 50-100 strands of hair approximately, but then the same is replaced by new ones, as this is a natural hair growth cycle. Your hair goes through three distinct phases of growth- anagen, catagen and telogen. These stages occur simultaneously and it is the characteristic of each phase that determines the length of the hair.Hair fall is a common concern witnessed by a lot of women where they lose more than a normal number of hair strands every day. A reduction in hair density and more scalp visibility like- widening of the hair partition, are also signs of Hair Thinning.Women start noticing hair thinning between ages 25 to 30. Both hairs falls and thinning can be attributed to reasons like lack of nutrients, hereditary factors, ageing, illness, stress and hormonal imbalances. The levels of endocrine hormones, particularly androgens and hormonal changes caused by menopause also cause hair fall and thinning in women.FEMALE PATTERN BALDNESS/ANDROGENIC ALOPECIALosing/shedding up to 100 strands a day is normal for women and there is nothing to worry about; because those fallen hair are generally replaced by new hair and the hair growth cycle tends to continue this way. But you need to check that your hair fall problem is limited to this extent only or it is something beyond that!Generally, people think that baldness occurs more in case of men; but the considerable percentage of women is also among the hair loss/baldness sufferers. Approximately 40% of women are suffering from hair loss by the time they are age 40. It is considered that women hair loss or baldness can be serious life-altering which can no longer be overlooked. It can make a destructive impact on emotional well-being and self-confidence of women.WHAT CAUSES FEMALE PATTERN BALDNESS? According to the normal growth cycle, each hair grows for 2 to 6 years, then rests and finally falls out. The new hair soon begins growing in that place and if new hairline does not grow as per the requirements, then the female pattern baldness occurs. Women are less prone to complete baldness; but as a result of hair thinning, the density/volume of their hair gets extremely affected.There are multiple reasons available that can contribute to female hair loss or baldness:• Aging• Changes in the levels of hormones due to reaching menopause, pregnancy• Genetics/Previous baldness history in the family• Certain skin diseases, autoimmune diseases, a major illness, surgery• Deficiency of Iron, vitamin B (biotin) or other vitamins• Hair shaft abnormalities that are present since birth• Excessive usage of hair straightening products or use of some cosmetic hair products enriched with high chemicals, such as hair gels, sprays etc.• Conditions like patchy hair loss (alopecia areata)• Medications in case of Cancer such as chemotherapy and beta-blockersHOW IT CAN BE DIAGNOSED & TREATED?If you are losing more hair than usual and they are not growing back, then it is definitely a matter of concern. You can visit an experienced doctor or dermatologist and discuss your hair thinning/hair loss problem. The doctor will examine your pattern of hair loss and he may perform a blood test to identify the causes that are affecting your hair growth.You can prevent female pattern baldness with early diagnosis. The right medications will potentially minimize/stop future hair loss and the appropriate hair growth treatment plan will help you to re-grow your lost hair.Alopecia Areata Alopecia areata is a common autoimmune disorder that results in unpredictable hair loss from the head, beard, or any part of the body. It affects regardless of age and gender, though most cases occur before the age of 30.It is genetic and passes down in the family. One in five people suddenly over a course of just a few days start to lose tremendous amounts of hair. People with alopecia areata who have only a few patches of hair loss soon recover their hair without treatment.The condition occurs when white blood cells attack the hair follicles, causing them to shrink which dramatically slows down hair production. It is not known why hair follicles fall in this way, but it progresses rapidly and can cause large patches, thus causing social awkwardness. It is often conjectured that stress could be a probable cause of Alopecia Areata but there aren't many researches to validate the claim.Further, it can develop into complete loss of hair on the scalp termed alopecia totalis or in extreme cases the entire body called alopecia Universalis. Corticosteroids, powerful anti-inflammatory drugs that can suppress the immune system can stop white blood cells from attacking the hair follicles.Traction AlopeciaTraction Alopecia is a form of acquired hair loss that results from prolonged or repetitive tension to the scalp hair. It was first described in 1907 in patients hailing from Greenland who had been diagnosed with hair loss after wearing hair in tight ponytails for longer periods.This issue can develop due to:1. Regularly wearing your hair in tight ponytails, buns, braids, dreadlocks.2. Using relaxers and rollers on hair.3. Having longer beard and hair and twisting and braiding it, increases its weight and causes submandibular traction alopecia.The likelihood of traction alopecia increases with age and also from what age you started to put pressure on your hair. There are different phases in this type of hair fall and only getting a consultancy from the best hair transplant clinic in India will provide you with the best solution.The different stages in Traction Alopecia:A. Early stages: There is thinning of hair and you start to notice hair growth cycle change slowly but gradually and the amount of Telogen (resting) hair increase.B. Later stages: Sebaceous glands and terminable hair follicles reduce and are replaced by fibrous tracts (scars). Inflammation is mild to absent.Anagen EffluviumAnagen Effluvium refers to hair shedding that commences during the growth stage of the hair growth cycle. Anagen effluvium has shown to cause diffuse non-scarring alopecia. This is in stark contrast to telogen effluvium where hair shedding onsets during the resting phase of the hair growth cycle.It is generally associated to be caused by infections, toxins, autoimmune diseases, drugs, or radiations. Patients who are undergoing chemotherapy also have hair loss due to anagen effluvium.Usually, in anagen effluvium, the end of the hair that is scraped from the scalp is tapered, irregular, or broken off. Anagen hairs have long roots covered with the inner and outer root sheaths and they get pigmented. Telogen EffluviumTelogen effluvium or hair shedding which arises during the telogen or resting phase of hair growth cycle. It is in complete opposition to anagen effluvium where hair shedding happens during the growth stages. It is usually caused due to hormonal imbalance but consuming medicines that misbalance hormones can also cause hair loss.Usually, hair starts to recover on its own because this type of hair loss is temporary. But if there is a pattern found in hair loss, then the hair fall will increase and you will be required to consult a Hair specialist.Cicatricial AlopeciaCicatricial or scarring alopecia comprises of diverse groups of scalp disorders that result in permanent hair loss. This destructive process can occur as a primary or secondary cicatricial alopecia.Primary cicatricial alopecia refers to a group of idiopathic inflammatory processes that cause follicle inflammation destroying the hair follicle. Secondary cicatricial alopecia can be caused by almost any cutaneous inflammatory process of the scalp skin or by physical trauma, which injures the skin and skin appendages. Regardless of Cicatricial alopecia being primary or secondary, it causes replacement of hair follicle with fibrous tissue, thus hair can't grow here. But Cicatricial Alopecia is just about 3% of the overall cases of hair fall complaints. Bald patches, in this case, are due to inflammation thus anti-inflammatory medications are suggested. Minoxidil 2% solution has shown to be effective, but hair transplant is the best treatment.FolliculitisFolliculitis is the name given to a group of skin conditions in which there are inflamed hair follicles. There is always a red spot with a pustule on the skin.Folliculitis may be superficial or deep. It can affect any place where there is a presence of hair, including chest, buttocks, back, arms, and legs. Acne and its variants are also types of folliculitis. Folliculitis can be due to infection, occlusion (blockage), irritation, and various skin diseases. Folliculitis can be due to bacteria, yeasts, fungi, viral infections, parasitic infections, and many others. Taking medications to curb down the folliculitis and suppress the cause of irritation can lead to a stoppage of hair loss. Eosinophils are present whenever there is an inflammation in the body thus treatment may also include immunosuppressants.Hair Loss by Folliculitis isn't a lot but it can lead to major hair loss if you allow it to stay and ignore it.Dandruff, Dry & Flaky ScalpItchiness due to dandruff often causes irritability and embarrassment. Dandruff does make your scalp itchy and flaky. That white flake which you scratch off from the scalp is nothing but itchy dead skin. Males are more prone to dandruff concerns compared to females. It can be observed with the onset of adolescence which then continues till adulthood. You may try to get rid of it by maintaining a good hair wash routine, but that is not a sustainable solution.The scalp skin constantly renews itself. That is when the old skin drops off and a new one replaces it. This cycle is not visible when it is in the initial phase. But when the process accelerates, many more old skin cells shed in the form of visible clumps or flakes. The moment you brush your hair or rub through it, you will notice these flakes fallen on the shoulders or against any dark-coloured clothing.In terms of severity, itching and flaking are equally alarming. The common form of dandruff affects the entire scalp, but not the skin over the face or neck. Severe dandruff concern means quick shedding of old skin, which can lead to uncontrollable itchiness.Apart from drying of the scalp skin, there are many other reasons for dandruff. If your scalp skin is sensitive to hair products, it can also lead to dandruff. Also, environmental factors such as heat and humidity can aggravate dandruff. The concern can be observed either throughout the year or can vary as per season.Dandruff, if not treated at the right time, can cause hair loss and scalp inflammation. If your skin is suffering from acne or oily skin, the condition can worsen because of the flakes.

" Onam " 10- Sardarnagar, B/h Boss Colour Lab, Opp. Jain Upashray, Astron Cinema Road, Gujarat

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DR.RAMOTIA

DR.RAMOTIA

Hair Transplantation

Dr. P.M. Ramotia M.D. (Dermatology) Practicing for last 20 years. I am a well known skin specialist in Rajkot, Gujarat, India. Reaching here and achieving the success has not been easy. I always dreamed to be a well known doctor. With my confidence, sheer faith in God and with good and positive results of my medicines / treatment over the period of time, I have achieved this height today. Purchasing clinical place on Dr. Yagnik Road was a major turning point in my career.

" Onam " 10- Sardarnagar, B/h Boss Colour Lab, Opp. Jain Upashray, Astron Cinema Road, Gujarat

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