By ANNE MOORE
Good things come in threes, it’s said, and so does hair. It
occurs in three layers and three growth cycles.
Hair’s a special form of protein called keratin, which
also constitutes the nails on our toes and fingers. Its outer layer
is called the cuticle, and it protects the middle layer called the
cortex, the really interesting layer, which determines the color
of your hair and whether it is straight or curly. The innermost
layer, the medulla, causes hair to look different in the sunshine
because it reflects light.
Hair grows in three cycles — the growth stage, the transition
or hair loss stage and the resting stage. The follicle produces
both the terminal hair, which grows longer and can be
seen easily, as well as vellus hair, usually referred to as “peach fuzz.”
It is normal to lose 50 to 100 hairs per day. There are
several types or forms of alopecia (the medical term for hair
loss). One is androgenetic alopecia, which can happen even
to teenagers and for which you can thank either side of
your family for passing the genes along to you. Heredity
can also predispose you to the speed and pattern and
extent of your baldness.
Alopecia areata is blamed on your immune system. What
causes your system to periodically attack your hair is not
known. Small, round and smooth patches of hair loss are the
pattern of this type of alopecia. However, sometimes all of the
body hair is lost, a condition called alopecia totalis. This condition
is treatable, and most of the time the hair grows back
between bouts.
Other causes of hair loss include iron deficiency, particularly
in athletes and women with heavy menstrual periods,
and protein deficiency caused by certain fad or low-protein
diets, eating disorders such as bulimia, and just plain not getting
the proper nutrition. Surgery, anesthesia and diseases
such as diabetes, lupus and thyroid disorders as well as medications
such as some of those used for gout, arthritis,
depression, heart problems, high blood pressure and acne
can be blamed for hair loss.
High fever, illnesses such as flu, and chemotherapy and radiation
treatments are also culprits. Hormonal changes resulting
from birth control pills, childbirth, menopause and thyroid are
major causes of hair loss. And, finally, STRESS. Hair loss is just
one more problem among the many the body undergoes when
stressed, for whatever reason.
But there’s more. Let’s call it hair abuse. Pulling and twisting
the hair by some individuals is just an unconscious, nervous
habit. For others, this behavior could be part of an illness requiring the help of a mental
health professional.
Those chemicals we use to make us
so beautiful — the dyes or tints, bleaches,
straighteners, relaxers and perms —
can cause problems with hair. Here’s a
rule of twos: not too often, not for too
long, and no two procedures in one day.
By going only to hair professionals who
use top-of-the-line products, you can
most likely avoid these problems.
Finally, tight braids, hair weaves and
ponytails or other styles that constantly
pull on the hair can be hair loss culprits,
causing traction alopecia.
When women suffer hair loss, it can
be emotionally devastating. After all,
women aren’t supposed to go bald.
Just look around — in books and book
covers and descriptions in the writing,
billboards, magazines, TV and movies —
women are depicted with long, flowing,
shiny and, yes, thick hair.
Hair loss in a woman can affect
every area of her life as she tries to hide
the problem. Activities can wither away
as she tries to avoid water, heat and
wind and even her sexuality. Many
women become depressed, as their
self-esteem takes a dive, and they
almost become reclusive. Some may
even question their sexuality.
Right now, the choices you have are
to do nothing and accept it, to seek nondrug
or drug therapy, to use wigs or hair “systems,” or to have surgery to restore
your hair. Since education is clearly
important, let’s address each of these
choices. If you can accept your hair loss
without sustaining emotional or psychological
damage, good for you!
There are many products on the market
making claims of a cure for hair loss.
These non-drug products are not controlled
by the FDA, so they can make
claims that may not be true. The overthe-
counter product, Rogaine, or the
prescription product, Propecia, may
cause a little “peach fuzz” to grow or
slow the hair loss, but neither will cause
permanent hair to grow. They must be
used continually, as any benefits gained
by these products will be reversed when
you stop using them. Note: Use of
Propecia is very dangerous to women,
especially pregnant women.
Dermatologists and other physicians
have access to some prescription creams, shampoos, shots and
other methods to try to help your situation, depending on
what is causing the baldness.
Wigs and hair “systems” can be made of synthetic materials
or from real human hair. The quality of the wig can vary
from the less expensive and mass-produced to the custommade
and extremely expensive. With custom-made and custom-
fitted wigs, the construction of the foundation and the
wig is important so that the hairs appear to be growing from a
human scalp. There are, of course, maintenance costs associated
with wigs, such as cleaning, styling and replacing.
There are several ways a wig or hairpiece can be attached to
your head. Clips, although quick and easy, can be so tight that
they can cause traction alopecia. Adhesive tape leaves the hairpiece
sticky. Some systems are actually semi-permanently
bonded to the hair. As the name implies, hair weaves are actually
woven into your own hair. These weaves need to be tightened
frequently as your real hair grows. The maintenance can
be quite expensive.
In 1959, a dermatologist in New York was the first to successfully
transplant hair from the back of the head to the balding
areas. The procedure is known as “donor dominance,” the
theory being that by using hair from a more permanent area, it
will prevail over the bald area and grow.
Other procedures have been developed over the years,
including one using larger, round plugs of hair that were grafted
onto the scalp. Problems arose when the hair in the middle
of the transplant died, leaving a hole in the middle. This
became known as "donutting.” Other problems included
raised areas at the base of the graft and the famous “doll’s
hair” appearance where the grafts were round clumps of hair
placed in the middle of bald areas in little rows. Unfortunately,
they stayed that way! Scalp reduction and the flap are other
techniques used and are pretty much self-explanatory.
In San Antonio, several doctors perform hair transplantation.
As a matter of fact, we have father and son physicians who
practice state-of-the-art hair transplantation surgery. The father,
Dr. B. L. Limmer, is recognized as one of the premier hair transplant
surgeons worldwide, having developed and perfected a
technique referred to as the “gold standard of hair transplantation”
— microscopically magnified micrografting. His son, Dr.
Bradley Limmer, has been involved in the development of follicular
unit micrografting. This technique can also be used for
eyebrows, eyelashes, beards, mustaches and to cover scars.
Take care of what you have. Use mild shampoos, air dry if
possible, go easy on the chemicals, and curtail ponytails,
weaves, braiding and similar restricting techniques so as not to
stretch your hair.
When you do have hair loss, consult with a physician to
determine the actual cause of the loss, whether it’s treatable
and if the condition is temporary or permanent.
Make sure the physician is board certified, experienced at
transplanting and has some aesthetic vision for your transplant
results. Don’t hesitate to ask to talk to other patients who have
had these procedures. The physician should be open to discuss
any concerns you might have.
Hair loss affects so many millions of people, there is ongoing
research to develop new drugs that might restore hair and
even a “buzz” about cloning of individual hairs in the future.
