Traction Alopecia: Prevention and Treatment

Traction Alopecia Can Be Prevented and Treated

Traction alopecia is a hair loss issue where the sooner you come to terms with it, the easier and faster the treatment.

Early detection and making the appropriate change is the key to overcoming traction alopecia. Because it is a type of hair loss called "traumatic" alopecia, you need to remove the source of the trauma that is proven to be certain hair care practices and styling techniques that put African-American women at risk.  Doctors and hair loss experts agree that you can cause irreparable damage if you ignore the signs and symptoms of traction alopecia.

Why are my braids too tight?

Everyone has different hair root tolerance. Some scalps can accommodate the tension of a hairstyle and some can't.  The follicles will react negatively right away, or gradually over time. "But it's not the actual hair style, or braids, that's the problem," explains Diahna Husbands, a hair loss treatment expert and owner of Diahna Lynn Hair Studio in Maryland, "It's the tension used by the person braiding -- if they are pulling too tight -- that causes the problem."  She also advises any hair loss clients to see a dermatologist just to make sure of the reason for the hair loss. "A proper diagnosis is also the key to success with any hair loss issue."

Not only can the dermatologist tell you why you're losing your hair, "but in the case of traction alopecia we can suggest a course of action that includes changing your hairstyle immediately, possible medications, and in severe cases of prolonged traction where follicles are dead, hair transplant surgery," explains Dr. Valerie Callender, M.D., a board-certified dermatologist, hair transplant surgeon, specialist in African-American women's hair and skin disorders, and Director of the Callender Skin and Laser Center in Washington D.C.

Loosen up your hairstyle!

In the case of traction alopecia caused by hairstyling that is pulled continuously too tight, the areas of hair loss are usually symmetrical and occur along the temples and the above the ears, explains Dr. Callender.  When caught early enough, switching away from a damaging hairstyle can halt the condition from becoming permanent.  In most cases of traction alopecia, patients will notice small red bumps on their scalp and they can see their hair beginning to thin or break around the hairline and in between the braids. In this case, experts agree the treatment is first and foremost, removing the braids and finding a more relaxed hairstyle to remove the stress so follicles can normalize.

This process of re-growth can take anywhere from three to six months or even longer and you will need to work with your hairstylist to determine some new styles you can wear.  You may decide to cut off the damaged parts and go natural and short, or wrap your hair loosely in a hair wrap, or in severe cases of loss, to wear a wig. "I'd suggest a wig to any woman who is so frustrated with how bad her hair looks that she just can't bother with it until the damage grows out! I also advise these clients come in for a deep conditioning scalp massage once monthly to help stimulate follicles gently for healthy hair re-growth," says Husbands.  Another great tip from Callender is to use a hair pencil. "Most women have some soft hairs still growing around the hair line and you can use a matching hair pencil to fill in the depth. A little colored hair pencil can go a long way to helping you feel and look a whole lot better during the transition!" says Callender.

Medications that can help

For more stubborn cases involving infected follicles and prolonged traction, along with changing your style immediately, the most common course of action from the dermatologist is oral and topical antibiotics followed by either cortisone injections and/or topical cortisone cream to reduce the inflammation that is damaging the follicles, explains Callender.  "After that, we may prescribe Rogaine to stimulate quicker re-growth at 2% generally or 5% depending on the amount and severity of the hair follicle trauma.  And the great thing about Rogaine for traction alopecia is that once follicles regain their health and start growing, Rogaine will no longer be necessary. It's one time we can prescribe Rogaine for temporary results that last!"

Hair transplant surgery

If follicles are damaged beyond repair and the traction of your hairstyle has been going on a very long time, hair transplant surgery may be necessary to restore your hair line or any missing patches, says Dr. Callender, who specializes in performing the surgery for African-American women. "Just because you have never seen advertisements on TV or in magazines for surgical hair replacement services showing African-American women does not mean it is not for you. This surgery can restore an African-American woman's healthy hairline and self-esteem."  But, advises Dr. Callender, "it is very important to find a hair transplant surgeon skilled and experienced in working with African-Americans because of the different hair texture, keloid formation tendencies regarding scarring, and the different race-specific original reasons for the hair loss."

Prevent traction alopecia

• Change hairstylists if they constantly braid so tight you need a painkiller after a visit.
  
• Let your hair down and switch up your styles regularly to give follicles a rest.
  
• Get a scalp massage and deep conditioning treatment once a month to help stimulate follicles.
  

Hair Replication

Hair Replication Replaces Hair With a Tattoo

Cosmetic scalp pigmentation is a novel and permanent hair loss solution. But can hair replication stand the test of time? 

 

Skin tattooing -- permanent pigmentation of the scalp -- is being used in studios and hair clinics as a technique to conceal hair loss. Like a pointillist painting, the sum of thousands of tiny dots creates a generalized impression of a full-haired but shaved head.

Men who prefer a very short "buzzed" or shaved hairstyle use this look. On them, the micro skin pigmentations replicate what the follicles would look like -- if they were still there, actively producing hair. Women and men with longer hairstyles might use the technique to darken the scalp where they part thinner hair, or in a bald patch caused by something other than male or female pattern baldness. This effect is similar to topically applied concealers -- except that tattoo hair replication will not wash out.

To be clear, hair replication varies between companies providing the treatment and, arguably, from artist to artist. A poor execution would include an unnatural hairline, or the use of pigments and applications that would lead the hair replication to "bleed" and fade (turn green) with time. Some companies claim to have overcome these issues with newer dyes and application techniques.

As with a decision to get a tattoo anywhere else on the body, hair replication scalp pigmentation is a decision of relative permanence and should not be taken lightly. Removal is possible but at a cost. The individual needs to ask, "is this what I want the rest of my life?"

If the answer is a firm "yes," he or she needs to study the technique and its purveyors carefully before making that commitment and choosing this option.

Hair Replacement Web Site To Join Forces with Children's Hair Loss Charity

Ft. Lauderdale, FL. -- HairLoss.Com, the largest and most comprehensive web site dedicated to providing consumers with referrals and information about hair loss treatments and conditions has recently announced its alliance with Children with Hair Loss, a nationwide nonprofit dedicated to providing free nonsurgical hair loss solutions to children suffering from hair loss.

According to Michael Garcia, Spokesman for HairLoss.com, "this alliance between HairLoss.com and Children with Hair Loss is a significant positive step towards helping every child with any degree of hair loss to gain back their natural appearance and, more importantly, their confidence and self esteem."

Children with Hair Loss is a 501 (C) 3 nonprofit organization founded by Regina Villemure to be a resource for all children who suffer from medically-related hair loss, such as alopecia areata or hair loss due to cancer and its treatment. The organization has just celebrated its tenth anniversary.

"This alliance is truly exciting, not just in the sense that HairLoss.com's generous support will allow us to help more children, but having a web site with its stature behind us will help us to raise to pubic awareness about childhood hair loss," explained Villemure.

As part of the agreement, HairLoss.com has pledged to supply the charity with as many human hair replacement wigs -- also known as "hair systems" or, in medical jargon, "full cranial prosthetics" -- to meet the organization's increasing demand; a demand, according to Villemure, which is growing each year.

"This is not Locks of Love," said Villemure, "which actually assist very few children each year due to their strict acceptance standards and hidden costs. Children with Hair Loss exists to help every child under the age of 21 who suffer from alopecia, burns, chemotherapy, radiation treatments, compulsive hair pulling and more. Our services are free, without condition, without judgment and with a lot of love and compassion provided throughout the process."

Spokesman Garcia agrees. "Regina has created something very special with her organization that is unparalleled in the areas of compassion and sincerity. The same is true with the artistic and technical skills of their partners who will take the hair replacement prosthetics that we donate to them, apply them to the child so expertly that the child's hair -- and more -- is restored."

Advancements in the nonsurgical hair replacement industry have allowed manufacturers to produce hair replacement prosthetics that are made of human hair and that look and behave like a real head of hair. Styling technicians take a mold and design of a child's head, making note of the hairline, part line and hair color to create a design that will seamlessly blend in with existing hair or cover the entire head. The base of these hair replacement units virtually disappears on the child's skin allowing the attached hair to appear completely natural.

To learn more about Children with Hair Loss, or to apply for assistance, visit http://www.childrenwithhairloss.us.

Dandruff: What Causes It?

Learn the Causes Of Dandruff and Other Scalp Conditions 

 

First understand that dandruff is a normal human condition and not a disease.

 

To be clear, dandruff, true dandruff, is not a disease, nor is it a symptom of disease. It is part of the natural human condition to shed the outermost layer of skin. Dandruff is an indication that new skin is rising from underneath. That old skin has to go somewhere, of course, which generally happens when we sleep, are in the shower and go about our daily lives.

(In case you didn't know this, most household dust indirectly originates from human skin. Dust is the dead carcasses and feces of tiny house-dust mites -- Dermatophagoides farinae and related species -- which eat our skin before they depart this life and land on our coffee tables and computer screens.)

But it's true that some people get more dandruff than others. And depending on the nature and relative cleanliness of the hair in your scalp, the natural sloughing off of dead scalp skin might accumulate in your hair. In the majority of cases, the fix is to shampoo more often, perhaps with a pyrithione zinc-based shampoo, the active ingredient in most over-the-counter dandruff shampoos.

There are also other causes of itchy, flakey skin on the scalp. Some are downright frightening, and in advanced cases the irritation can lead to spot hair loss, aka alopecia areata. The following conditions may lead to an itchy flaking on the scalp:

Contact dermatitis
 
Generally considered a sensitivity to hair care products, this skin inflammation, which resembles a burn, is a reaction to an irritant or allergen. Other symptoms include itching, tenderness, swelling and skin lesions (rash, vesicles and bullae/blisters). These irritants can be soaps, detergents, solvents or acids.

Eczema
 
Itchy skin that can occur anywhere on the body, including the scalp, eczema produces skin that becomes scaly, dry and thickened from scratching. Ultimately, the skin oozes fluid and crusts over. It tends to run in families, coincides often with allergies and asthma and is believed to be an over-response of the immune system to soaps and detergents, heat or cold and contact with pet dander. It is not contagious.

Inflamed follicles (folliculitis)
 
The follicles, the source of each strand of hair, can become inflamed from infection by a fungus or staphylococcus bacteria. This infection is often a secondary effect of eczema or dermatitis. Other causes of folliculitis might include diabetes, tight clothing (including hats and ball caps), poor hygiene in combination with heat and humidity, and use of hot tubs.

Psoriasis
 
More commonly found elsewhere on the body (elbows and knees), psoriasis can be found on the scalp and is often mistaken for seborrheic dermatitis. It is seen as thick, silvery scales.

Seborrheic dermatitis
 
Characterized by flakey white or yellow scales originating on red, greasy skin on the scalp, it is largely found on the scalp. Seborrheic dermatitis also appears on the body where oil glands are plentiful (eyebrows, sides of the nose, the groin area and armpits). It may be a result of irritation from Malassezia, a yeast, and can be stimulated by stress, oily skin, fatigue, extreme weather, poor hygiene and use of personal care products containing alcohol. Obesity also can be a risk factor, as can HIV infection. It more often is seen in men than women. Chronic itching and scratching can lead to temporary, spot hair loss and secondary fungal infections.

From a preventive standpoint, three things seem consistent across all conditions: Pay attention to the symptoms, particularly if other members of your family have similar symptoms and diagnosed conditions. Maintain proper hygiene by shampooing frequently. And if symptoms persist over several weeks after trying mild, over-the-counter remedies, go see your doctor.

Propecia: Frequently Asked Questions

Learn the Risks and Benefits of Propecia and Hair Loss 

Knowing the ins and outs of Propecia can help you decide if this hair loss treatment is for you.

 

Propecia (generic name: finasteride) has been in use as a means to stem hair loss since 1994, per approval of the Food and Drug Administration (FDA). It is taken internally and has a higher success rate than minoxidil (Rogaine), which is applied topically. It is effective in a majority of men, in varying degrees, but comes with at least one significant side effect that warrants concern.

Q. Does Propecia work? 

A. Efficacy studies by the manufacturer (Merck & Co., Inc.) shows that Propecia halts hair loss in eighty percent (86%) of men taking it. Additionally, forty-eight percent (48%) regained some hair lost already.

Q. What is Propecia made of? 

A. Finasteride (17beta-(N-tert-butylcarbamoyl)-4-aza-5 alpha-androst-1-en-3-one) is an orally active testosterone Type II 5-alpha reductase inhibitor. In a 1-mg dose it is Propecia, prescribed for hair loss. In 5-mg doses it is Proscar, a medication that offers a small reduction in the chance of developing an aggressive type of prostate cancer and is also prescribed for BPH (benign prostatic hyperplasia), noncancerous prostate enlargement that comes with age).

Q. How does Propecia work? 

A. Finasteride/Propecia prevents the formation of DHT (dihydrotestosterone), which is in excess supply in men who are losing their hair, by blocking the enzyme that metabolizes DHT. Most patients report a slowing of hair loss in three months and regrowth of hair (if at all) by the six-month point.

Q. Does Propecia have side effects? 

A. Men need to be concerned with a small chance (about 3.8 percent in one study) of experiencing one or more adverse effects: erectile dysfunction, decreased libido and decreased volume of ejaculate. Additionally, some patients experienced pruritus (strong itch), urticaria (hives), testicular pain and swelling of the lips and face.

Of arguably greater concern is how finasteride/Propecia can have serious effects on unborn fetuses. When a pregnant woman has mere skin contact with the drug -- for example, when touching a broken pill -- it can result in significant genital abnormalities in male offspring.

Men who have had the following conditions should speak with their doctor about using Propecia out of caution: liver disease, abnormal liver enzyme test results, bladder muscle disorders, prostate cancer, difficulty urinating and known strictures of the urethra.

Q. Will Propecia continue to work as a person ages? 

A. Individuals using Propecia must continue using it to keep their hair, and it appears to remain efficacious with consistent long-term use.

The drug has been on the market for more than 16 years, and there are no reported negative effects in the long term outside of the known risk of side effects from short-term use. Tests on the incidence of male breast cancer among long-term users have been inconclusive and do not suggest a high risk. There may be a benefit among long-term users with a family history of prostate cancer in preventing its incidence.

Q. Will the texture of the hair be the same? 

A. A series of small studies on hair texture indicates no change from taking Propecia. A review of blogs suggests that nonprescriptive copycat supplements claiming to deliver similar results may actually cause abnormal texture and other side effects. But of course those observations are not substantiated by research because supplements are not held to the same standards as prescriptive medicine.

Q. Can't women who are postmenopausal use Propecia? 

A. Merck (Propecia's manufacturer) studied the drug on women who were no longer in danger of becoming pregnant (postmenopause), but after one year the study was discontinued because there was no measurable hair growth. This is believed to be because hair loss in women is due to the enzyme aromatase -- over which finasteride has no effect -- versus DHT, the cause of male pattern baldness.

Q. Can Propecia be used together with Rogaine? 

A. There appears to be no clinical downside to using the two medications in combination, and proponents suggest that together there is a synergistic effect. The FDA does not track or comment on the safety or efficacy of this two-hit approach.

Q. Is finasteride available only under the brand name Propecia? 

A. As a 1-mg treatment (for hair loss, versus the 5 mg of Proscar for treating prostate issues), it is currently available as Propecia or the generic finasteride.

Q. Does a person need to have a prescription? 

A. Yes, Propecia requires a doctor's prescription. Some online retailers provide their own doctors who supply the prescription. The reader is advised to exercise all necessary caution with regard to pre-existing conditions and the appearance of side effects after beginning a regimen of treatment.

Q. How was Propecia discovered? 

A. Like minoxidil, finasteride was discovered by accident. The Proscar version of finasteride, at 5 mg per dose, was found to regrow hair in men in early studies. Appropriate testing was conducted to get FDA approval for this secondary use at a lower dosage.

Q. Is Propecia expensive? 

A. Online sources show a range in price from $28 to $71 (U.S.) per month. Dosage is 1 mg per day.

Laser Hair Therapy: Questions & Answers

Laser Hair Therapy Is Becoming a Popular Hair Loss Treatment

Laser hair therapy is a noninvasive and complementary addition to your regular hair loss treatment regimen.

Laser hair therapy has become a very popular hair loss treatment in recent years when the FDA approved some laser devices as a treatment for hair loss. But before you jump in with both feet, learn all you can about this treatment to see if it is the right hair loss treatment for you.

Q. What is laser hair therapy used for?

A. Laser hair therapy is best used during the early stages of hair loss because it can halt and prevent further loss and even "wake up" some sleeping follicles. Once hair has been lost for several years and the follicles are dead, nothing can bring them back. Experts advise starting laser hair therapy as soon as possible after you first notice hair loss and thinning.

Q. Is laser hair therapy too hot or dangerous?

A. Laser hair therapy is performed with a low-level laser light, which is a "cool" laser, as opposed to a "hot" one, so it does not burn and has been proven safe and effective in Food and Drug Administration (FDA) studies. Laser hair therapy has been approved as a hair loss treatment by the FDA to promote hair growth in women and in men who have male pattern baldness with Norwood-Hamilton Classifications of I to V.

Q. Is laser hair therapy effective for both women and men?

A. Hair loss treatment specialists agree that since laser hair therapy can stimulate resting hair follicles to grow, which can improve hair count by 10 percent, it improves existing hair health and growth and works well for men and women as a complement to any other hair loss treatment in use today. Men who use finasteride (Propecia) internally and men and women who use minoxidil (Rogaine) externally can use laser hair therapy to stimulate follicles further and improve both treatments' efficacy. Men and women who have suffered from traction alopecia use laser hair therapy in addition to topical cortisone and antibiotic treatments to stimulate traumatized follicles. Men who have received a hair transplant can use laser hair therapy to stimulate growth of their transplanted follicles as well as preserve their existing hair. And laser hair therapy works for receding hairlines -- finasteride and minoxidil do not.

Q. What is the science behind laser hair therapy as a hair loss treatment?

A. Because hair is meant to fall out and regrow from the roots, when follicles begin to shrink and degenerate, the hair does not grow back and consequently hair loss occurs. Based on the scientific principle of photobiostimulation, laser hair therapy, studies have shown, increases blood flow to the scalp and jump-starts hair follicles when used on a regular basis. This slows down and may even reverse the degenerative hair loss cycle and stimulates live follicles to produce thicker, stronger and healthier hair.

Q. Do I have to adhere to a schedule?

A. Depending on your specific hair loss situation, you will most likely visit your clinic one to three times a week for a treatment that may last 20-30 minutes. Laser hair therapy does not work instantaneously, though, because the follicle needs time to produce a new hair that will then exit the scalp and grow to a measurable length before you will notice results. Usually results can be seen in about three months, with significant results in approximately six months.

Q. Do I have to go to a hair loss treatment clinic for laser hair therapy?

A. Currently there are two ways to undergo laser hair therapy. One is to schedule 20- to 30-minute appointments under an in-studio laser hair therapy "hood" unit at a center that provides hair loss treatments. These in-studio, standing laser devices contain anywhere from 150 to 250 laser diodes, which gives your scalp significant exposure to the effects of the laser because of the strong concentration of laser light. ??For those who would rather administer laser hair therapy themselves, try a laser comb or laser brush at home. You will need to hold the unit and move it systematically all over your scalp for the recommended 20-30 minutes two to three times a week, so you must be self-motivated. Keeping this schedule might be difficult for some, and the handheld units are simply not as strong as the in-studio hood units.

Q. How do I know which laser brush or laser comb to choose?

A. The simple fact is the more laser light diodes a laser has, the stronger the unit. So look for the unit with the most diodes that you can afford. If budget permits, you can buy a standing laser unit for at-home use so you can sit in a chair. For the handheld units, "teeth," which are aligned with the laser beams, are useful in keeping the laser light the proper distance away from the scalp; the recommended distance is one-half inch. Watch out for mirrors that are said to reflect the light -- the diodes are what produce the powerful laser light, so don't be pulled in by these claims.

Q. Will I have to perform laser hair therapy forever?

A. Laser hair therapy's successes are tempered by the fact with that it works on only live follicles and is a long-term, ongoing treatment. If you stop your laser hair therapy treatments, hair loss will likely resume at the original rate before treatment.

Q. Does laser hair therapy work together with other hair loss treatments I am using?

A. Yes! Laser hair therapy can give lagging hair follicles a boost and can work in conjunction with such other treatments as DHT blockers (e.g., finasteride) and topical shampoos as well as topical minoxidil or a hair transplant for even more positive results.

A Fitness Survival Guide for Hair Systems

Don't Sweat the Adhesives for Hair Systems

Adhesives for hair systems are often the weakest link in the hair replacement process.

Horses sweat, men perspire and women glisten. Or so goes an old phrase rooted somewhere in southern gentility.  All well and good, but for anyone who wears a hair replacement system -- male, female, horse -- any form of moisture produced by the scalp can spell trouble.

The thermoregulation process -- sweating, how the body lowers temperature by wicking body heat out through moist skin -- is the enemy of adhesives that hold hair systems in place.  It's your scalp doing what it's supposed to do, but when blocked it is perspiration that eventually wins out. The result is a premature loosening of the adhesive.

The conundrum is pretty obvious: If you care about your hair, you probably care about fitness and your health. So how does one exercise if perspiration is the problem?

There are no silver bullets to eliminate this problem. But there are methods to mitigate it -- in what you eat and drink, the types and quality of bonding adhesive you use, and the activities you engage in.

Perspiration is natural, but at odds with adhesive hair systems.

I spoke with Scott Heinly, a representative for Premier Products, Inc., a leading developer and manufacturer of adhesives, solvents and specialty cosmetics for the hair care, hair replacement and wig care industries as well as the movie industry. The company's cosmetic chemists work to address any and all challenges of adhesion, hygiene and skin health relative to hair replacement systems.

Water and oil are enemies of effective adhesion, explains Heinly. "There are precautions everyone can take, but a lot depends on the individual," he says. "It boils down to a trial-and-error process of discovering what works for you." He provides the following tips:

Determine if you're a soft bond or hard bond person.

This is largely a matter of deciding if you live an active or inactive life. If you plan to sweat, swim and move around a lot -- think amusement park rides, dancing, gymnastics, rugby, cliff diving -- a hard bond adhesive uses cyanoacrylate, a refined, medical-grade version of super glue, to achieve a stronger hold.  Softer bond adhesives (methacrylates are the key ingredient) are recommended for people who are less prone to sweat by factors of age, genetics and activities.

But this is where individual differences can matter. Heinly says that everyone's skin is different and some products may cause an allergic reaction. When that happens, he or she needs to try a different product. He also warns against using hardware store grade super glue products because their impurities often lead to skin irritation.

Apply bond to clean, oil-free skin. Absolute hygiene at application is essential to either holding system. Heinly recommends treating the scalp with products that are astringent, such as those containing witch hazel or tea tree oil. "It's good for the skin anyway," he notes. Of course this precludes use of skin lotions on the scalp.

Watch the alcohol consumption. Your body eliminates alcohol through various channels: breath, urine, feces, saliva, mother's milk and sweat. Alcohol breaks an adhesive bond, and the effect is proportionate to the amount consumed. If you go on a bender some Friday night, the adhesive will break down more quickly on Saturday, Sunday and Monday.

Oily foods make for oily scalps. This is good incentive to cut back on saturated fats and transfats. Most fried restaurant foods, full-fat dairy, creams, meats and poultry contain saturated fats. Transfats are a type of saturated fat in cookies, crackers, donuts and fried potatoes and onions. But unsaturated fats are essential to health. If you don't know the difference, consider the source: Saturated fats come from animals with feet; unsaturated fats are from vegetables, nuts and fish (footless, all).

Minimize sweat. While someone using a hard bond (also known as "permanent bond") may expect three to six weeks of wear between cleanings, the duration will skew to a shorter time frame with active, perspiring people.

As a fitness trainer, I highly recommend engaging in fitness activities more rather than less. Recent studies show increased longevity benefits from strenuous exercise. But lower-intensity fitness activities that produce a minimal amount of sweat, if at all, are still of great value. In fact, a majority of the American adult population would benefit from simply walking more, aiming for 10,000 steps per day (about five miles). Consider also yoga (not the hot-room version), tai chi or strength training in a cool, air-conditioned studio. These are gentler ways to achieve fitness, flexibility and peace of mind -- no sweat.