NNEKA'S HAIR LOSS INFO
Many women suffer from hair loss due to stress, medical conditions, and heredity. There are many things that one can do to cope with or manage these problems. Please feel free to look through the various conditions that affect women of all ages, nationalities, and classes. It is very informative and backed by research. If you have any questions, please feel free to email me @ nnekasessentials@gmail.com.
Alopecia Areata- A major hair loss cause
Alopecia areata (AA) is a highly unpredictable autoimmune skin disease. It causes alopecia not only on the scalp but also in other hair growing areas of the body. It can affect men, women, or children. It is perhaps the second or third most common form of hair loss after androgenetic alopecia and telogen effluvium. It is a common hair loss cause that can often be seen in a dermatology clinic.
The reason for the development of this major hair loss cause is still unknown and the public is still not quite familiar with alopecia areata. Due to the ignorance of the masses this hair loss cause can have a profound impact on one's life and functional status, both at work and at school.
Mechanism of the hair loss cause
In this major hair loss cause, the affected hair follicles are mistakenly attacked by a person's own immune system (white blood cells). It leads to the arrest of the hair growth stage. Alopecia areata in the initial stage is evident as one or more small, round, smooth bald patches on the scalp. Slowly it can progress to the total scalp and result in major hair loss. When the alopecia covers the entire scalp it is called alopecia totalis and when it leads to hair loss over the complete body then it is called alopecia universalis.
Although there is a lot of inflammation involved in this hair loss cause, the harmful effects of the immune system focuses on the roots of the hair follicle under the skin. As a result, not much is visible above the skin surface. There is no redness and often no pain, although a few people do find their skin itchy or painful to touch in the very early stages of alopecia areata development. The hair loss can be quite sudden developing in a few days and it may develop anywhere on the scalp.
Causes
Current studies suggest that in alopecia areata some unknown element triggers the immune system which then targets hair follicles. The studies also indicate a presence of some genetic traits that make some people more predisposed to the disease. These specific genetic traits increase the susceptibility and also the degree of disease intensity. There are also some infectious diseases like seborrheic dermatitis where hereditary issues play an important role.
Some dermatologists believe that there are a wide range of contributing factors that can make someone more susceptible to developing alopecia areata. Hormones, allergies, viruses, and even toxins might contribute to this severe hair loss cause. Dermatologists believe that a combination of all these factors may result in the development of alopecia areata in an individual.
Traditionally alopecia areata is believed to be a stress induced disease and it is treated accordingly by some dermatologists. But very little scientific evidence has been found to support the view that stress causes AA.
Effects
Alopecia areata occurs in men and women of all ages and races. The onset of the autoimmune skin disease most often begins from childhood itself which can be psychologically devastating. Although not life-threatening, this severe hair loss cause is a major cause of concern, due to its sudden onset, recurrent hair loss and unpredictable results. Due to all these effects the hair loss is emotionally disturbing.
But fortunately, unlike many other autoimmune diseases, the target, hair follicles, are not completely destroyed and can regrow once the inflammation subsides. People with just one or two patches of AA often have a full recovery within 2 years whether or not they receive treatment. However, about 30% of individuals find the hair loss cause persists and becomes more extensive. They may experience repeated cycles of hair loss and regrowth through alopecia areata.
At present, there is no permanent cure for this severe form of hair loss, although the hair may return by itself. Some of the treatments of this hair loss cause, are generally effective in milder cases, but none are universally effective. Another genetic hair disease called Hypotrichosis has no effective treatments. Once the hair sheds off, hypotrichosis affected individual has no hair regrowth in his lifetime.
If any hair disease results in permanent hair loss, the embarrassing baldness can be camouflaged by attractive wigs. It is the best option where medications and various modern treatments fail to resolve your hair loss cause. Proper grooming like cutting or styling can give the wig a natural and attractive look.
Explore and find out the right hair loss cure for alopeica areata. You may be pleasantly surprised by the effects of the cure.While some side effects of medical conditions, such as chemo hair loss, cause hair to fall out in clumps, thyroid hair loss typically involves a thinning of the hair all over. Hair may also lose its shine and become brittle or lifeless. If you notice a change in the condition of your hair, you may want to see a doctor and ask for a thyroid blood test.
Causes of Thyroid Hair Loss
There are two types of thyroid hair loss—hyperthyroid hair loss (also known as hyperthyroidism hair loss or high thyroid hair loss) and hypothyroid hair loss (also known as hypothyroidism hair loss or low thyroid hair loss). Unlike genetic hair loss, such as male pattern baldness, thyroid hair loss and other medical types of hair loss can be attributed to stress on the body. When the body experiences a hormonal change, nutritional deficiency or another issue (in the case of thyroid hair loss, a problem in regulating the thyroid hormone), energy directed to hair cells will be transferred to other areas of the body where it is needed more, and hair will begin to fall out.
While overactive and underactive thyroid hair loss is common, it's important to note that hair loss alone does not indicate a thyroid condition. If you notice your hair thinning, talk to your doctor—he or she will likely recommend you get your blood tested for the presence of a thyroid issue.
Thyroid Hair Loss Treatment
Even if you've already experienced thyroid hair loss, there are things you can do to help slow the symptoms or to protect your hair from future loss. Treatment options include:
- Treatment for thyroid condition. Getting treatment for your thyroid condition is often the best way to help stop thyroid hair loss.
- Ongoing monitoring. Unfortunately, some treatments for thyroid conditions can also exacerbate hair loss over time, so you'll want to monitor your treatment and symptoms closely with your doctor.
- Supplements. Certain hair growth vitamins and minerals may help prevent further damage from thyroid hair loss. Be sure you consult your doctor before you begin taking any supplements to ensure they won't interfere with any current medications or medical conditions.
Learning as much as you can about chemo hair loss before it starts to happen is one of the best ways for cancer patients to remove any stress about the issue. While it may seem like just another negative thing to have to deal with, there are ways to make dealing with chemo hair loss easier.
Preparing for Chemo Hair Loss
Like any medical condition or disease hair loss, such as thyroid hair loss or anorexia hair loss, chemo hair loss has its own causes and patterns. If you do experience hair loss, here's some of what you can expect:
- Hair loss occurring during the second or third week after your first chemotherapy cycle
- Loss of all of your hair in some cases
- Losing clumps of hair rather than an all-over thinning or loss
- Potential loss of not only the hair on your head, but also your eyebrows, eyelashes and pubic hair
It's important to note that not everyone who undergoes chemotherapy experiences hair loss in the same way. Some will lose very little hair, while others may lose nearly all their hair. For those who wish to conceal their hair loss, wigs and cancer scarves are an option. Others may choose to simply shave their remaining hair and stay completely bald during their treatment. What Nneka recommends is that you save a portion of your hair, deposit it in a ziplock bag and send it to us. We will match it with our selection of hair colours and textures, set up an appointment with you to assess your needs and measure your head. We then will reconstruct a wig that resembles your natural hair and send it to you within 10-20 days. These wigs are invisible hairline wigs made with 100% human remy donated hair. Please contact us for more details @ 519-562-7530 or nnekasessentials@gmail.com.
Hair Regrowth after Chemo
The good news about chemo-induced hair loss is that it's not permanent—hair will begin to regrow anywhere from three to six months after chemotherapy is complete. Some individuals even notice their hair growing back while they are still undergoing treatment.
An interesting thing about hair regrowth after chemo is that your hair may not grow back exactly as it was. The texture and color may change, and you may even find yourself with curly hair when you used to have straight hair, or vice versa. It's important for patients to be aware of the potential for these changes and to know that they are completely normal.
Trichorrhexis Nodosa
One of the most common hair shaft defects a dermatologist encounters is trichorrhexis nodosa (trichonodosis). Trichorrhexis nodosa is a focal defect in the hair fiber. When observed under microscope a large number of fraying and swelling nodes are evident in particular spots along the length of the hair fiber. These focal defects develop due to the absence of a cuticle layer.
The function of the cuticle layer is to provide physical support, and protect the cortex of a hair shaft from ultra violet rays, harmful synthetic hair care products and harsh hair brushing. But if the cuticle is absent then the cortex underneath is directly exposed. The cortex is less resistant to the physical and chemical factors of the environment, when compared to the cuticle.
The exposure of the cortex layer to chemicals in the environment leads to damage and reduction of the strength of the hair fiber. The chemical bonds that are present in the cortex break down and the hair becomes more flexible and weaker. The hair may split and fray into minute strands at the point of cuticle break down. As we comb, brush or generally manipulate our hair, these defective nodes in the hair fiber may break.
Types
Trichorrhexis nodosa can be of two types:
- Proximal trichorrhexis nodosa
- Distal trichorrhexis nodosa
Proximal trichorrhexis nodosa is the most severe and most often occurs in Afro-Caribbean people. Hair of this ethnic group is subjected to greatest trauma due to their tight, curly hair. Proximal nodes in the hair shaft indicate increased hair fragility. Apart from trichorrhexis nodosa other scalp hair disorders like acne keloidalis nuchae are also common in black populations. Acne keloidalis nuchae is a hair condition in which severe pustules are formed on the neck or the posterior part of the scalp.
Distal trichorrhexis nodosa occurs in straighter hair. In this shaft defect, only a few whitish colored nodules are seen in the hair fiber. The surface of hair may become dry, dull, or brittle. Distal trichorrhexis nodosa is more commonly seen in Caucasian and Asian populations.
Causes
The causes of this major hair shaft defect can be divided into two categories:
Congenital trichorrhexis nodosa means the hair shaft defect is present from birth. Some people have naturally weak hair where the cuticle is not properly produced. Congenital trichorrhexis nodosa is usually hereditary, and it first develops at a very young age.
Natural growth of irregular and brittle hair fiber can also be due to metabolic disorders and conditions such as trichothiodystrophy. Metabolic disorders such as abnormal urea synthesis, abnormal copper or zinc metabolism, and defective cysteine or sulfur incorporation into hair fiber can result in defective hair shaft production.
Acquired trichorrhexis nodosa is much more common than the congenital condition. Acquired trichorrhexis nodosa is the result of excessive hair manipulation and over-processing. Too much brushing or hairstyles that put constant stress on the hair can cause this hair shaft defect. Also, excessive cleansing, dying, and perming may disrupt the cuticle layer in focal areas along a hair shaft. Trichorrhexis nodosa is particularly seen in people who overuse hot combs or permanent waves to style their hair.
Once the cuticle is removed from hair fiber due to excess styling, the cortex is exposed leading to severe damage.
Effects
This hair fiber defect damages the cuticle layer resulting in the disruption of the cortex. Also longitudinal and transverse fissures can occur in the fiber giving it a paintbrush-like look.
Hair shaft abnormalities such as pili torti and monilethrix cause similar damage to the hair fiber as that of trichorrhexis nodosa. Pili torti is a twisting of hair fiber at focal points along its length leading to multiple fractures in a single strand.
Treatment or hair care remedies for the defects
Treatment or hair care remedy for this severe hair shaft defect depends on the cause which may vary from person to person. If the cause of the hair shaft defect is congenital then treatment will focus on improving the strength of hair fiber and follicle.
But where the defect is the result of excessive grooming the obvious treatment or hair care remedies are to reduce the amount of hair manipulation. People are encouraged to reduce brush use, avoid hair styling that involves chemicals, and use only very mild shampoos and conditioners. Also, prior to styling it is recommended to have detailed information on safe styling agents.
The styling procedures like straightening, coloring or curling if done in a proper way with the right products will not only give a trendy look but also take care of the hair.
References:
Shannon Harrison and Rodney Sinclair. “Optimal Management of Hair Loss (Alopecia) in Children”, 2003, Am J Clin Dermatol; 4 (11)
Loose anagen hair syndrome
Loose anagen hair syndrome (loose anagen syndrome, loose anagen hair) is a non-inflammatory, non-scarring form of hair loss. It is a condition that has been defined very recently and it generally affects the children. As the name suggests, loose anagen syndrome means growth of hair that is “loose” and easily pulled out of the hair follicle.
It is generally diagnosed in young children and is more likely to occur in girls than boys. In this type of hair shaft defect the hair never seems to grow and so the sufferers do not require a hair cut. The hair fibers on the scalp are generally thin, especially at the back of the scalp.
Causes of hair loosening
The hair becomes loose and comes out of the follicle due to the repeated rubbing of a person’s head on a pillow while sleeping. Frequent rubbing pulls out more of the hair from the back of the head whereas the front of the scalp has less contact with the pillow and so the hair is more likely to remain in place. But the remaining hair does not grow very long and it can be unruly and difficult to comb and style.
Mechanism of loose anagen hair syndrome
The mechanism of hair loosening in loose anagen syndrome is uncertain. But the researchers generally suggest the unhealthy root sheaths to be the reason. Though the hair follicles affected by loose anagen hair syndrome remain in growth phase, the root sheaths that normally surround and protect the hair shaft are not produced properly.
Also, the hair fiber is poorly anchored with the hair follicle. The poor attachment of the hair fiber is due to the lack of adhesion between the hair shaft and the inner root sheath. It is suggested by the experts that there is premature keratinization of the inner root sheath. The early keratinization reduces the adhesion of the inner root sheath with the hair shaft. So the hair fibers are weak and can be pulled out easily from the scalp.
Microscopic observation of the hair fiber
The affected hair fibers when observed under microscope are often seen to be irregularly shaped with longitudinal grooves. Although the structure is strong, sometimes the fibers have a sparkling (spangled) look when viewed under bright light. Very occasionally the fiber has a sticky feel when touched.
Treatments or hair care secrets
The treatment or hair care secrets for this defect are to handle the hair gently. Gentle handling can decrease the shedding of fibers to a fair extent. No other treatment or hair care is necessary, as the defect usually reverts spontaneously to its normal healthy stage in mid or late teens.
References:
Harrison S, Sinclair R. “Optimal Management of Hair Loss (Alopecia) in Children”, 2003, Am J Clin Dermatol; 4 (11)
Common hair pulling disorders
In terms of the mechanical action that causes hair loss, traction alopecia and trichotillomania are exactly the same. In both of these hair pulling disorders the hair is plucked out of the skin which leaves clear bald patches or diffuse, thin hair.
In traction alopecia the cause may involve things like tight hat bands or tight braids. If bands are used to tie tight pony tails, or cornrow hair styles are used then the roots of the hair are pulled on (traction). And when the traction continues for a long time and the same hair is repeatedly stressed, then the hair sheds off and the follicles in the skin can become damaged. The hair may eventually stop growing leading to permanent scarring alopecia.
Trichotillomania
Trichotillomania is characterized by the repeated urge to pull out hair fibers mainly from the scalp, though the focus can also be on pulling eyebrows, eyelashes, beard, nose, pubic or other body hair. It is a condition in which the affected individual plucks or pulls out their own hair. Often, the pulling of scalp hair leads to bald patches.
Once a bald area has been made it becomes even more enticing for an individual to pull the hair around it and make the alopecia patch larger. Sometimes the effect of hair pulling is more generalized and looks like diffuse alopecia. Diffuse alopecia tends to affect the whole scalp, rather than specific areas of it.
Trichotillomania is generally a non-scarring, non-inflammatory form of hair loss. But long term repeated plucking over several years may result in scarring alopecia to some hair follicles. Scarring Alopecia manifests itself with the onset of rough patches on the surface of the scalp.
Cause of trichotillomania
The general cause of Trichotillomania may be anxiety disorders or mood problems. The hair pulling disorder is considered as a neurobiological condition This form of hair pulling disorder is not only seen in humans, but also in many other species like mice and cockatoos. Mice under stress will pull out each others hair while unhappy cockatoos may pluck out their own feathers.
Effects of the hair pulling disorder
In this disorder the affected individual is most often unaware of their impulsive habit. In some cases individuals who pluck their hair also eat it which is a condition called “trichophagia”. This is a very dangerous condition that needs to be treated with some urgency. As the hair is not digestable in the stomach, it can build up into a hair ball. This hair ball can severely irritate the stomach leading to ulceration. In some cases the formation of hair ball in the stomach can be life-threatening too.
Treatment
Treatment of trichotillomania is quite difficult and complex. There are 2 approaches for treating trichotillomania. One approach is to visit the psychiatrists and the other is to the dermatologists.
Psychiatrists will naturally focus on the psychology of the patient. He/she will try to find out why the patient might have developed the habit of hair pulling. The psychiatrist may try a therapy treatment to cure the hair pulling disorder particularly when the patient is a child. While in adults they may suggest suitable drugs.
Dermatologists take a more direct approach while treating this hair pulling disorder. Children with trichotillomania may be made to wear gloves. The gloves stop the sensation of touch and this makes it impossible for the child to identify suitable hair for plucking. Sometimes the affected child's hair may be covered with vaseline which makes it difficult to get hold of the hair and also the hair becomes unpleasant to touch. In extreme cases the scalp may be bandaged so that the child can't touch the bald area.
Traction Alopecia
Unlike trichotillomania, traction alopecia treatment is simple if treated in the early ages. An effective treatment is to simply avoid hair styling that puts excessive strain on the hair roots. Even after avoiding the causes of the traction alopecia it may take a period of several months for the hair to recover from this severe hair pulling disorder. Areas of scalp subjected to chronic traction alopecia may never fully recover. Chronic traction alopecia may be sometimes treated by hair transplants.
If the treatments of these severe hair pulling disorders are taken up at an early stage, there is enough probability that the hair will regrow in these areas. The only factor that should be carefully maintained is a strict hair care regimen. So even if you are suffering from these severe hair pulling disorders remain disciplined in your hair care regimen and have patience to watch your hair growing vigorously.
References:
Monk BE, Neill SM, du Vivier A. “Fashion causes traction alopecia. Practitioner”, May 1986; 230(1415):401-2.
Hair disease in African Americans
There are a few infectious hair diseases that are more common in African-American / African populations compared to other ethnic groups. The most common of these diseases include Seborrheic dermatitis, Atopic dermatitis and Tinea Capitis. Seborrheic dermatitis is common in both African American adults and infants while Tinea Capitis and Atopic Dermatitis is common mostly in small children.
In African-American adults the other common hair disease is Acne keloidalis nuchae. It is more common in men though a few cases of the same hair disorder have been reported in women. Whilst it is not clear what genetic effect makes African-Americans more susceptible to developing these conditions, the problems are more likely to occur as compared to other ethnic groups and they need to be treated to keep them under control.
Atopic dermatitis
Atopic dermatitis, also called eczema and atopic eczema, generally affects infants. It is the most common form of dermatitis. Dermatitis refers to a rapidly evolving red rash that may be blistered and swollen. The condition is sometimes chronic which refers to a longstanding irritable area which is often darker than the surrounding skin, and causes considerable itching.
Appearance and location
There is quite a variation in the appearance of Atopic dermatitis. It generally develops into acute flares with inflamed, red and sometimes blistered and weepy patches. In between flares, the skin may appear normal or suffer from dry, thickened and itchy areas. It can often occur on the scalp in amongst the hair and this can affect the quality of hair growth. Other than the scalp, the disease can occur in the diaper area, hands, arms, feet, or legs of infants.
Although the color, severity and location of the rash may vary, the rash always itches which tends to become uncontrollable and makes the problem worse. Kids can’t help but scratch themselves, but massive scratching and rubbing can tear the skin, leaving an opening for bacteria to enter and cause infections.
Treatments and medication for black hair care
Topical emollients and low- to mid-potency topical corticosteroids have been the mainstay of treatment for this severe scalp hair disorder. For children who are above 2 years of age, topical tacrolimus ointment and cream has been approved for daily use. In general, corticosteroids are not used in children except perhaps mild topical corticosteroids. Use of an emollient as a steroid-sparing agent is used in the treatment of mild to moderate atopic dermatitis in children. For the treatment of moderate to severe dermatitis where the skin is broken and there may be a risk of infection, oral antibiotics can be used.
In the infant, little hair care can be taken as the length of hair is short and it is not advisable to use artificial black hair care products on the tender skin. These hair care products can further irritate the scalp dermatitis and make it worse. The only black hair care that can be taken up in the case of infants is the maintenance of a clean scalp and soft combing.
Acne keloidalis nuchae
Acne keloidalis nuchae (AKN) invovles the presence of skin-colored, to hyper pigmented follicular based papules on the nape of the neck and posterior part of the scalp. In this severe hair disease pustule formation and severe keloid development is observed. A keloid is a thick, irregular scar which is caused by excessive tissue growth.
The causes of the disease are not known exactly, but some researchers suggest that the disease can be due to the injury produced by short haircuts. In African men it is a fairly common practice to shave the posterior hairline with a razor and this may be the underlying cause of the acne keloidalis nuchae. Others have suggested that the causes of this scalp hair disease are constant irritation from shirt collars, chronic low-grade bacterial infections and also the use of antiepileptic drugs. All these factors result in the accumulation of increased numbers of mast cells in the posterior region of the scalp skin.
Treatment
Combinations of treatments can bring the greatest success in this hair disease. Topical or oral antibiotics can help decrease inflammation. These oral antibiotics can be coupled with intralesional steroids which can be directly injected into the papules or keloidal nodules for best results. But before the usage of intralesional steroid treatments, patients should be aware that the injected area might become hypopigmented. If this side effect occurs, it may remain for 6-12 months.
For the severe cases of acne keloidalis nuchae, hair removal by laser can be used. Laser hair removal will reduce the hair growth in the particular area thereby reducing the likelihood of inflammation. But it should be always remembered that after the application of carbon-dioxide laser, the hair growth of the particular area will be permanently reduced.
Other conditions
African American people, especially women, generally suffer from Traction Alopecia due to their tight braiding and various other tight hairstyle accessory like hard rubber hand. These tight hair styles lead to the loosening of the hair from the follicle accompanied by follicular-based inflammation in the scalp. Another hair disease that the African women are generally more likely to suffer from compared to other ethnic groups is Scarring Alopecia.
There are various categories and sub categories of Scarring Alopecia. African American women are more prone to suffer from chronic cutaneous lupus, and central centrifugal scarring alopecia, Central Centrifugal Scarring Alopecia completely destroys the hair follicle and replaces it with scar tissue, causing permanent hair loss.
Treating scalp hair disorders is a challenging task because of the emotional nature of hair loss and sometimes because the pathogenesis of the condition is unknown. Treating African-American patients can add an extra degree of complexity as the characteristic feature of African hair is usually rigid and curly. So it is necessary to approach a dermatologist who is expert in his skills and has prior experience specifically with hair conditions in African-Americans. But before you approach, remain informed yourself about the common scalp diseases and their related medications or other useful black hair care products.
References:
Amy J. McMichael, “Hair and scalp disorders in ethnic populations”, 2003, Dermatol Clin 21 629–644
Hypotrichosis
Hypotrichosis is the term dermatologists use to describe a condition where there has never been any hair growth. This is different from an alopecia. Alopecia describes any condition where there was once hair growth, but there isn’t any more. Hypotrichosis describes a situation where there wasn’t any hair growth in the first place. The affected area is totally bald and it remains the same for the whole life of the individual.
Hypotrichosis is a condition that affects an individual right from birth and it usually stays with them throughout their lives. Hypotrichosis is generally due to genetic aberrations or defects of embryonic development.
Hereditary issues or genetics also lead to pattern baldness but this is quite different from Hypotrichosis. In pattern baldness the hair remains on the scalp up to puberty. Only after the onset of puberty, due to hormones and other factors, the hair begins to shed off from a particular portion of the scalp.
Also pattern baldness only affects the hair follicles on the scalp whereas, individuals affected with hypotrichosis have many other physical or mental problems beyond their lack of hair. Conditions like Graham-Little syndrome, Ofuji syndrome, cartilage-hair hypoplasia, Jeanselme and Rime hypotrichosis are some of the major conditions where hypotrichosis is a symptom. But more studies are yet needed to be done to understand the mechanism underlying the symptoms.
Studies are also going on to find out how the different genetic defects lead to the formation of bald patches in the scalp. There are also other hair diseases like Alopecia Areata and Seborrheic Dermatitis where hereditary issues play an important role.
Types of Hypotrichosis
There are a few forms of hypotrichosis which are worth mentioning as they are relatively common forms of this hair disorder.
- Aplasia cutis congenita
- Triangular alopecia
- Congenital atrichia
Aplasia cutis congenita
Aplasia cutis congentia (congenital aplasia) is a developmental defect. Sometimes the skin of the infant in the mother's womb doesn't develop totally. The underlying cause behind this birth defect has yet to be understood.
A baby may be born with a patch of skin that is like an open wound or an ulcer. Often this defect occurs right at the back central portion of the scalp. If the defect is small, the skin will scab over and the baby is left with a scar. This leaves a patch of bald skin devoid of hair follicles.
However, if the defect is large it usually requires an operation. The operation is done to cut out the affected area and close up the skin. This is often done with some urgency as the open wound is a site of potential hemorrhage and infection.
Triangular alopecia
A similar condition to aplasia cutis congentia is Triangular Alopecia (Alopecia Triangularis). The condition is usually apparent from birth itself. In this hair defect, a triangular patch of skin and hair above the temples is affected. The skin fails to grow hair follicles in this affected area.
The long term result of this hair defect is much same as that of Aplasia cutis congenita. There is a bald patch on the temples where hair does not grow in the whole lifetime. The affected area can be surgically removed or if desired hair transplant can also be done.
Congenital atrichia
Congenital atrichia or papular atrichia is a hair loss pattern. While congenital atrichia is genetic and runs in families, it is also a gene defect that can spontaneously develop in the embryo during pregnancy though the parents may not have the condition.
Although congenital atricha is considered similar to hypotrichosis, it is not strictly so. People with congenital atrichia can be born with a full head of hair like any normal baby. But in early childhood they lose all their hair, and it never regrows.
Mechanism of congenital atricha
Researchers suggest that baldness due to congenital atricha is related to the blockage of chemical communication between Keratinocytes and dermal papilla cells. Keratinocytes are the cells which form the outer skin epithelium. In a normal scalp, these two cells react with each other and the biochemical signals that they receive from the reaction helps in hair growth and proper functioning of the normal cyclical process.
As the hair follicles enter their first telogen or resting state in early childhood, the two cell types get separated from each other in congenital atrichia. The epithelial cell component of the hair follicle retracts, as it normally does when the hair follicles go into the resting phase of the hair cycle. The dermal papilla cells normally go with the retracting epithelial cells thus keeping close contact which helps in the proper functioning of the hair growth cycles.
But in congenital atrichia the dermal papilla cells are left far behind deep in the skin. The reason behind their remaining in the deep dermis is not known but as they are too far from the epithelial cells there is no communication possible between them. Without this communication, a new anagen growth phase cannot occur and the hair never grows again.
Studies are going on to understand in more detail the mechanism of congenital atricha. There are no baldness treatments for Congenital Atricha or most of the conditions of hypotrichosis as they are due to genetic defects.
However, in recent years clinicians and scientists have been conducting extensive research to understand the hair biology and its related problems. This extensive research will certainly help to understand the various hair formation mechanisms. It will provide a better explanation of the hair problems and may also lead to some baldness treatments that will be able to control the hair loss to an extent.
Trichotillomania, the compulsive urge to pull out one's own hair, is recognised as a disorder leading to noticeable hair loss, distress, and social or functional impairment. It is often chronic and difficult to treat.
Trichotillomania may be present in infants, but the peak age of onset is 9 to 13. It may be triggered by depression or stress. Due to social implications the disorder is often unreported and it is difficult to accurately predict its prevalence; the lifetime prevalence is estimated to be between 0.6% (overall) and may be as high as 1.5% (in males) to 3.4% (in females).
The name, coined by French dermatologist François Henri Hallopeau, derives from the Greek: trich- (hair), till(en) (to pull), and mania ("an abnormal love for a specific object, place, or action").
Tinea Capitis - Ringworm of the scalp
Ringworm of the scalp is a fungal infection - it has nothing to do with worms at all. Ringworm is an infectious skin condition which can occur anywhere on the body skin, but if it develops on the scalp it can cause patches of hair loss. When it occurs on the scalp the professional term for scalp ringworm is “Tinea Capitis”. It is directly caused by the fungus and is quite similar to the fungus that causes 'athletes foot'.
In United States and other regions of the world, the incidence of ringworm of the scalp is gradually increasing and tinea capitis is becoming a more and more common diagnosis in dermatology clinics.
The patches of tinea capitis are usually redder around the outside with a more normal skin tone in the center. This makes the appearance of a ring, and so the disease is called ringworm of the scalp.
Although this infectious ringworm of the scalp is common in children, it is also frequently seen in adults. Most often, children pick up the infection first and then it spreads to related adults who are in contact with the children.
Ringworm of the scalp usually begins as a small pimple that progressively expands in size, leaving scaly patches of temporary baldness. The fungus gets into the hair fibers of the affected area and these hairs become brittle and break off easily leaving a bald patch of skin. The affected areas are often itchy, red, inflamed, scaly patches that may blister and ooze.
Ring worm: The dermatophyte fungus
Ringworm of the scalp is caused by several types of fungus. The most common among them are:
- Microsporum audouini
- Trichophyton tonsurans
Microsporum audouini is a very common cause of ringworm of the scalp all over the world. But Trichophyton tonsurans is also increasingly found as a major cause, especially in Latin America.
Other fungi that may cause tinea capitis may include Trichophyton schoenleinii, Trichophyton megninii in Southern Europe and Africa, and Trichophyton violaceum in the Middle East. Also Microsporum gypseum can sometimes cause tinea capitis. This fungi is common in soil and may be transferred to humans by contact with infected animals. Microsporum gypseum induced ringworm is most often seen in people who work with animals such as farmers or veterinarians.
Mechanism
The fungal infectious agents that cause ringworm of the scalp are opportunists. The fungi are likely to enter the scalp skin through a cut or scrape. Once they get underneath the outer skin barrier they multiply and spread out in a circle.
They particularly like to locate themselves in and around growing hair follicles. This weakens the hair fiber and infected fibers can be very brittle and liable to break off.
Effects
The effects of the ringworm of the scalp can vary depending on the type of agent involved, the individual's immune response, and the type of hair they have. Some forms of ringworm of the scalp may involve significant inflammation and even scarring of the skin can occur in extreme cases. Some infections may expand very rapidly to affect the entire scalp whereas others may progress very slowly and the individual may experience scaly skin and mild hair loss for several months or even years before the diagnosis is made.
Typically, a tinea capitis infection spreads to cover a patch of scalp of up to four centimeters in diameter, but for some people ringworm of the scalp can be more extensive. In a superficial tinea capitis infection, the patchy hair loss may typically resolve in about 7 months, but again some people can have ringworm of the scalp for much longer.
Treatment
The best treatments for ringworm of the scalp involve the use of antibiotics. Most commonly an antibiotic called Griseofulvin is used. Griseofulvin is very effective against fungi in hair and skin but it is not very good at treating yeast or bacterial infections. More recently, some agents like ketoconazole have been used to treat scalp ringworm. In terms of reducing skin scaling and inflammation associated with tinea capitis, medicated shampoos can be helpful. The active agents of medicated shampoos like ketaconazole, zinc pyrithione, and selenium sulfide are beneficial to help reduce scaling. However, the medicated shampoos are not strong enough to cure the ringworm so oral medications are also required.
Scalp infections and infestations like tinea capitis are still very common, even in the developed Western world. The diseases are due to fungus which are microscopic, and can easily be transmitted from one individual to another so it is very necessary to avoid the sharing of toiletries like hair brushes or towels in order to prevent scalp contamination.
References:
Shannon Harrison and Rodney Sinclair, ”Optimal Management of Hair Loss (Alopecia) in Children”, 2003, Am J Clin Dermatol, 4 (11)
On the left is Nneka's Pink Tip Car Eyelashes on a customer's car and on the right is the imitations from the discount store!! You be the judge. Imitations will damage your paint, fall of your vehicle almost immediately and melt in the heat as you ca see. 
I think the person parking lost something.... :) - Our exclusive high quality molds are built to last and are designed for highway driving, weatherproof, and will not damage your vehicle! All of our designs are done locally here in the Ontario, Canada region not overseas! 
Take a look at the imitation car eyelashes (on the left gray car) melted to the headlights (Nneka's Bling Car Eyelashes are on the maroon vehicle with pink tips!). The owner of the gray vehicle who purchased from a copy-cat big name company will experience paint damage once they attempt to people the imitation car eyelashes off their car. 
