What is normal hair growth?

The scalp hair grows about one centimeter per month. It’s growth cycle is divided into 3 phases.

• Growing phase (Anagen) lasts for 2 to 6 years
• Stage of partial degeneration (Catagen) lasts for 10 to 14 days
• Resting phase (Telogen) lasts for 2 to 3 months whereby the hair drops subsequently

About 90% of the hair on the scalp is in the growing phase. About 10% is in the resting phase. The average life span of a hair is about five years.  

How many hairs are normally shed every day?

Everyday some of the hair is being shed as part of the cycle. Up to a hundred strands of hair can be shed in one day.

What can cause excessive or abnormal hair loss?

Excessive hair loss or baldness (Alopecia) may occur:

• After a stressful condition such as :
  • Serious illness
  • Major surgery
  • After giving birth

Hair stops growing and goes into a resting phase (Telogen effluvium) about 3 to 4 months following the above stressful episodes.

• As a result of hormonal problems
  • Thyroid diseases
• Due to underlying diseases such as Systemic Lupus Erythematoses (SLE)
• As a side-effect of certain medicines e.g.:
  • Anticoagulants (Warfarin)
  • Medicine used to treat cancer (Chemotherapy)
  • Birth control pills (Oral contraception)
  • Antidepressants
• In Androgenic Alopecia
  • Male-pattern baldness:
    • Is an inherited condition common in men
    • Can occur as early as in the 20’s
    • Starts with receding of the hair line in front and on top of the head
  • Female-pattern baldness:
    • Occurs in genetically predisposed women
    • Generalized thinning over the entire scalp, more marked on the top of the head
• Other causes of excessive hair loss are:
  • Infections – fungal infections, commonly seen in childrenk
    • Patchy hair loss occurs
• Alopecia aerate – auto immune disease where the hair follicles are destroyed by the patient’s own cells
  • It can occur as patches of bald areas
  • It can cause baldness of the entire scalp (Alopecia totalize)
  • It can affect the entire scalp, eyebrows, underarms and pubic hair (Alopecia universalis)
• Psychological disorder with impulsive pulling of hairs (Trichotillomania)
  • It usually affects girls more than boys
  • It is associated with depression

What should I do if I have excessive or abnormal hair loss?

You should consult a doctor for advice and treatment.

• If the hair loss is due to stress, do not worry because it is temporary and the hair will re-grow
• Investigations to rule out other diseases such as thyroid diseases and SLE may be required and would need to be treated accordingly
• Fungal infection is treated with antifungal medicines
• Medications may be helpful in some instances
  • Topical minoxidil 2% and 5% may help slow or prevent male and female pattern baldness
  • Finasteride tablets can be used for male-pattern baldness
• Psychological therapy is required for treatment of Trichotillomania