The term alopecia literally means hair loss, another term that is also used to describe hair loss conditions is effluvium, which means an outflow, and this can affect different phases of the hair growth cycle. There are several different types of hair loss and quite a few of them are a constant battle for black women. The following is a brief look at ten types of hair loss:
- Diffuse Alopecia
Over processing of Hair
The main cause of hair loss for black women is over processing of and physical damage to the hair. Over processing includes: perming, relaxing, straightening, bleaching and dyeing of the hair, these all involve harsh chemicals that can significantly affect the integrity of hair fiber. Using these cosmetic approaches too frequently or inappropriately can lead to irreversible damage to the hair fiber. The more hair fiber is damaged by these processes the weaker it will be and the more likely it will break off.
The hair cuticle or outer part of the hair, overlap each other like fish scales along the length of the hair fiber. The cuticle helps protect the softer inner fibers or cortex of the hair from damage. Usually, to process the hair, the outer cuticle of the hair has to be opened up so that the chemicals can infiltrate the hair cortex and either straighten or make it curly or remove or add colors in the case of hair dying processes. If chemicals are added for an extended period of time or in strong concentrations or even too frequently the hair cuticle can become damaged and instead of laying flat and tight on the surface of the hair, it becomes loose and frayed, this leaves the vulnerable cortex exposed. Because the cortex of the hair is softer and more prone to damage when left exposed to the environment the hair will be severely weakened. Other factors that can exacerbate the weakness of the exposed hair are: chemicals in shampoo, water and air pollution. When this happens the hair becomes super weak and then breaks, usually you may find that this will happen to the older part of the hair. However, over processing can damage the root of the hair near the scalp and this is called diffuse alopecia or thinning hair loss.
Physical Damage of Hair
As well as chemical damage, physical processes can also damage the hair and cause hair loss, grooming techniques that put a lot of physical stress on the hair fiber can cause the cuticle to flake and strip away, this may include vigorously combing and brushing or washing of the hair.
Additionally, the use of heat and heat appliances are added factors. When you wash your hair, some water gets under the cuticle and into the cortex- this is why air drying and then sealing is the number one way to retain moisture. If you dry your hair with a high heat appliance, you will heat the water that is in the hair cortex, this makes the water expand inside the hair and pushes outwards to leave spaces in the hair fiber. In severe cases the hair develops little bubbles inside, a condition called “bubble hair”. These bubbles make the hair weaker wherever it is formed and this causes the hair to break off at these sites. If you combine over processing with heat damage then you will experience hair loss in short order. These conditions can be remedied if bad hair habits are nipped in the bud.
- Traction Alopecia
Traction alopecia is a condition where the hair is plucked out of the scalp leaving clear bald patches or sparse, thin hair. Anything that pulls on the roots of the hair severely overtime can cause traction alopecia, examples include, tight hair styles, ponytails, corn rows, hair style with the hair sectioned and drawn tight in the same area, hats, weaves, wigs and braids, worn tightly. If the situation continues for a prolonged period, the root of the hair can become so damaged that they stop growing permanently. Ouch! Who wants that? You can allow your hair to grow back in the places where you experience traction alopecia by avoiding the habits that led to alopecia in the first place. See more on Traction Alopecia: Hair Today, Gone Tomorrow .
- Alopecia Areata (AA)
This type of hair loss occurs when the immune system starts to attack hair follicles. Just why or how AA develops is not clear. Researchers believe AA is an autoimmune disease Thankfully, it is not contagious; you can’t catch AA from someone who has it. AA can affect men, women, and children. It often appears as well-defined circular bald patches on the scalp. Many people will get just one or two patches, but for some, the hair loss can be extensive. Usually, most people can’t tell when they are getting AA; there is no sensation — just a patchy shedding of hair.
The hair loss can be quite sudden, developing in a matter of a few days and it may happen anywhere on the scalp. The patch is usually smooth bald skin with nothing obvious to see beyond the absence of hair. Fortunately, the hair follicles are not completely destroyed and can re-grow if the inflammation subsides.
- Scarring Alopecia
There are many forms of scarring alopecia; the common theme is a potentially permanent and irreversible destruction of hair follicles and their replacement with scar tissue. Most forms of scarring alopecia first occur as small patches of hair loss that may expand with time. In some cases the hair loss is gradual, without noticeable symptoms, and may go unnoticed for a long time. In other instances, the hair loss is associated with severe itching, burning, and pain, and is rapidly progressive. The destruction of the hair follicle occurs below the skin surface so there may not be much to actually see on the scalp skin surface other than patchy hair loss. Affected areas may be smooth and clean, or may have redness, scaling, increased or decreased pigmentation, or may have raised blisters with fluids or pus coming from the affected area.
- Telogen Effluvium (TE)
Hair follicles on the scalp do not continuously produce hair. They cycle through a growth stage that can last two or more years, and then regress to a resting stage for up to two months before starting to grow a new hair fiber again. The resting stage is called the telogen stage and telogen effluvium is a condition where the number of hair follicles producing hair drops significantly for any reason during the resting, or telogen phase. TE appears as a diffuse thinning of hair on the scalp, which may not be even all over. It can be a bit more severe in some areas of the scalp than others. Most often, the hair on top of the scalp thins more than it does at the sides and back of the scalp. There is usually no hairline recession, except in a few rare chronic cases.
The shed hairs are typically telogen hairs, which can be recognized by a small bulb of keratin on the root end, usually looks like a little bit of white on the root part of the hair. People with TE never completely lose all their scalp hair, but the hair can be noticeably thin in severe cases. Whatever form of hair loss TE takes, it is fully reversible. The hair follicles are not permanently or irreversibly affected; there are just more hair follicles in a resting state than there should normally be.
What triggers TE?
Women soon after giving birth. Called postpartum alopecia, the sudden change in hormone levels at birth is such a shock to the hair follicles that they shut down for a while. There may be some significant hair shedding, but most women regrow their hair quickly.
Physical trauma such as being in a car crash.
Surgery can sometimes be a shock to the system and a proportion of scalp hair follicles go into hibernation. As the environmental insult passes and the body recovers, the TE subsides and there is new hair growth.
Some drugs may also induce TE, especially antidepressants. Often a switch to a different drug resolves the issue.
Chronic illness may lead to TE.
Chronic stress and diet deficiency. A lack of a mineral, vitamin, or essential amino acid can certainly cause TE.
- Anagen Effluvium
Anagen effluvium is a diffuse hair loss like telogen effluvium, but it develops much more quickly and can cause individuals to lose all their hair. Anagen effluvium is most frequently seen in people taking cytostatic drugs for cancer or those who have ingested toxic products like rat poison. Cytostatic cancer drugs and various toxins and poisons inhibit rapid cell growth, including the proliferation of cells in the hair follicles. The result is a sudden shut down of hair fiber production.
The onset of anagen effluvium is very rapid. Some individuals who start taking anti-cancer drugs can literally pull their hair out in clumps within the first two weeks. Because these drugs act so quickly and are so potent, the hair follicles have no time to enter into a telogen resting state, as with telogen effluvium, a response to a more moderate environmental challenge.
Instead, in anagen effluvium the hair follicles enter a state of suspended animation, frozen in time. The hair fibers fall out quickly, but instead of looking like typical telogen hairs with little bulbs of keratin on the root end, the hairs that fall out are mostly dystrophic anagen hairs with a tapered or sometimes feathered root end.
- Trichorrhexis nodosa ( Trichonodosis)
Trichorrhexis nodosa is a focal defect in the hair fiber. When observed under the microscope most of a hair shaft looks entirely normal. However, in isolated spots along the length of a fiber, swelling and/or fraying can be seen on the hair shaft. These focal defects develop where there is an absence of cuticle.
Causes of trichorrhexis nodosa can be congenital or acquired. Congenital trichorrhexis nodosa is very rare, but some people have naturally weak hair where the cuticle is not properly produced. Congenital trichorrhexis nodosa is usually hereditary, it runs in families, and it first develops at a very young age.
Acquired trichorrhexis nodosa is much more common and develops as a result of excessive hair manipulation and over-processing. Too much brushing, hairstyles that put constant stress on the hair, excessive washing, dying, and perming may disrupt the cuticle 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 then the hair cortex swiftly breaks down.
Ringworm has nothing to do with worms; it is actually a fungal infection. Ringworm is first and foremost an infectious skin condition and can occur anywhere on the body, but if it develops on the scalp it can cause patches of hair loss. Ringworm is the same thing as athletes foot, and the same kind of fungal infection can affect the nails too. 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 in 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 and inflamed, scaly patches that may blister and ooze. The patches are usually redder around the outside with a more normal skin tone in the center. This may create the appearance of a ring, hence the name, ringworm. Treatment for ringworm varies depending on the particular fungus involved. Some types of ringworm infection will resolve spontaneously and so no treatment may be given.
Folliculitis is a term for focal inflammation of hair follicles. It looks like acne with little rings of inflammation surrounding the opening of a hair follicle. In the early stages of a folliculitis the hair fiber may still be present in the middle of the folliculitis, but as the folliculitis progresses the hair often falls out. When folliculitis is severe, the inflammation is so intense that it can actually permanently destroy the hair follicles, leaving little bald patches. There are forms of folliculitis which are non-infectious such as those caused by oils and greases applied to the skin that clog up the hair follicles, but folliculitis is usually due to a bacterial infection.
The term dermatologists use to describe a condition of no hair growth. Unlike alopecia, which describes hair loss where formerly there was hair growth, hypotrichosis describes a situation where there wasn’t any hair growth in the first place. Hypotrichoses are conditions that affect individuals right from birth and usually stay with them throughout their lives. The majority of hypotrichoses are due to genetic aberrations or defects of embryonic development.
Nobody wants to lose their hair unnecessarily, in fact hair loss can be downright depressing, in cases where the loss of hair is acquired, which means caused by something we may be doing, of our own volition, it behooves us to stop those practices in order to have a head of hair that we can be proud of.