Frequently Asked Questions

The scalp, elbows and knees are common sites for the scaling. The scaling fluctuates, the patches bleed easily if scratched, and the ears are often affected – the crease of the ear, and on the inside and outside of the ear.

It can be divided into “temporary self-correcting diffuse hair loss” or “permanent diffuse hair loss until the cause is corrected.”

It is this interlinking that normally holds the hair strongly in the hair follicle.

It’s predominantly females who suffer from this problem with young fair-haired girls appearing to be more prone than others suggesting genetics plays a part.

You may suspect this problem if the hair comes out easily, on a gentle pulling, and you cannot see or feel any hair bulb. However, under the microscope, one can see very poor anagen bulbs, without the root sheath.

This is where recession of the hair occurs at the temples and/or the front/crown areas of the scalp. The final stage of such a loss leaves a band of hair around the back and sides of the scalp and baldness over the rest of the scalp.

The thinning usually begins during the late teens and early 20s and sufferers are well on the way to baldness by the age of 30. About 50% of men suffer genetic hair loss to varying degrees by the age of 50.

Genetic hair loss is not caused by poor circulation, tight scalp, blocking of hair follicles by sebum, or by microorganisms in the hair follicles.

Genetic hair loss is easily recognised by its location on the scalp (top and/or front) and by the manner in which it occurs. It is not marked by a rapid loss of hair. Hair follicles in certain areas begin to produce hairs of a shorter growth phase and, with each succeeding cycle, thinner hairs are produced until only fine vellus hairs are left. Usually the whole process takes between ten and forty years.

This thinning does not lead to baldness. The growing phase of many of the hairs in the area become shorter, producing shorter, finer hairs. However, many of the hairs in the front/top sections are untouched by this process so that the general appearance of the scalp is of a thinning in the area of question. Some women complain of a “burning” sensation in the top/front section.

The thinning often begins at the time of menopause or after a hysterectomy in those women genetically predisposed. At these times, the change in the sex hormone balance gives the male sex hormones (androgens) more influence and triggers the thinning.

In the past, women in their twenties or thirties seldom suffered female pattern hair loss unless a hormonal imbalance was present. However, trichologists are now seeing more younger women with genetic thinning. It is believed that the reason for this is the progestogens in some oral contraceptives. Progestogens levonorgestrel and norethisterone, have a male sex hormonal influence and might trigger genetic thinning in those women genetically predisposed to it.

Occasionally a diffuse Alopecia Areata can occur, when hair is lost from all over the scalp, but not in patches, sometimes leading to baldness. It can also affect hairs from anywhere on the scalp, head and body.

Alopecia Areata is an autoimmune problem, which in this case, means that one group of white blood cells attacks some cells of the hair bulb. Millions of different groups of white blood cells circulate in the blood and lymphatic system. They help protect the body from attack by viruses, bacteria and other micro-organisms.

People who experience Alopecia Areata have a genetic predisposition for the problem, however it still takes something to trigger the problem. The trigger could be a viral or bacterial infection, a vaccination, stress, trauma to the skin or exposure to a substance not previously encountered.

Tufted folliculitis is sometimes seen where several hairs grow out of the same hair follicle.

Not only do chemicals burn the scalp but they can also trigger an autoimmune reaction, leading to further patches of cicatricial baldness.

Often the hair has also been braided in the past and/or present, so traction alopecia is often seen in patients who suffer CCCA. Perifollicular is usually present around the follicles that still exist.

Highlighting (lightening) the hair requires the use of oxidation products on the hair that will oxidise the pigment of the hair. As a result, the pigment loses its colour and the hair becomes lighter.

A solution of hydrogen peroxide, of pH 2.5 to 4 is normally mixed with a powder bleach containing compounds such as ammonium persulphate and potassium persulphate that act as oxidising agents and also increase the pH of the hydrogen peroxide solution once the two are mixed together. When the two are mixed together, the pH is increased to around 10, which makes the mixture a very powerful oxidising agent. It is essential that the hydrogen peroxide solution and the powder bleach are mixed in the correct proportions.

The scalp appears smooth because the follicles have disappeared. These problems are usually autoimmune (white blood cells attack the stem cells in the hair bulge) and occur gradually.

These are a result of over-heating the hair, with thermal styling tools i.e.: blow-dryers and irons. The bubbles can change the colour of hair; bleached hair can turn pinkish.

It looks like a white speck on the hair. These are a result of over-heating the hair, with thermal styling tools i.e.: blow-dryers and irons. The bubbles can change the colour of hair; bleached hair can turn pinkish.

Nits are glued to the hair shaft on one side and do not flake off. Nits need the temperature of the human head to survive. The eggs take 8 – 10 days to hatch.

The adult Louse: Do not hop or fly (they are wingless) but can crawl at a rapid rate (23cm/min under natural conditions). An adult louse is approx. 2mm to 4mm long and has six legs. They live for three to four weeks, staying close to the scalp for food, warmth, shelter and moisture. The adult louse feeds every 3hrs to 6hrs by sucking blood and simultaneously injecting saliva.

They are formed when the tip of the external root sheath breaks off. Hair Casts will not lead to hair breakages and their cause is not known.

In this condition, the hair lacks sulphur – the element that makes hair and nails strong.

The hair shaft fluctuates in diameter and is identified by nodes occurring at regular intervals, with the constricted areas not having any medulla.

Inherited as an autosomal dominant trait (inherited from either parent), people can be born with it or it occurs for the first time during infancy.

The black areas are empty spaces in the cortex of the hair. The empty air-filled spaces make the hair very fragile and prone to breakage. Interestingly, it is sometimes seen with Alopecia Areata.

It is more common in children than adults and in some cases, is classified under ‘obsessive-compulsive disorders’. The constant pulling produces a ragged irregular patches of incomplete baldness, usually in easily accessible areas such as the scalp, eyelashes and eyebrows. The follicles are intact and the scalp looks normal. On the scalp, several shorter hairs - either new or broken ones – are seen in the affected areas.

This can also be classified as an obsessive-compulsive condition.