Hair Disorders

Hair disorders is a broad category that includes the following types.

• Alopecia: the loss or thinning of hair (two types of alopecia are scarring in which hair follicles are destroyed and nonscarring which can be reversible)
• Male-pattern baldness (androgenic alopecia): the most prominent type of hair disorder affecting to varying degrees half of all men over 50 years of age
• Hirsutism: male-pattern hair growth affecting eight percent of adult women
• Hair shaft disorders: usually hereditary abnormalities

Signs and Symptoms

Hair disorders are accompanied by the following signs and symptoms depending on the type.

• Alopecia (nonscarring) involves hair loss all over or in circular areas receding hair line broken hairs smooth scalp inflammation and possibly loss of lashes eyebrows or pubic hair.
• Alopecia (scarring) is limited to particular areas and involves inflammation at the edge and follicle loss toward the center of lesions violet-colored skin abnormalities and scaling.
• Hirsutism involves male-pattern hair growth in women irregular menstruation lack of ovulation acne deepening of voice balding and genital abnormalities.
• Hair shaft disorders involve split ends and hair that is dry brittle and coarse as well as skin and other abnormalities.

What Causes It?

Hair disorders can be caused by any of the following.

• Alopecia (nonscarring)—skin disorders certain drugs certain diseases autoimmunity iron deficiency severe stress scalp radiation pregnancy or pulling at your own hair
• Alopecia (scarring) —skin disorders diseases or bacterial infections
• Hirsutism— excess of androgen (steroid hormone that stimulates development of male sex organs and secondary sexual characteristics). This overproduction of androgen could result from certain drugs or conditions.
• Hair shaft disorders—overprocessed hair (coloring permanent waves excessive heating) or certain diseases

Who's Most At Risk?

People with the following conditions or characteristics are at risk for developing hair disorders.

• Alopecia—male gender genetic predisposition pregnancy physical or emotional stress poor diet
• Hirsutism—genetic predisposition lack of ovulation
• Hair shaft disorders—genetic predisposition damaging grooming practices

What to Expect at Your Provider's Office

If you are experiencing symptoms associated with a hair disorder you should see your health care provider. A physical exam can help identify the type of hair disorder and laboratory tests can reveal any underlying diseases. In the case of hirsutism imaging may help diagnose the cause.

Treatment Options

Prevention

Having a well-balanced diet and avoiding potentially damaging hair treatments can help prevent some types of hair loss.

Treatment Plan

The primary goals of treatment are to treat the underlying cause regrow the hair when possible and correct damaging grooming practices.

Drug Therapies

Your provider may prescribe the following medications.

Alopecia:

• Minoxidil (Rogaine) for hair regrowth and possibly to prevent further loss
• Tretinion (Retin-A) to decrease thick scalp layer and increase minoxidil penetration
• Topical or injectable steroids

Hirsutism:

• Steroids
• Oral contraceptives

Hair shaft disorders:

• Minoxidil
• Drugs for underlying diseases

Surgical and Other Procedures

• Cosmetic therapies such as surgical placement of follicle-supporting plugs or folds
• For hirsutism possibly removal of ovarian tumor

Complementary and Alternative Therapies

A comprehensive treatment plan for hair disorders may include a range of complementary and alternative therapies.

Nutrition

• Eat foods high in B vitamins and minerals such as whole grains dark leafy greens and sea vegetables; eat adequate protein.
• Avoid sugar caffeine and refined foods.

Potentially beneficial nutrient supplements include the following.

• B-complex vitamins especially B₅ (100 mg four times per day) biotin (300 mcg per day) PABA (30 to 100 mg three times per day) and inositol (250 to 1 000 mg per day)
• Minerals especially calcium (1 000 mg per day) magnesium (400 mg per day) selenium (100 to 200 mcg per day) manganese (10 mg per day) and zinc (20 to 30 mg per day)
• Vitamin C (500 to 1 000 mg three times per day) vitamin E (400 IU per day) and vitamin A (10 000 IU per day) or beta carotene (25 000 IU per day)
• Omega-3 fatty acids (EPA DHA flaxseed oil fish oil) or omega-6 fatty acids (borage or evening primrose oil) 1 tbs. or equivalent two to three times per day

Herbs

Herbal remedies may offer relief from symptoms. Herbs are generally available as dried extracts (pills capsules or tablets) teas or tinctures (alcohol extraction unless otherwise noted). Dose for teas is 1 heaping tsp per cup of water steeped for 10 minutes (roots need 20 minutes).

For alopecia and hair shaft disorders:

• Ginkgo leaf (Ginkgo biloba) rosemary (Rosemarinus officinalis) prickly ash bark (Xanthoxylum clava-herculis) horsetail (Equisetum arvense) yarrow (Achillea millefolium) and elderberry (Sambucus nigra)
• For bacterial infections add coneflower (Echinacea purpurea) with goldenseal (Hydrastis canadensis); for fungal infections add oregano (Origanum vulgare)
• For stress substitute oatstraw (Avena sativa) for elderberry

For hirsutism:

• Saw palmetto (Serenoa repens) 200 mg two to three times per day

Topical applications of essential oils may be beneficial in skin infections and for stimulating new hair growth. Use three to four drops each of chamomile (Matricaria recutita) rosemary and sage (Salvia officinalis) in 1 tbs. vegetable oil (for example flax borage or olive). Massage gently into affected area one to two times daily.

Homeopathy

Some of the most common remedies include Ignatia Pulsatilla and Sepia. Acute dose is three to five pellets of 12X to 30 C every one to four hours until symptoms are relieved.

Acupuncture and Massage

These approaches may help address the underlying cause of a hair disorder.

Supporting Research

Behrman RE ed. Nelson Textbook of Pediatrics. 15th ed. Philadelphia PA: W.B. Saunders; 1996.

Cecil RI Plum F Bennett JC eds. Cecil Textbook of Medicine. 20^th ed. Philadelphia PA: W.B. Saunders; 1996.

Dambro MR. Griffith's 5-Minute Clinical Consult. 1999 ed. Baltimore MD: Lippincott Williams & Wilkins Inc.; 1999.

Dawber RPR. An update of hair shaft disorders. Dermatologic Clinics. 1996; 14(4).

Fauci AS Braunwald E Isselbacher KJ et al eds. Harrison's Principles of Internal Medicine 14^th ed. New York NY: McGraw-Hill; 1998.

Fiedler VC Alaiti S. Treatment of alopecia areata. Dermatologic Clinics. 1996; 14(4).

Goroll AH ed. Primary Care Medicine. 3^rd ed. Philadelphia PA: Lippincott-Raven Publishers; 1995.

Habif TP. Clinical Dermatology. 3^rd ed. St. Louis MO: Mosby-Year Book; 1996.

Lawless J. The Encyclopedia of Essential Oils. The Complete Guide to the Use of Aromatics in Aromatherapy Herbalism Health & Well-being. New York NY:Barnes & Noble Inc.; 1992:199.

Rakel RE ed. Conn's Current Therapy. 50^th ed. Philadelphia PA: W.B. Saunders; 1998.

Morrison R. Desktop Guide to Keynotes and Confirmatory Symptoms. Albany Calif: Hahnemann Clinic Publishing; 1993.

Copyright © 2000 Integrative Medicine Communications

The publisher does not accept any responsibility for the accuracy of the information or the consequences arising from the application use or misuse of any of the information contained herein including any injury and/or damage to any person or property as a matter of product liability negligence or otherwise. No warranty expressed or implied is made in regard to the contents of this material. No claims or endorsements are made for any drugs or compounds currently marketed or in investigative use. This material is not intended as a guide to self-medication. The reader is advised to discuss the information provided here with a doctor pharmacist nurse or other authorized healthcare practitioner and to check product information (including package inserts) regarding dosage precautions warnings interactions and contraindications before administering any drug herb or supplement discussed herein.