Understanding Hair Loss Part2
Wesley Wilborn, MD
Before continuing let us briefly review the human hair growth cycle as I discussed in my last column.
• Anagen, the active growth phase of the hair growth cycle, will last 2-6 years or more depending on one’s genetic makeup.
• Catagen, the transitional phase between growing and resting, usually lasts 2 weeks.
• Telogen, the resting and shedding phase, usually lasts a few weeks to 2 months.
Prior to the emergence of relaxers as the primary method of straightening hair, hot combing was the most common method.
The use of the straightening comb causes hair loss from the top of the head referred to as “hot comb alopecia”.
A similar type of hair loss has also been attributed to the use of relaxers. A military dermatologist in the 1980’s coined the term “FDS – follicular degeneration syndrome” to describe this type of hair loss.
The mechanism of these two causes of hair loss is similar in that the entire hair follicle is destroyed. In “hot comb alopecia” it is commonly believed that the hot grease seeping into the pores causes permanent damage to the hair follicle. In “follicular degeneration syndrome”, relaxer seeping into the pores destroys the hair follicle, causing similar scarring and permanent damage.
Since the old method of straightening is no longer in use let us devout our attention to relaxers as the primary cause of this problem.
Relaxer, applied directly to the scalp, can penetrate deep enough to destroy hair follicles because these hairs are closer to the surface of the scalp (recall telogen is the resting/shedding phase of hair growth). At any point in time only about 5% or less of the scalp hairs are in the telogen phase and only a few hairs can be affected. Because the top of the head is like a shelf the relaxer can seep downward into the pores I estimate that it will take 8 or more years of repeated relaxing to destroy enough hairs for it to become noticeable. Of course the more often one gets a touchup the earlier we may see this. The following photograph is an example of how the scalp may look.
Although “follicular degeneration syndrome” is the most serious form of hair loss cause by chemicals, breakage is actually more common. Breakage can be caused by either relaxers or dyes and is more commonly caused by use of both. In breakage only the length is affected. With proper care the hair length can be restored.
Treating hair follicle loss can be a very difficult and sometimes impossible problem to resolve; obviously the best treatment is prevention. Discontinuing the use of relaxers would certainly solve this problem but how many women are willing to give this up? Certainly, in this situation, better technique is the key, as prevention of follicular degeneration syndrome, relies heavily on the skill of the person applying the relaxer.
Decreasing the frequency of touchups to 8 or more weeks and getting the relaxer in and out of the hair as quickly as possible will help tremendously. For those of us old enough to remember when relaxers first came out they were not applied directly to the scalp and we did not have this type of hair loss problem. As a preventive measure I recommend the use of the Tress Therapy Root Restore Conditioner as a base and neutralizer during the relaxing process. I designed this product to chemically neutralize the relaxer that seeps into the pores and to neutralize the hair after the relaxing process while keeping the hair straight. The Tress Therapy Root Restore Conditioner forms a acidic barrier between the delicate hair follicle and the relaxer, thereby decreasing hair follicle scarring and preventing hair loss.
Next month diseases of the scalp.____________________________________________
Dr Wilborn is an Associate Clinical Professor of Dermatology of Emory University School of Medicine, Atlanta, GA., and member of the advisory board of the Circumscribed Cicatricial Alopecia Foundation. He has been in private practice for