Ηair Loss Archives | Dr Anastasia Therianou
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Can covid-19 affect our hair?

Can COVID-19 affect our hair?

At any given time, about 85% to 90% of the hairs on the average person’s head are actively growing, this is called the anagen phase, and the others 10-15% are resting (the telogen phase). Typically, a hair is in the anagen phase for two to four years, then enters the telogen phase, rests for about two to four months, and then falls out and is replaced by a new, growing hair. The average person naturally loses about 100 hairs a day.

Major psychological stress, which is not uncommon during this pandemic, but also people who have been affected by the virus are some major triggers that can affect the aforementioned hair growth cycle.

This is recognized as a ‘shock’ for the body and pushes more hairs into the resting phase. This condition is called telogen effluvium. Around 30% of the hairs stop growing and go into the resting phase before falling out. So if you have telogen effluvium, you may lose an average of 300 hairs a day instead of 100.

Other triggers can also be:

  • Surgery
  • Major physical trauma
  • Extreme weight loss
  • The extreme change in diet
  • Abrupt hormonal changes, including those associated with childbirth and menopause
  • Iron deficiency
  • Hypothyroidism or hyperthyroidism
  • Some medications

Because hairs that enter the telogen phase rest in place for two to four months before falling out, you may not notice any hair loss until two to four months after the event that caused the problem. So you will notice that your hair might start falling out 2-4 months after you recovered from COVID-19  or 2-4 months after the emotional stress. Telogen effluvium rarely lasts longer than six months, although some cases last longer.

COVID-19: Although losing a great number of hairs within a short time can be frightening, the condition is usually temporary. Each hair that is pushed prematurely into the telogen phase is replaced by a new, growing hair, so there is no danger of complete baldness. Because the hair on the scalp grows slowly, your hair may feel or look thinner than usual for a time, but fullness will return as the new hairs grow in.

COVID-19: If you have telogen effluvium, you’ll notice more hair than usual accumulating on your pillowcase, on the shower or bathroom floor, and in your hairbrush. Your scalp hair may feel or look less dense than usual. Often, though, the hair loss is subtle, and other people may not notice anything different about your hair.

Most cases of telogen effluvium can be diagnosed based on medical history and an examination of the scalp and hair. If the hair loss has been occurring for several months, there may be visible thinning patches, but often the hair loss is not dramatic enough for a doctor to notice.

If you have large bald patches, you probably don’t have telogen effluvium. If the doctor gently tugs on some hairs on your scalp and four or more hairs come out, you probably have telogen effluvium.

Also, the hairs will look like hairs in the telogen phase — they will have a white bulb at the end that was in the scalp, and will not have a gel-like covering around that end of the hair.

Your doctor also may do blood tests to check for conditions such as thyroid abnormalities that may be contributing to hair loss.

Nothing can be done to prevent most of the types of physical shock that can start telogen effluvium. Some cases may be caused by a poor diet, and these might be prevented by eating a balanced diet that provides enough protein, iron, and other nutrients.

No treatment for active telogen effluvium has been proven effective.

COVID-19: Some causes of the disorder can be corrected. For example, if you have a poor diet, consult a dietitian to help you balance it. If the hair loss began after you started a new medication, talk to your doctor to see if the medication should be discontinued.

Many times, however, the cause is a specific event in the past, and you can expect that the hair will grow back. In cases where hair growth has not returned to a satisfactory level, your doctor may prescribe topical minoxidil (Regaine), a lotion applied to the scalp that may stimulate hair growth in some people.

The outlook for telogen effluvium is very good. Most cases run their course within six to nine months, and the hair usually grows back. In some cases, the disorder may last longer. In other cases, not all hairs grow back.

 

What causes hair loss?

What causes hair loss?

Experiencing hair disorders can be very distressing. Our hair is our crowning glory, a crucial part of our identity, and hair falling out can affect our confidence and even our mental health.

Anyone can experience hair disorders, but it’s more common in men, and age is also a factor.

Hair loss can occur gradually or very suddenly and can affect your scalp, eyebrows, beard, and even your whole body. Some types of hair disorders are temporary – for example, as a result of stress, chemotherapy, childbirth, and menopause. Some types of hair falling out can, of course, be permanent.

There are a variety of treatments available to prevent further hair disorders and, in some cases, restore hair growth. Treatments for permanent hair loss include hair transplants and tattooing.

You may have tried a variety of different remedies and supplements for your hair loss and be feeling a sense of despair because nothing has helped so far.

If you are experiencing hair loss, the sooner you can get to the root cause and receive the right treatment, the better.

Here are some of the potential reasons for your hair falling out.

1. Hair Loss-Genetic predisposition

If there are hereditary hair disorders in your family, you may be predisposed to losing your hair prematurely. Male or female pattern baldness tends to run in the family, so it is worth finding out if this is something other family members have experienced, now or in the past.

2. Hair Disorders-Health causes

If you have had an illness, have undergone an operation, are experiencing thyroid deficiency or have been prescribed certain drugs, you can experience hair disorder. Autoimmune conditions can cause hair loss, such as alopecia areata, discoid lupus erythematosus, or lichen planopilaris.

3. Hair falling out -Medication

Drugs and treatments that can cause hair falling out to include antiepileptics, antivirals, anticoagulants, antipsychotics, antidepressants, antimalarials, antithyroid drugs, beta-blockers, and retinoids. Excessive Vitamin A and some types of birth control can also cause hair loss.

4. Hair Loss-Lifestyle causes

Following a rigorous diet can be linked to hair loss, as can crash dieting. Excessive sun exposure can also be a factor. And as both active and passive smoking can worsen male or female pattern baldness, these are to be avoided.

5. Tight hairstyles

Hairstyles that pull tightly on the hair can cause hair loss. If you tend to wear your hair in tight haircuts – braiding, cornrows, hair extensions, tight ponytails, and dreads – it’s essential to give your hair a break from these styles and give your hair a chance to recover.

The sooner you find out what’s causing your hair falling out and take steps to stop it, the better your results.

You can find more information on the American Academy of Dermatology website: https://www.aad.org/public/diseases/hair-loss/insider/shedding.

I can offer a diagnosis of complex cases and personalized treatment based on your particular needs. I can provide you with advice via online video consultation and still offer face-to-face consultations for urgent cases. To arrange a meeting with me, Dr. Anastasia Therianou, an expert in dermatological care for hair loss and mole problems, call 0203 464 4884.

What is a dermatologist?

Dermatologists diagnose and treat skin conditions like skin tags or atypical moles, hair loss, and nail diseases. To become a dermatologist you have to be medically qualified just like any other doctor, and then train in general medicine. A dermatologist will then work, research and training in a specialist area, developing expertise in a dermatological sub-specialty. The whole process takes about 15 years.

Dermatologists treat over 3,000 skin diseases, including acne, psoriasis, and skin cancers, plus a huge variety of nail and hair conditions.

As well as prescribing topical and oral treatments, dermatologists are trained to carry out skin surgery, laser treatments, and more. With such expertise dermatologists are the best people to diagnose and treat your medical condition.

Skin conditions

Common reasons for referral to a dermatologist include eczema, psoriasis, and severe acne, acne scars. But the skin is a complex organ and there are in fact over 3,000 skin diseases, with about 20 of them accounting for the vast majority of dermatologists’ workload. In recent years skin cancers have increasingly been added to this workload, due in part to holidays abroad and the erroneous belief that tanned skin is healthy. There are also many underlying systemic diseases that manifest as skin rashes.

dermatologist moles
How you can identify the type of moles

Nail conditions

Fungal infections are a very common nail condition treated by dermatologists. Beyond infections, a dermatologist can also diagnose a range of abnormal growths within the nail. Some of these nail growths can be benign but may also be viral warts, fibroid tumors, or malignant growths. Symptoms and signs of nail conditions can include discoloration, scaling, or the nail ‘lifting’ so it is no longer completely attached.

nails dermatologist
Nails problem diagnosis

Hair conditions

A dermatologist is the best person to diagnose and provide hair loss treatments, which can be the result of a wide variety of conditions. These include anemia, androgenetic alopecia, alopecia areata, male pattern baldness, hair follicles, female pattern, and many different autoimmune diseases, thyroid disorders, traction, and baldness. Female hair loss can also occur as a result of polycystic ovary syndrome, after pregnancy and during menopause.

hair loss problems
Hair loss problems

What can a dermatologist diagnose?

Many scalps, hair, and nail conditions can be diagnosed by a thorough physical examination. The consultant will also review your medical history, ask about the symptoms, and examine the affected area.

In some cases, certain tests such as dermoscopy, a blood test, a skin swab, or skin biopsy may be necessary for diagnosis, or a trichometry or trichoscopy with video dermatoscopy.

You should seek medical advice when you first notice a medical condition. Consult your GP first for common problems such as mild acne, rosacea, and minor rashes.

They may refer you to a dermatologist near if specialist diagnosis and treatment is required. Seeking a consultation early will help reduce the potential risks and complications that may arise due to the dermatological condition.

I am a consultant dermatologist at Imperial College Healthcare NHS Trust, a big teaching medical team in hospital in central London.

While I cover general dermatology including acne, psoriasis, and eczema, my areas of particular interest are hair and nail disorders, skin cancers, and complex skin diseases.

I am one of the few London dermatologists in the UK who specialize in hair loss. Dr. Anastasia Therianou is a hair loss expert and mole, problem expert. To arrange a consultation book an appointment with me in my dermatology clinic in Harley Street.

To book an appointment or to request more information click here and please fill out the form and we will contact you shortly.

How can I stop hair falling out?

Hair falling out can be extremely distressing if you are losing a large amount of hair, or if it looks like you are. 

It is of course normal to shed up to 100 hairs per day. As there are 100,000 hair follicles or more on your scalp, this hair loss does not make a big difference to the appearance of your hair, unless you have long hair, in which case it might look like you are losing more. 

But if you are losing more than 100 hairs a day this is more likely to be noticeable and there may be an underlying issue causing your hair falling out.  

Excessive daily hair shedding (telogen effluvium) is not caused by genetic predisposition – male or female pattern baldness that tends to run in the family – but occurs as a result of a number of possible factors, including nutritional deficiency, a medical condition or stress. Let’s look at those causes and how to mitigate them.

#1 Diet

Following a very strict diet can be linked to hair loss, as can crash dieting. The best advice is to follow a balanced diet, with meat, fish, fresh vegetables and fruit – the Mediterranean diet, for example.

#3 Menstruation

Women who have a heavy period can experience chronic anaemia, which can in turn cause hair loss. A visit to your GP and a blood test will help you find out if you need to increase your iron intake.

#4 Motherhood

A new mother will notice excessive hair shedding about two months after giving birth. This is quite normal and is only a temporary problem, lasting at most a few months.

#5 Stress

People who are constantly under a great deal of stress can experience long-term hair shedding, so it’s important to find ways to mitigate the stress, such as meditation, yoga and mindfulness. A short-term stressful experience, such as losing your job, can lead to temporary hair falling out. 

#6 Sunbathing

If you are experiencing hair loss it’s important to avoid exposing your scalp to the sun as this can cause your hair loss to increase.

#7 Birth control

Some forms of birth control can affect normal hair growth, causing or exacerbating hair falling out. If you are using Norethindrone, Marvelon, Progestin implants/injections or Ortho Evra skin patches, discuss alternatives with your GP.

#8 Tight hair styles

Wearing your hair tightly pulled back can eventually lead to hair loss. Harsh hair care products can also be a factor. Avoid tight hairstyles – tight ponytails, braiding, corn rows, hair extensions and dreads – especially if you are noticing patches of hair fall.

#9 Supplements

If you take multivitamins it’s important to be careful. Taking excessive amounts of some vitamins, such as vitamin A, can cause increased hair loss. So you may need to adjust your dosage.

#10 Medication

Some drugs can cause hair loss. If you take antiepileptics, antivirals, anticoangulants, antipsychotics, antidepressants, antimalarials, antithyroid drugs, beta-blockers or retinoids, discuss alternatives with your practician.

#11 Smoking

Both active and passive smoking can cause this problem. Smoking has been proven to increase the androgen levels at the follicular level, worsening androgenetic alopecia – male or female pattern baldness. So give up smoking and stay away from smokers.

For more information on the causes of hair loss: aad.org

If you have ruled out these factors and you are still experiencing excessive hair falling out, you need to see an expert.

To arrange a consultation book an appointment with me, Dr Anastasia Therianou, expert in dermatological care for hair loss and mole problems!

Why You Need A Dermatologist For Hair Loss – Not A Trichologist

Why You Need A Dermatologist For Hair Loss – Not A Trichologist

If you are looking for the right person to treat your hair loss it’s important to know the facts so that you get the very best treatment available. Hair loss can be caused by a whole range of conditions, such as alopecia areata, many different autoimmune diseases, anemia, thyroid disorders, traction, and baldness. As well as potentially being caused by one of these disorders, female hair loss can also occur as a result of polycystic ovary syndrome, after pregnancy and during menopause.

With so many possible causes of hair loss, it’s important to get an accurate diagnosis and this is why a dermatologist is the best option. Dermatologists have medical training, unlike trichologists who are qualified by and registered with the Institute of Trichologists.

A trichologist is an expert in human hair, from making it look its best through to treating problems with your hair and scalp. A dermatologist is a medical doctor who specializes in skin, hair, and nails – and has the training and expertise to conduct a full examination and any necessary tests to give an accurate diagnosis.

This training and depth of knowledge are vital. Typically a trichologist will train for up to four years. My training to become a dermatologist included six years of medical school, two of core medical training, four years specializing in dermatology, then another year on my special interest areas. That’s 13 years of medical training to specialize in skin and hair, giving a depth of knowledge that enables the diagnosis and treatment of a wide range of hair loss conditions. I am one of the few dermatologists in the UK who specialize in hair loss.

A trichologist can of course help in some cases but can only give patients topical treatment for hair loss, as they are not medically trained. Unlike a dermatologist, they cannot perform tests that help with the diagnosis and evaluation of the condition and inform the best course of treatment; these require special training.

For example, a dermatologist can perform a trichoscopy with a video dermatoscopy, a non-invasive technique that allows a rapid and magnified observation of the skin’s surface enabling the evaluation of hair thickness, presence of regrowing hairs and scalp inflammation. We can also perform a trigonometry, which involves an instrument that provides a numeric value of the hair quality. All vital to in-depth diagnosis.

drther

Dermatologists can also carry out a scalp biopsy, where a sample from the scalp is taken under local anaesthetic and tested under the microscope by a histopathologist. These tests are often necessary to evaluate cases of hair loss.

Only a dermatologist is qualified to carry out these tests, without which a full and thorough evaluation and diagnosis is not possible. Getting to the cause of your condition leads to better treatment. Furthermore, there are a variety of oral treatments available for hair disorders which a trichologist cannot prescribe – but a dermatologist can so these are some reasons why You need A Dermatologist for Hair Loss and not  a Trichologist.

Why You Need A Dermatologist For Hair Loss – Not A Trichologist

A trichologist can only give you topical treatments for hair loss, such as minoxidil of various strengths. While dermatologists may prescribe this, they can also administer oral minoxidil, injections in the scalp, other tablets such as spironolactone or finasteride, or a combination of the above with other oral treatments. In this way a dermatologist has a far greater range and depth of diagnostic tools and techniques to help them evaluate your hair loss and its causes, and is far more likely to get you good regrowth results.

So if you are concerned about hair loss and want the most thorough and effective treatment and advice, please get in touch. The sooner you find out what’s causing your hair loss and get treatment and advice, the better your results. To arrange a consultation with me, Dr. Anastasia Therianou, an expert in dermatological care for hair loss and mole problems, call 0203 464 4884.

Is Your Hairstyle Causing Hair Loss?

 Is your Hairstyle Causing Hair Loss ?

A tight ponytail, cornrows or braids can look great. But did you know that wearing your hair tightly pulled back can eventually lead to hair loss? Hairstyles that constantly pull on your hair include cornrows, dreadlocks, hair extensions, braids, buns, ponytails and up-do’s that are tightly pulled. Even wearing hair rollers while sleeping can be a cause of female baldness. Medically known as traction alopecia, here is how to avoid permanent hair loss.

Look for early signs
If you do often wear your hair pulled back, the first signs of the problem may be broken hairs around the hairline or patches of hair loss where it is pulled tightly, for example thinning of hair between the braids. If you spot any of these signs change your style to one that doesn’t pull so your hair can regrow.

Loosen up your hairstyle
This is especially important around the hairline. Opt for thicker braids and dreadlocks and make sure you wear braids for no longer than two months. Changing hairstyles can also help to reduce the way your hair is being pulled and give it a chance to recover.

Weave wearers beware
Weaves and extensions are great way to add volume and length to your hair. To prevent them from causing hair loss, dermatologists recommend that you wear them for short periods of time, as pulling can increase your risk of developing traction alopecia. So remove weaves and extensions immediately if they cause pain or irritate your scalp and opt for sewn-in weaves rather than any that use glue.

girl in braids

Have your hair relaxed
A hairstylist who has training in using chemical relaxers can choose the product that will achieve the results you want while minimising the damage to your hair. To find out whether your stylist has this training, ask a few questions and be prepared to walk away if you’re not satisfied with the answers. You should also ask what your stylist will do to help maintain the health of your hair.

Don’t ignore these symptoms
Change your hairstyle immediately if you notice any of the following problems or you could experience hair loss:

  • Pain from tightly pulled hair
  • Stinging on your scalp
  • Crusts on your scalp
  • Tenting (sections of your scalp are being pulled up like a tent).

When the pulling continues, most people eventually notice that their hair stops growing. Where you once had hair, you’ll see shiny, bald skin. When traction alopecia advances to this stage, your hair cannot grow back. Many women come to me with hair loss problems, seemingly unaware that their hair style may be at fault.

For more information on traction alopecia you can visit the British Association of Dermatologists link http://www.bad.org.uk/shared/get-file.ashx?id=6323&itemtype=document

If you have hair loss, it’s never too early to see a dermatologist with a special interest in hair disorders. People develop hair loss for many reasons and your hairstyle may be the cause. It’s also possible that it’s due to something else. The sooner you find out what’s causing your hair loss and take steps to stop it, the better your results. To arrange a consultation with Dr Anastasia Therianou, expert in dermatological care for hair loss and mole problems, call 0203 464 4884.

Is there hope for treatment of alopecia areata ?

What is alopecia areata?

This is a disease that develops when the body attacks its own hair follicles (where hair grows from), which can cause hair loss anywhere on the body. Many people who develop alopecia areata develop a round or oval bald patch on their scalp.

The majority of patients who develop alopecia areata are otherwise healthy. They have hair loss and sometimes nail changes, but they remain in good health.

Hair loss tends to be unpredictable. Hair may regrow without treatment. This happens more often when someone has a few bald patches. When the hair regrows, it may fall out again—or it may not.

If alopecia areata affects the nails, you may see dents, ridges, or brittle nails. Some people develop red nails.

Currently, there are no approved therapies for Alopecia Areata, and many of the available treatment options lack considerable efficacy.

 

The research leading to new treatment

Because hair loss can greatly affect a person’s quality of life, researchers continue to study alopecia areata. Much of this research focuses on developing more effective treatments. This is giving new hope to patients, especially those living with widespread hair loss.

Janus kinase (JAK) inhibitors are a type of drugs which have clear science, supporting their use in alopecia areata, and an increasing number of positive studies demonstrate their efficacy in regrowing hair.

Although not yet specifically approved for alopecia areata, JAK inhibitors are already making their way into expert authored treatment algorithms for the management of this disease, especially in severe cases who have already tried other treatments.

These are the most advanced therapies in the pipeline for the treatment of Alopecia Areata patients. Hair experts see great results but hair loss reoccurs once the drug is discontinued.

Tofacitinib is one of these drugs. It has recently been approved for the treatment of psoriatic arthritis, rheumatoid arthritis, and ulcerative colitis, so it is being used by the rheumatologists.

So far it seems a safe drug, even if there are some side effects. Because this is still new, we know less about the risk of longer-term side effects than we do for other medicines.

The most common side effects are headaches and diarrhea. These aren’t usually serious and should soon pass. Feeling sick is fairly common, especially when you first start taking tofacitinib.

The other concern is the unknown risk of lymphoma.

As these drugs suppress the immune system, your doctor may decide not to prescribe this treatment if you’re pregnant, planning to try for a baby, or breastfeeding or if you have or have had:  an infection, or repeated or serious previous infections such as shingles, disease of the lungs, liver or kidneys, heart problems.
High blood pressure or high cholesterol, stomach ulcers, history of cancer.

Forecasts suggest the first approved therapy for Alopecia Areata will likely be available in 2022. In the meantime, some patients are provided with this medication as ‘off-label’ use.

If you ‘re concerned about your hair loss or hair thinning, book a consultation with a hair expert today. New developments are consistently being made within the hair loss sector.

Oral Minoxidil : New treatment for male and female baldness: new use of an old drug

What is Oral Minoxidil?

Oral Minoxidil is a drug originally used to treat high blood pressure. Interestingly, it was found out that one of the side effects of this medicine is to increase hair growth, so it was started to be used as a topical treatment in Androgenetic alopecia (baldness).

How you can use it?

Minoxidil is used with other medications to treat high blood pressure (hypertension). Lowering high blood pressure helps prevent strokes, heart attacks, and kidney problems. Minoxidil works by relaxing blood vessels so blood can flow more easily.

The use of topical minoxidil is the only approved treatment for female pattern hair loss, in other words, baldness in women and it is one of the just 2 approved treatments for male baldness.

How oral minoxidil works?

How it works is not fully understood, but it is probably due to increased blood flow to the roots of the hairs. This way it makes hair longer and thicker and it stops it from falling.

Topical minoxidil is available 2% and 5%, both as a lotion and foam, and anyone can buy it over the counter in most pharmacies. Can also be found online which could be cheaper.

Is Oral minoxidil safe?

It is considered a safe treatment, with very few, mild side effects. However several times people find that the use of topical versions could make their hair greasy, fuzzy and it is not uncommon to develop irritation of the scalp with associated itching and burning sensation.

There are also reports of patients who become allergic to it.

As a result, they stop using this topical treatment and try to find other options to stop hair loss and improve the appearance of their hair.

When can you use oral minoxidil?

There are many off-license treatment options available for baldness and based on each individual’s severity of the condition, other medical issues, as well as considering many other factors, every hair expert proposes the best options for every patient.

Oral minoxidil is a relatively new off-label treatment option. The approved indication for oral minoxidil is severe high blood pressure unresponsive to standard treatment.
In terms of side effects, it can lower the blood pressure, it can increase the fluids in the body and it can also increase the heart rate.

How to use Minoxidil

Take this medication by mouth with or without food as directed by your doctor, usually once or twice a day.

The dosage is based on your medical condition and response to treatment. Follow hair loss expert instructions carefully before you take it.

It may take several days to a couple of weeks before you get the full benefit of this drug. Tell your dermatologist if your condition does not improve or if it worsens (your blood pressure readings remain high or increase).

Does Oral minoxidil work?

Nowadays, there have been several studies over the world to support that if it is used in a very low dose in both female or male baldness, it is an efficient and safe treatment, and many hair experts have started prescribing it to their patients.

This treatment should not be used during pregnancy or in women who are trying to conceive.

When should you not use minoxidil?

Moreover, people with heart problems such as heart failure, angina, or recent heart attack, or patient with phaeochromocytoma, significant kidney problems, or acute porphyria may not be suitable for this type of treatment.

If you don’t like applying the lotion or the foam once or twice a day, if every time you use it makes your scalp itchy, if you have fed up using it, or even if you think that it does not work, then oral minoxidil might be a suitable treatment for you.

If you would like to discuss this treatment option further, or you want to see what other alternative treatments are available, book a consultation with Dr. Anastasia, an expert in hair disorders.

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