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Curly Nikki

Dr. Perry on Hair Loss

By January 27th, 20218 Comments
Our Resident MD is back, and this time she’s talking hair loss and possible solutions.


Dr. Perry on Hair LossTied up, tied down, burned with a hot iron, pulled, and pushed – I feel totally neglected. Why can’t I just be left alone? Why can’t I just be massaged with special care, set free and treated with respect and kindness? I may just break and leave this place. Better yet, I could totally drop out of sight where no one can find me.

Sound like a victim of domestic abuse? Not exactly, this may be your hair crying out for rescue.

Alopecia (hair loss) is frustrating, demoralizing and downright scary. Society puts a great deal of pressure on us to achieve and maintain a glorious mane. Unfortunately, circumstances sometimes arise which causes one to lose hair.

There are two basic categories of hair loss: Scarring and Non-scarring Alopecia. Within each category, there are multiple causes. It is possible to achieve hair regrowth in many cases of non-scarring alopecia. Scarring alopecia portends a more permanent and emotionally devastating situation, as it means that the hair follicles have been sufficiently destroyed so that regrowth is not likely. Non-scarring alopecia is more common than scarring form; therefore, my discussion will be limited to this type of hair loss. Scarring forms can be the result of extensive and prolonged destructive hair care practices, or a medical condition (i.e. lupus). The skin on the scarred area of the scalp will usually be shiny in appearance and thin in texture. A dermatologist should be consulted for diagnosis and treatment.

The most common causes of Non-scarring alopecia are:

Traction alopecia– Hair loss due to traumatic hair care practices such as braiding, twisting the hair too tight or wearing binding hairstyles frequently. This common type of hair loss is usually most prominent around the hairline. Hair is more fragile and subject to breakage in these areas. Solution: Loosen up that hair! You’d probably fall out too if you were bound down too tight. Braiding/Twisting should be done loosely. If small bumps and or pain may appear in newly styled and affected areas, the braid/twist should be immediately removed. If you’ve already been a victim of traction alopecia and are looking for regrowth, treat affected areas with gentle hair care practices. Avoid the use of drying gels and products which may irritate/ dry out the hair and scalp skin. A dermatologist may be able to assist in providing medical treatments which can encourage a better environment for hair regrowth.

Telogen Effluvium– Hair loss due to major hormonal shifts related to pregnancy, stress and major illness. This type of hair loss is frustrating because the hair tends to thin diffusely throughout the scalp. It is normal to lose up to 100 hairs per day, but this condition results in an enhanced rate of shedding causing much more hair to fall out on a daily basis. Characteristic “club hairs” can be detected among the shed hair. They have a small white bulb at the end. Fortunately, this condition resolves on its own without medical treatment. Unfortunately, it can take several months after the hormones have become regulated that adequate regrowth is noted. Solution: Be gentle with your hair and patient for resolution.

Anagen Effluvium: Hair loss as a result of chemotherapy. This is another temporary hair loss state which usually occurs in response to medications used in cancer treatments. Hair will regrow in most cases, after offending medication is stopped.

Androgenetic Alopecia (Genetics): Women can also lose hair in a specific pattern in the crown region of the scalp due to hereditary causes. Some hair follicles in this region are genetically predestined to become smaller and eventually inactive. The hair then falls out. In women with this type of hair loss, the front hairline is usually spared with balding most pronounced in the crown region. Solution: Rogaine (minoxidil) has been used successfully in some cases to achieve a bit of regrowth. Seek the advice of a dermatologist for evaluation of and treatment for this type of alopecia.

Alopecia Areata : Hair loss thought to be associated with immune factors. This type of hair loss can cause solitary bald patches on the scalp (in its mild form) to complete loss of all body hair (most severe form). Solution: Most individuals with the mild form are successful at achieving hair regrowth with the assistance of cortisone injections and/or topical prescription agents. A visit to the dermatologist would be required for these treatments.

Hair breakage: On average, hair grows a half an inch per month. The terminal length of hair (the maximum length) is genetically determined. A major key to being able to fully appreciate increasing hair length is preventing breakage. Eliminating or minimizing traumatic hair care practices (i.e. direct heat styling), and moisturizing sufficiently are the best ways to retain length. Shampooing, Conditioning regularly and deep conditioning treatments with supple moisturizing agents help maintain hair moisture. Curly hair makes it more of a challenge for natural scalp oils to effectively move down the strand. The curlier the hair, the more difficult this process becomes. Therefore, adding moisture to the strands (especially the ends), sealing and protecting them with various styling techniques can really benefit your hair. Fortunately, there are many conditioning products available. Avoid petroleum and mineral oil containing products. These ingredients occlude pores and can lead to facial breakouts.

Treat yourself to a scalp massage regularly to stimulate the hair follicles. This is very relaxing and can help improve circulation which is always a good thing for hair health!

Until next time . . .

Take care of yourself, so you can care for others. Do your best to be your best. The better you are, the brighter the world gets.

Disclaimer: This information does not serve as a substitute for individual medical care by a physician. This article is an informative guide to point you in the right direction. All product recommendations and advice are suggestions which may or may not work for your individual needs. Specific medical issues and concerns should be addressed by your health care provider. Patricia Perry, M.D. is a dermatologist in private practice in Southern California who can be reached for consultation at 2625 W. Alameda Ave., Suite 504, Burbank, CA 91505. Phone: (818)559- SKIN (7546).


  • Anonymous says:

    Thanks for the input you guys! I'm not post-partom but did have some minor surgery at the beginning of December so maybe it's related to the surgery. I didn't consider this before.

    I bought some scalpacin (sp?) and massaged it onto my scalp. That really helped. I've been natural for so long that I couldn't remember my scalp's condition before going natural – it was dry and flaky.

    I'm a deep conditioning feign and really try to take care of my hair so this is really distressing. A lot of the shedding has stopped and I'm not manipulating it very much. It's in a protective bun.

    Thanks again! I'll check out that blog too!

  • b. says:

    Anon 3:56,

    Post-partum shedding (if you just had a child) can also cause shedding. I don't recall seeing this mentioned in the article above, but that can also be a factor. Of course, I don't know if you've had a child recently or not, but maybe this info will help someone. (Google it or go onto Naturally Fabulous's blog for more info)

  • Anonymous says:

    Have you been deep conditioning weekly for at least the month PRIOR to your recent direct heat experience? Have you had any other major stressors on your physical or mental health? Have you ever previously had a history of dandruff or problems with a scaly scalp?

    An antiseborrheic shampoo ( like Nizoral AD or Neurtogena T-Gel ) left on for 10 min. on the areas on your scalp where the scaling is occurring followed by a DT on the hairstrands may help. Try and style with INDIRECT heat (i.e. under a bonnet hairdryer WITH a thin scarf/do-rag tied over the rollers/twists/rods/braids) while sitting under dryer (on med heat setting) and do not follow with direct heat (flatiron, maxiglide, etc). DT weekly throughout the winter months.
    Good luck!

  • NappySince10/01/08 says:

    This comment has been removed by the author.

  • Anonymous says:

    Hi there,

    Great information. I've never posted on this site but enjoy reading what you all have to say. Sometimes I avoid this site b/c I'm a serious product junkie and reading this site sends me straight to the store for more products! Here's what's prompted my post:
    Recently,I've been experiencing hair loss. I've been natural for 3 years and have never used heat on my hair until 2 or 3 weeks ago. I roller set my hair, sat under a bonnet dryer, and ran the chi iron through it on medium heat. I feel guilty for straightening it(silly, I know) but the weather's been cold and my hair takes too long to air dry (it's pretty thick and long). Well ever since I've worn my hair this way, my hair's been shedding like crazy and my scalp had white flaky patches. Keep in mind that my hair is not breaking off, it's shedding from the scalp and I haven't put any additional heat on my hair. Does anyone have any ideas as to why this is happening? Could my scalp be in shock?

  • Unknown says:

    This is a good article all about hair problems.I am very conscious for my hair but sometimes I can't get time to maintain my hair.You have given very useful information and I will try to follow your suggestions.Thank you very much..


  • NappySince10/01/08 says:

    great article. Im trying to get my hairline back as we speak. It is frustrating and can be so depressing sometimes.

  • Anonymous says:

    Great info. Thx!

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