Hair loss is a health problem understimated in its devastating effects by many. Health care professionals can fall into this category. The perceptions is that there is little that can be done and that it is not a real health problem. Women in particular seem often to be dismissed and told their problem is due to stress. Stress is a wonderful catch-all - it suddenly becomes the patients problem and only they can change it. It allows the doctor to get the patient out of their office, and maybe never to come back. There is no published research to support the view that stress, as in the trials of everyday life is a causative factor in hair loss. You might like to ask are all fighter pilots bald...it must be a stressful job, I am sure you can think of other examples. Stress is too often a substitute for the words I don't know. Stress, as in physiological stress e.g. following physical or severe emotional trauma or surgery may cause temporary hair loss. There is also some anecdotal evidence to suggest that traumatic life events can be linked to the onset of a specific type of hair loss, alopecia areata. However, it is not always the case, people can simply wake up one day and find they have a bald patch. Because this, in itself, is traumatic many people will try to assign some recent life event as the cause of the problem. This association will often be wrong but in our society these things develop into modern myths, and sadly in this case are often cultivated by those who should know better.
One of the most interesting features of hair is its cyclic activity.
In many animals hair growth is seasonal, with regular moults. In the animal kingdom it is of crucial importance to get the moulting right. There is evidence of seasonal shedding in humans but it is a relatively weak change in hair growth. Human hair follicles are generally independent of each other, in terms of their position in the growth cycle. As you may expect we shed more hair in the spring and less in the autumn.
There are usually thought to be three types of hair:
|Lanugo||In utero||Fine, up to several cm long, shed in utero or post partum|
|Vellus||all over the body||Short fine hairs, usually sparse, at puberty some convert to terminal hairs|
|Terminal hairs||Scalp, axilla, pubic, beard||Long, thicker hairs, pigmented|
The deciding line between a vellus and a terminal hair can be a bit vague but efforts have been made to define them more closely.
All hairs have three basic phases of growth Anagen- the growing phase where hair fibre is being synthesised. In humans it is approximately 1000 days long but has wide variations and is genetically determined.
Catagen- a short transit phase where fibre elongation stops and the follicle diminishes in size.
Telogen- a resting phase where the fibre may be lost, typically 100 days. After this time the hair re-enters anagen. The new hair may push out the old one from the previous cycle or they might share a follicle opening until some physical trauma pulls out the fibre. As the Anagen Telogen (A/T) ratio is 1000/100 and an average head might have 100,000 hairs it can be estimated that about 100 hairs will be shed a day under normal conditions, there will be wide variations in this though. Little is known concerning the transition from one part of the cycle to another. The production of a new anagen hair is highly reminiscent of an embryonic type induction and it is difficult to think of any other biological phenomenon like this in an adult.
This is governed by two major factors; the rate of linear growth and the duration of anagen. Typically a fibre might grow at 0.3mm/day. The anagen duration is determined genetically. This explains why the complaint is often heard that an individual "can't grow their hair long" or that someone else has longer hair but "I haven't had mine cut for ages and it just doesn't grow". The hair will grow for the number of days allowed for genetically and then stop, it is not a never ending fibre in humans (unlike sheep!). Blame your genes. Little if anything is known about this process.
A complex process involving several pigments, which I don't know enough about to pontificate. So instead I'll distract you with cute picture showing what can go wrong! However, grey hair doesn't exist. Well, that is not strictly true either. What is seen as grey hair is often a mixture of pigmented and non-pigmented (usually white) hairs, the combined effect is an overall greying. Take a close look, it is very clear once you are aware of it.
Can you "go grey overnight"
Yes, probably. Alopecia areata is a disease affecting the hair follicle, which causes bald patches or even total loss of body hair. In some individuals non-pigmented hairs are not affected or not as badly affected. Someone with Alopecia areata with rapid onset will selectively shed their pigmented hairs, the white hairs remain. Hence the person goes "grey" overnight. There is anecdotal evidence for this but little documented, by its very nature, such an event would be difficult to record. However, dermatologists have seen patients complaining of hair loss one week and then turning up with white (sparse) hair a week later. There is no evidence that a shock or trauma can have this effect.
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