Hair extensions and traction alopecia

Hair extensions are a popular product used to create extra hair length or volume. They may be made of human hair (up to 250 hairs) or artificial hair. There are several types that are attached to the original hair in different ways. These include clip-ins, weaves (sewn to a braided corn row), pre-bonded with adhesive (attached with heat), tape, and micro-link (attached with metal rings). Hair extensions may cause stress and pulling on the natural hair by creating friction during sleep and by adding weight when the hair is wet. Constant pulling of the hair from extensions can create traction alopecia (hair loss). This may also happen from constant tension with tight ponytails, braids, corn rows, buns, head pieces, and head coverings.^1,2 The tension may pull the hair out at the roots completely or create inflammation of the hair follicles which causes them to weaken and stop producing hair. Traction alopecia is evident when the pattern of hair loss is in the same pattern as the source of the tension.

Prevention

Many people wearing hair extensions may not be aware that they have traction alopecia.³ There is a reversible phase when removing the cause of the tension may allow hair to return to normal. If hair does not return to normal within 6-9 months after removing the source of the problem, hair loss may be permanent. If hair loss is permanent, hair transplantation may be used to restore living hair to the areas. In order to prevent traction alopecia, hair extensions should be fitted by a trained professional. Extensions should also be removed as often as possible; clip-ins removed before bed may help prevent hair loss compared to other types of extensions. If you think you may have traction alopecia, please contact your dermatologist.

Article by: M.A. MacLeod, MSc., Mediprobe Research Inc.

References

1. Ahdout J, Mirmirani P. Weft hair extensions causing a distinctive horseshoe pattern of traction alopecia. J Am Acad Dermatol. 2012;67(6):e294-e295. doi:10.1016/j.jaad.2012.07.020.
2. Khumalo NP, Jessop S, Gumedze F, Ehrlich R. Hairdressing and the prevalence of scalp disease in African adults. Br J Dermatol. 2007;157(5):981-988. doi:10.1111/j.1365-2133.2007.08146.x.
3. Yang A, Iorizzo M, Vincenzi C, Tosti A. Hair extensions: a concerning cause of hair disorders. Br J Dermatol. 2009;160(1):207-209. doi:10.1111/j.1365-2133.2008.08924.x.

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Top Options for Treating Hair Loss

Medication

There are currently two FDA approved hair loss therapies on the market:

Minoxidil – available as a topical foam or solution shown to  promote hair growth (1) and can be used by both men and women.

Finasteride – an oral medication for men over the age of 18 that has been shown to increase hair counts (2). Documented side-effects of finasteride include erectile dysfunction, diminished libido and reduced ejaculation however they have been reported by only a small percentage of patients (3).

Transplant

A widely used technique whereby hair follicles are harvested from the back of the scalp and positioned in areas of hair loss, resulting in natural-looking hair growth (4). Innovations in transplant technology allow the donor area to remain virtually undetectable. Options are now available to individualize the procedure to patient’s needs including the strip method and the follicle unit extraction method.

Hair Concealers

A variety of concealing products are available as an alternative to medication or surgery. As the name suggests, these products will not restore hair loss but can conceal it effectively. Hair thickening fibers for instance are microscopic hair fibers which can be sprinkled onto target areas to cover hair thinning and loss. A great benefit to hair thickening fibers is their resistance to water, sweat and adverse weather but still wash out with normal shampooing. They can also be used in addition to medication.

Article by: Dr. J.L. Carviel, Mediprobe Research Inc.

References

1. Gupta AK, Charrette A. Topical Minoxidil: Systematic Review and Meta-Analysis of Its Efficacy in Androgenetic Alopecia. Skinmed. 2015 Jun;13(3):185–9.
2. Gupta AK, Charrette A. The efficacy and safety of 5α-reductase inhibitors in androgenetic alopecia: a network meta-analysis and benefit-risk assessment of finasteride and dutasteride. J Dermatol Treat. 2014 Apr;25(2):156–61.
3. Perez-Mora N, Velasco C, Bermüdez F. Oral Finasteride Presents With Sexual-Unrelated Withdrawal in Long-Term Treated Androgenic Alopecia in Men. Skinmed. 2015 Jun;13(3):179–83.
4. Gho CG, Neumann HAM. Advances in Hair Transplantation: Longitudinal Partial Follicular Unit Transplantation. Curr Probl Dermatol. 2015 Feb;47:150–7.

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The Essentials of Female Hair Loss

Of recent popular discussion has been the suggestion that essential amino acids can be used to either prevent, or correct hair loss. Thus if you are looking for a natural and un-invasive remedy, essential amino acids might sound like the perfect plan. But is this treatment effective and how does it work?

Firstly, amino acids are the individual components which join together to create protein, including the protein found in hair. Our bodies are able to synthesize many of the amino acids required for our proteins but not all. The rest are supplied through diet and are referred to as the essential amino acids. Therefore it might make sense to assume that consuming more essential amino acids should equal more hair. Moreover, nutritional status has been correlated with hair loss, however in most cases adequate levels of essential amino acids are obtained through diet without the need for supplements (1). As has been discussed previously in this blog, there are many reasons for hair loss but poor nutrition on its own does not seem to be a common diagnosis. Although there does seem to be at least one documented exception.

An increased intake of the essential amino acid lysine in combination with iron has been shown to be effective for women specifically (2–4). A clinical study reported that over 70% of women noticing increased hair loss were also low in iron (2). Furthermore, menstruating women have a greater need for increased daily iron (1).

Overall, a diet that contains a moderate amount of the essential amino acid lysine as well as iron may improve hair loss in women. Try some lysine-rich choices including meat, fish and eggs as one step in maintaining your quality of hair.

Article by: Dr. J.L. Carviel, Mediprobe Research Inc.

References

1. Rushton DH. Nutritional factors and hair loss. Clin Exp Dermatol. 2002 Jul;27(5):396–404.
2. Rushton DH, Ramsay ID, James KC, Norris MJ, Gilkes JJ. Biochemical and trichological characterization of diffuse alopecia in women. Br J Dermatol. 1990 Aug;123(2):187–97.
3. Kantor J, Kessler LJ, Brooks DG, Cotsarelis G. Decreased serum ferritin is associated with alopecia in women. J Invest Dermatol. 2003 Nov;121(5):985–8.
4. Rushton DH, Norris MJ, Dover R, Busuttil N. Causes of hair loss and the developments in hair rejuvenation. Int J Cosmet Sci. 2002 Feb;24(1):17–23.

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