Archives for: February 2010
Diffuse hair loss and its treatment
February 12th, 2010Exerpter from:
Cleve Clin J Med. 2009;76:361
Diffuse hair loss: its triggers and management.
Harrison S, Bergfeld W.
TRIGGERS OF DIFFUSE TELOGEN HAIR LOSS
Triggers of telogen effluvium are numerous
Physiologic stress
Physiologic stress such as surgical trauma high fever chronic systemic illness and hemorrhage11 are well known to cause telogen effluvium 2 to 3 months after the insult. Telogen hair shedding can be experienced 2 to 4 months after childbirth (telogen gravidarum)
Emotional stress
The relationship between emotional stress and hair loss is difficult to ascertain, and hair loss itself is stressful to the patient. Historically, acute reversible hair loss occurring with great stress has been reported. However, the relationship between chronic diffuse hair loss and psychological stress is controversial. Evidence for this association appears to be weak, as everyday stresses are likely not enough to trigger hair loss.
Medical conditions
Both hypothyroidism and hyperthyroidism can cause diffuse telogen hair loss that is usually reversible once the euthyroid state is restored. Chronic systemic disorders such as systemic amyloidosis, hepatic failure, chronic renal failure, inflammatory bowel disease, and lymphoproliferative disorders2 can cause telogen hair shedding. Telogen hair loss has also been reported in autoimmune diseases such as systemic lupus erythematosus and dermatomyositis, as well as in chronic infections such as human immunodeficiency virus type 19 and secondary syphilis.11 Inflammatory disorders such as psoriasis, seborrheic dermatitis, and allergic contact dermatitis can all cause diffuse telogen hair loss.
Dietary triggers
Nutritional causes of diffuse telogen hair loss are zinc deficiency and iron deficiency. Severe protein, fatty acid and caloric restriction with chronic starvation and crash dieting can also induce diffuse telogen hair loss. Malabsorption syndromes and pancreatic disease can precipitate telogen hair shedding. Essential fatty acid deficiency can also be associated with diffuse telogen hair shedding usually 2 to 4 months after inadequate intake. Vitamin D is an essential vitamin in cell growth, and vitamin D deficiency may be associated with diffuse hair loss. Biotin deficiency can result in alopecia, but this is a very rare cause of hair loss.