Hair Loss Series Review Modules 1- 3

1. Hair Loss Series Review Modules 1- 3

2. Module Review Index • Module 1-3 Review: • Hair Anatomy • Overview: What causes hair loss • Types of Hair loss • Client Fact Finding Sources: • National Alopecia Areata Foundation • Medline Plus – NLM and NIH • E-medicine • Hair Club

3. What is the difference between the hair follicle and hair shaft? Hair follicle : Determines the characteristics of the hair (Alive) Sac of skin tissue buried deep in the scalp with a bulb at the bottom Sebaceous gland is attached to the follicle and gives hair its shine by producing sebum oils Capillaries supply nutrients to the follicle Hair shaft: Hair that is seen above the scalp (Dead) Hair that is seen above scalp- These are the dead cells that turned into keratins Why is some hair curly and some straight? The way the bundles of keratin are arranged in the hair shaft Position of the bulb in the hair follicle Shape of hair follicle – it may be curved or straight Irregular growth in the hair bulb All hair twists as it grows. Usually the more twists, the curlier the hair. African hair can twist 12 times as much as Caucausoid and is usually more vulnerable to chemical or physical damage because of its structure. Coiled hair (extremely curly hair) has a lower elasticity and breaks easily Module Review Hair Anatomy Is conditioning really that important? YES! • Slows down the natural weathering and wearing down of the cortex • Dry hair lacks moisture, and moisture must be restored to regain the healthy look • Lack of moisture means the number of hydrogen bonds may be reduced • Conditioning re-establishes the hydrogen bonds and improves the moisture content of the hair by improving the weatherproofing of the cuticle

4. What are the 2 types of hair found on the body? Terminal and Vellus What are the 3 types of hair? Asian,Caucasoid, African What are the 3 layers of the hair shaft? Medulla: Inner most core of the hair where strength is determined Cortex: Middle and largest layer. Determines color, texture and elasticity Cuticle: Protects hair from the environment by forming a tightly packed layer of scales that overlap What are the 3 phases of hair growth and how long do they last? Anagen: Hair is actively manufacturing new keratinized cells Growth phase (lasts 2 -3 yrs) Represents 90% of the hair on the head Catagen: The follicle canal shrinks and detaches from the dermal papilla. Hair bulb disappears and root end forms a rounded club Transitional phase (2-3 weeks) Hair stops growing Represents less than 1% of hair Telogen: Resting phase: (3-4 months) No growth Represents about 10% of scalp hair Module Review Hair Anatomy

5. What Causes Hair Loss? Genetics: Inherited from either the mother or the father The dominant trait can skip generations and siblings Hormones: Testosterone combines with an enzyme called 5-alpha reductase 5-alpha reductase mediates the metabolism of testosterone to DHT (dihydrotestosterone) DHT attacks and shrinks the papilla creating thin looking hair and eventually hair loss Hormone medication can create hair loss and thin hair Age: Most men and women will lose their original density as they grow older Child Birth: Women will experience hair loss while going through a pregnancy Often times the hair will not return at the same density level as before the pregnancy Stress: Mental and/or physical Bodies under stress produce increased levels of hormones Exogneous male hormone intake STIMULATES 5-alpha reductase, creating or forming excess DHT Steroid/Drug use: Drugs create stress both physical and mental Drugs affect hormones and nutritional balance Both can trigger hair loss Diet/Vitamins: Fast foods (high in animal fat) create poor nutrition, rapid weight loss and hair loss Iron (avoid low levels) is found in eggs, red meat, raisins and celery Zinc (avoid low levels) balances Copper and enhances immune function Copper (avoid extreme low and extreme high levels) balances Zinc and stimulates function in hair growth cells. Copper is found in chocolate Protein (avoid low levels) is found in eggs, chicken, red meat and fish Module Review Overview

6. How is DHT formed? An enzyme called 5-alpha reductase mediates the conversion of testosterone to DHT. So, what actually happens to the hair? If you are genetically predisposed, the anagen phase gradually becomes briefer and briefer, and eventually the hair becomes finer and shorter, and less deeply colored (the hair is miniaturized). Also, the ratio between hairs in the anagen phase and those in the telogen (resting) phase is increased. More hairs are in the telogen phase. What are androgens? Androgens are male hormones and genetics are the traits that we inherit from our families. Androgens are produced by the testicles and adrenal glands in men. How does Minoxidil work? Keeps hair in the growing phase (anagen) for a longer period of time How does Propecia work? Active ingredient: Finasteride Used to block the formation of DHT by blocking 5 alpha reductase The first and only FDA approved pill proven to treat male pattern hair loss on the crown and central mid-scalp in men. What is donor dominance? Donor Dominance –The term Donor Dominance means that the hair follicles taken from the donor region will survive and thrive in an area that is affected by genetic alopecia. These "donor" follicles are genetically programmed never to be lost !! Module Review Overview

7. Diffuse Hair Loss What is the difference between anagen effluvium and telogen effluvium? Telogen Effluvium- Triggered when a physiologic stress or hormonal change causes a large number of hairs to enter telogen phase at one time. Early and excessive loss of normal club hairs from normal resting follicles in the scalp Anagen Effluvium: Process where the “stressor” (physical, emotional, hormonal or medicinal) causes an interruption in the growth cycle while the hair is still in the Anagen phase. What are some common signs of hormonal imbalance? Often the signs and symptoms of a hormonal imbalance are obvious such as stunted body growth, sudden and excessive weight loss or gain, or a strong thirst. However, a slight imbalance may be reflected in the hair. It would be noticeable in the loss of texture, the lack of growth and even hair fall. If this is detected in its early stage, it may save the client serious problems later on. Module Review Types of Hair Loss 2 types of hair loss that are reversible: • Telogen Effluvium • Anagen Effluvium

8. What causes alopecia areata? Autoimmune disorder, which means the body’s normal immune system suddenly recognizes certain types of cells as foreign. The white blood cells are reacting to the other cells in the hair and skin. A biopsy will usually show large numbers of white blood cells have migrated in to the hair-beading areas and appear to attack the follicles. What treatment options are available to someone with alopecia areata? Treatment options where less than 50 percent scalp hair is lost? EXT with 5% Minoxidil: If scalp hair regrows completely, treatment can be stopped. 2 % minoxidil solution alone is not effective in alopecia areata- cortisone cream can be applied 30 minutes after the minoxidil. Cortisone injections: Doctor gives cortisone injections into the bare skin patches. Injections are repeated once a month. If new hair growth occurs, it is usually visible within four weeks. Treatment does not prevent new patches from developing. Treatment options for greater than 50 percent hair is lost? Bio-matrix What questions can you ask someone with Trichotillomania? Many people with Trichotillomania avoid having anyone else get close to their hair or faces. Many do not want to talk about the fact that they pull their hair, and will sometimes make up stories to explain the bald spots: “I wore my barrette too tightly.” “It fell out due to stress.” Not everyone with trich is ashamed about it. But it is important to know that, for some people, the embarrassment is intense. Most important is for the person with Trichotillomania to not feel judged, gawked at or viewed differently. Module Review Types of Hair Loss

9. Traction Alopecia: Areas that have been subjected to enough tension to pull out the hair- Braiding, weaves, backcombing. Excessive tension leads to breakage in the outermost hairs. What are the 2 types of traction alopecia? Marginal alopecia(Alopecia linearis frontalis)- Hair-loss pattern that usually results from the use of tight curlers, rollers, or straighteners during childhood. Hair loss mostly in temporal region due to constant contraction of the muscles used in facial expression and tension caused by braiding. Non-marginal (Chignon alopecia) - Hair loss in the occipital scalp region where the bun rests. People who have a history of pulling their hair into a bun. The typical patient is a 40-year-old woman who initially complains of itching and dandruff localized to the occipital area What causes lupus? Unknown, but it is likely to be a combination of factors Person’s genetic make-up and exposure to certain trigger factors may provide the right environment for lupus to develop: ultraviolet light, some prescription drugs and antibiotics, infections or viruses, hormones and stress. People can inherit something from their parents that predispose them to develop Lupus Module Review Types of Hair Loss

10. What you should know about your client: Hair Type and implications for having different types of hair Salon habits of your client How often is he/she visiting a salon? Why types of services? Hair Cut, chemical treatments, other Hair Care Habits at home Products How often shampooing and conditioning hair? Is he/she doing something to contribute to hair loss? Heat, tight braids, chemical damage? Has the client ever seen a physician regarding hair loss If yes, what type of hair loss has been diagnosed? (Reminder: Unless you are a doctor, you can never diagnose an individual’s type of hair loss) Has client been influenced by types of stressors Chemotherapy Pregnancy Steroid use Stress Autoimmune Disorders Previous hair loss treatments: What has he tried in the past? What is he currently using? Client expectations: (use Norwood rating and brochure as visual tools) How much hair does he require? Timing? Is he looking to prevent future hair loss? Is he looking for more hair? Module Review Client Fact Finding