Hair loss treatment

Dandruff can be best described as excessive shedding of dead cells from the scalp. Shedding of dead cells from the scalp is normal as long as it is not excessive. It is part of the regular process of cell renewal. The cells form in lower skin levels and are gradually pushed upwards by the new, growing cells that form underneath. By the time the cells reach the skin surface, they have died and become flat and they overlap each other like roof tiles and are ready to depart the scalp. In a normal, healthy scalp, the dead cells leave the surface unnoticeably. With dandruff, the whole process is accelerated and a larger number of dead cells are shed, forming big clumps that are visible to the naked eye. Dandruff is a common condition and some estimates say that it affects up to 50% of the population at some point in their lives.

There are three main causes and types of dandruff and each one of them should be treated differently. Some people mistake dandruff for dry scalp and start shampooing their hair less frequently, which, in the case of dandruff, leads to a worsening of their condition. The most common cause of dandruff is the overgrowth of a fungus that normally lives in our scalp called malassezia. This fungus feeds on the natural grease in the scalp, converting it into oleic acid. The reasons for the sudden overgrowth of this fungus are not yet known. 

Seborrhoeic dermatitis leads to a more severe form of dandruff than malassezia, causing greasy bran-like scale. Seborrhoeic dermatitis is usually accompanied by skin inflammation that, besides the scalp, also affects the eyebrows, the skin around your nose, ears and the lines on your cheeks, forehead and armpits. In moderate climates this condition typically improves in summer as direct sunlight relieves its symptoms. Cradle cap, however frightening it may look, is a mild form of seborrhoeic dermatitis affecting only infants and it clears itself by the time the baby turns one year old.

Psoriasis is the third known cause of dandruff, leading to its most serious form. It causes itchiness and inflammation of the skin and produces thick, silvery scales which occur most often in the scalp, knees and lower back. Psoriasis results in rapid shedding of the skin and, if this shedding occurs from the scalp, it is known as dandruff. This condition affects about 2% of the population and like the two aforementioned forms of dandruff, it is not contagious. An excessively oily scalp, autoimmune disorders, hormonal imbalances, elevated scalp sensitivity, extreme stress, heart problems, etc. are often associated with an increased occurrence of all forms of dandruff. It has also been observed that some cases of dandruff are triggered by chemicals contained in hair care treatments. However, the exact cause of any of the aforementioned dandruff-triggering conditions is not known.

When it comes to dandruff treatment options, for a start it sometimes helps to wash your hair more often and use a mild shampoo. In more severe cases it is advisable to try some of the special anti-dandruff shampoos freely available in pharmacies. For yet more severe conditions you may need to ask your doctor to prescribe you a prescription strength shampoo, which typically contains the same active ingredients as OTC products but in a higher concentration. The active substances used in anti-dandruff shampoos can include any of the following: coal tar, salicylic acid, zinc pyrithione, selenium sulphide, sulphur, ketoconazole, corticosteroids and caffeine. Each one of them addresses the problem from a different angle. For the most serious conditions, corticosteroid and anthralin treatments will most likely be prescribed by your doctor.

Alopecia areata is well known as an unpredictable hair disease affecting about 2% of the world’s population and it happens to be the second most common type of hair loss after male and female pattern baldness. It is often called patch baldness or spot baldness due to its patchy, balding pattern. In severe cases, it can affect the whole scalp (alopecia totalis) or the whole body (alopecia universalis). It is not yet known what causes alopecia areata. It is thought to be an autoimmune condition triggered by a person’s autoimmune system, which decides to attack its own hair follicles. Sometimes the hair grows back a few years later and stays and sometimes it falls out again. Although there is no ultimate cure for alopecia areata, some treatments have been proven to improve this condition. The most popular treatment option, which does not require a doctor’s prescription, is topical minoxidil, such as Rogaine. It can be used alone or in combination with other medicinal treatments that will be discussed later.

The most common amongst prescription treatments used for alopecia areata are corticosteroid shots, injected straight into the bald spot, and steroid gels and creams. Corticosteroid injections are said to be a more effective but also the more painful option of the two. The aim of this approach is to suppress the autoimmune reaction but it has been proven to work only on small bald spots. Another common treatment for small bald patches, which is also thought to affect the autoimmune reaction, is the application of topical anthralin. Anthralin is a tar-like substance used to treat psoriasis.

Topical immunotherapy is the most common form of treatment for extensive alopecia areata. It relies on an immunosuppressant such as cyclosporine that is applied to the skin to cause a skin reaction similar to mild eczema, which in some cases leads to hair re-growth. This method is also the most radical form of treatment, causing an array of negative side effects.

Another treatment applied for extensive alopecia areata is PUVA, which stands for "psoralen plus ultraviolet A radiation", consisting of a topical or oral application of psoralen, followed by ultraviolet radiation. This method is better tolerated than topical immunotherapy but it is also less effective.

A recently conducted research study with sulfasalazine also spells some promise for patients with severe cases of alopecia areata. Sulfasalazine is an anti-inflammatory medication first used to treat rheumatoid arthritis and is hoped to be soon used to treat alopecia areata.

This is the list of the most commonly prescribed medicinal treatments for alopecia areata. There obviously is an array of other alternative therapies that are claimed to improve this condition and do not require a doctor’s visit. Consumers should be aware that none of such products has ever been clinically shown to be effective in treating alopecia areata and such claims are possible only because these products are not regulated pharmaceuticals but non-regulated cosmetics.