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Hair-retention Arc Restore Syp to her hairy glory, Patient history,…
Hair-retention Arc
Restore Syp to her hairy glory
Patient history
Hormonal problems (any history of pills, surgeries, previous problems, period problems, be it cycle disruption or intensity of the menses, or even contraceptive pills thyroid problems)
when did the shedding start?
how do we describe the shedding rate? slow and constant, fast and sudden
timing, can the shedding be pinpointed in time, when did it start, are there any factors around the time it started or a bit before it
any noticeable change of habits, from shampoo to other products, bleaching frequency, nature of the water they shower with
iron deficiency/ anemia
any other effects on the nails?
history of stress ore remarkable events/illnesses
where have you noticed the most hair loss?
normal hair care routine?
things to do
Iron wise
Nonanimal foods that are high in iron include nuts, seeds, legumes, bean products, raisins, dark green leafy vegetables, whole grains, and iron fortified cereals
very light daily combing
lighter blow-drying with lower heat if option is available
Implement foods that are enriched with nutrients for hair include eggs, dairy, omega-3 fatty acids, nuts, spinach, sweet potatoes, avocados, berries, olive oil, red meats..
Consider a multi-vitamin
Ultimately professionally get the scalp checked for the redness
Cystine B6
Lab tests
Iron deficiency (ferritin)
● Thyroid dysfunction (TSH, T3, T4)
● Stage II syphilis (TPPA test).
Thyroid stimulating hormone
Ferritin
Testosterone
Prolactin
Dehydroepiandrosterone sulfate (DHEAS) to rule out hyperandrogen
Nutrition
caloric deficiencies that are not planned, of less than 1000 Kcal/day
protein: notably L-cystine, an amino-acid important for the healthy cycle of hair turn over, especially known to be related to TE if deficient, otherwise, L-lysine affects the quality of the scalp and the body of each hair keratin wise, it also lowers the retention of iron in the body, its deficiency is caused by low red meat intake
Vitamins: vit C for collagen and keratin production (quality wise), vit H or Biotin is rare but can be recognized because it also affects the nails and eyebrows (thinning and fragile state), vit b12 which causes lower hair quality less shining and less overall colour (usually for vegetarians), vit B3 essential for the energy production in each follicle regular intake is of 14mg/d, Vit D plays a role in hair follicle cycling and hair disorders, could potentially be used as a treatment option to stimulate hair growth if a deff is suspect
Minerals: zinc deff can cause TE on it's own, we should be getting 8 to 10 mg per day
Essential fatty acids: Linoleic acid and alpha-linoleic acid, usually seen in patients who avoid healthy fat sources as well as bad ones (Omega6 and omega 3 from red meat, vegetables and fish oil
Notably, vit A and E excess can also cause aggressive and handful-like hair loss
things to avoid
styling the hair too tightly
multiple hair wash
Tea and coffee directly after food
being aware of sun heat on the head on extra sunny days
being aware of passive smoking or car emissions that might get stuck on the hair and carried on
being aware of gym water or where the head rests at the gym
clinical tests
check for redness, scalp irritation, burning, flaking, could indicate dermatitis or other conditions tbd
Photos of the current state to be used for future comparison
Hair pull-test: The hair pull test is an examination technique that crudely assesses active hair shedding. It involves grasping 50–60 strands of hairs by thumb, index and middle fingers and gently sliding the fingers along the hair shafts. If more than 10% of grouped hairs are pulled out then the test is positive.
picture from the top, showing the scalp where the hairstyle split is usually made, looking for a medial bald spot
check if the hairline is receding
TE
hormonal factors
nutritional factors
systemic illness
stress (cortisol leads to early catagen phase)
diagnosis
patient history
clinical tests
lab tests
Systemic check
Systemic
Deficiency: vit b12, vit D, iron, vit C, vit b6 mostly
Anti-hypertensives, statins, anti-psychotropic agents, and antivirals. Conditions such as as Treponema palladium infection, malignancy, iron deficiency, hyper/as Treponema palladium infection, malignancy, iron deficiency, hyper/
Hirsutism is where women have thick, dark hair on their face, neck, chest, tummy, lower back, buttocks or thighs. Commonly scene as an indicator of alopecia caused by sex hormones
When the hair loss is genetic in origin, it is caused by a single version of an autosomal dominant gene. It varies when the effects kick in but for women it is usually delayed or even masked, based on how healthy their body is overall. As for appearance, it shows mostly as a receding hairline in both the frontal and temporal areas.
3 categories
The hair shaft: damage to the hair follicle or the body of each hair itself, as it is made of protein keratin and protected by sulfur crosslinks, more heat and bleach applied causes a disruption of the sulfur chain which leads to thinning of the hair and broken hair tipps can be seen.
treated usually by stopping the cause of it all and constant use of conditioner and other hair-nutrients and recovery takes 2 or more years.
Sometimes called androgenic alopecia, disorders affecting the hair follicle (FPHL: female pattern hair loss) basically testo transformed faster into DHT by 5 alpha-reductase.. which has more affinity for the androgen receptor .. so gradual thinning of hair follicle. Hyperandrogenic state is equally bad as a hypoandrogenic one, whereas one makes the hair fall at a faster rate and the latter makes it grow at a slower rate, or not at all
Disturbances of the hair cycle.. Telogen effuvium (TE): normally the hair on the scalp is majorly in the anagen or growth phase, and a small percentage is in the resting or telogen phase which are to be sheded daily.. 100 to 200 hair shed daily is normal. when the hair cycle is disturbed, more hair in the resting phase, as in, about to be shed, will be present on the head to suddenly be shed in a handful. It is usually temporary and it reverses itself over time when the causal factors subside.
FPHL treatment
2% (solution form) to 5% (foam form) minoxidil ( brand rogaine) solution applied once daily for 6 weeks or up to 12 months, or with combination with spironolactone (androgen receptor antagonists usually local)
oral finasteride 1mg/d (never mind it is for men only, too many side effects for women)
oral aldactone, androgen receptor antagonist
nutrient-rich treatment
nutraceuticals: botanicals with antioxidant, anti-inflammatory and growth promoting properties, they target multiple hair loss trigers
PRP(platelet rich plasma)
LLLT (laser)
Nutrafol women's capsules
anti-inflammatory aspect, stress adaptogenic, antioxidant and DHT inhibiting properties
study subjects took 4 tablets around the same time every day, either after or with their meals
also has vitamins and minerals such as E and C
Pantogar
L-cystine, medicinal yeast, pantothenic acid complex-based dietary supplement
L-cystine supplements were used first on sheep to make them wool more in 1960, then thought of for humans
1 pill 3 times daily with meals for 6 months
Dermatologic conditions
vitiligo, psoriasis, atopic dermatitis
polycystic ovarian syndrom is associated with acne and FPHL
Red patch, scalp redness
Seborrheic dermatitis:
redness on the scalp with oily hair and usually accompanied by dandruff, sometimes itchy, could also appear on other hair like eyebrows
Chemical irritation TBD (pool water, chlorotic bath water, shampoo, too much conditioner not fully washed, bleaching, allergy, bad combing, bad combs/brushes, too hot of a blow-dry, too hot ironing)
Etiology
where are the patches
when did you notice them
are they related to any other patterns or findings elsewhere
are there white outlines on the sides?
itchy? oily? hair loss around it?
Viviscal extra strength
oral protein supplement or MPS ( marine protein supplement)
subjects took 1 pill twice daily in the morning and evening following a meal
quick physiology
During the growth (anagen) phase, which is 2–6 years long, a hair grows at a rate of about 0.3 mm per day, or 1 cm per month. The maximum attainable hair length depends on the duration of the anagen phase.
A brief transitional (catagen) phase follows.
And then arrest (telogen) phase lasting 2–4 months, after which the hair falls out
Kenogen, latent phase where the follicle is preparing itself for the next cycle
in pathophysiological cases
Anagen is reduced, telogen is elongated, so the same hair lasts for shorter time and it sheds quicker, resulting in brief periods where the head seems full and the volume looks satisfying
Cystine b6
A dietary supplement which combines L-Cystine, Vitamin B6, Zinc and Arginine. L-Cystine is a sulfur-containing amino acid and is one of the essential components of the bristles (18%) and the nails (14%). L-Cystine contributes to the synthesis of keratin of the hair and nails. It accelerates the propagation of the keratin cells and affects the growth of hair and nails positive. Vitamin B6 is essential for the use of L-cystine.
different posology (4 tablets a day with meals preferably,
December, covid multiple fever, colds, no nail problem, dark hai, testo high maybe, no iron def, stress last year
Shampoo ordered to counteract potential dermatitis()
Full blood test with kindey filtration rate, iron levels vit levels minerals and testo levels