Diffuse Hair Loss, the hair on the whole head becomes evenly “thinner”. Do not forget to give your opinion on our article about Diffuse Hair Loss. Read here what can be behind it.
Diffuse hair loss: Thin hair
If the hair on the whole head becomes evenly “thinner”, that is, no longer as dense as before, there is a Diffuse Hair Loss. The scalp shimmers through more strongly than was the case in the past. However, individual bald spots are not recognizable.
Two main forms of diffuse hair loss
Diffuse Hair Loss, In one form, hair loss usually begins two to three months after the damaging event or after the onset of the disease – due to the increased entry of the hair into the resting or loss phase (also called the telogen phase, then referred to as telogen effluvium). After turning off the trigger, hair loss comes to a standstill. It usually takes six to twelve months for the hair to grow back fully. This affects most causes.
Less commonly, telogenic hair loss lasts for more than four to six months and can also recur. The causes are unclear here.
!Info: In principle, sufferers are all age groups, women more often than men.
In the other, quite an acute form, the hair falls out already in the growth phase (anagen phase, anagen effluvium). Then, after one to two weeks from the time of damage, rapid hair loss can occur, as is the case with some chemotherapy, radiation treatments, or even severe poisoning with heavy metals.
Most often, after the end of the treatment, the hair begins to grow again. Amazingly, after that, the hair can be denser, previously straight hair can become curly, and vice versa.
The following picture gallery explains exactly what the anagen and telogen phases are.
This is how the head hair grows
Diffuse hair loss: Numerous causes
Care mistakes: Some people think their hair is too much “hair care”. This can lead to damage to the hair itself, for example, due to intense hot blow-drying, curling irons, frequent bleaching, or perming. This can cause the hair to look brittle or break off more. Hair loss itself is usually not provoked by these stresses on the hair.
Stress: Some research suggests that stress can lead to hair loss.
Pregnancy, hormone intake: during pregnancy, the female hormonal balance changes. One consequence is that many expectant mothers can look forward to particularly dense and healthy-looking hair since the growth phase of the hair is prolonged. However, the hormonal change after birth often leads to the fact that the hair falls out more than usual over the entire head.
These fluctuations are often frightening for those affected but usually settle back to the usual level after a short time. Women who start with the “birth control pill”, switch to another preparation, or stop taking it, sometimes also observe effects on their hair.
Hyperthyroidism/hypothyroidism: A disruption of the thyroid gland as an important metabolic organ can also have a greater effect on the hair in some sufferers.
Symptoms (selection): In the case of hypothyroidism (hypothyroidism), in addition to lack of drive, increased sensitivity to cold and cool, dry skin, dull, brittle hair, and hair loss can occur.
Hyperthyroidism can manifest itself with soft, thin hair and Diffuse Hair Loss, as well as with increased irritability, heat intolerance, and warm-moist skin.
Infections, skin diseases: Various (skin) diseases can also be the cause of Diffuse Hair Loss or circumscribed hair loss: fungal diseases, infection with bacteria or viruses, as in herpes zoster, tumors on the skin, psoriasis, or eczema of the scalp.
Iron deficiency: Iron deficiency, especially a deficiency of storage iron (ferritin), is more often detected in patients with Diffuse Hair Loss. Whether this is really the cause of the increased hair loss is still not definitively clarified. An iron deficiency can result from an insufficient iron supply through the diet, an insufficient iron intake through the intestine, or an increased blood loss. Possible causes are then, for example, heavy menstrual bleeding or gastrointestinal ulcers.
Nutrient deficiency diseases: With a balanced diet in our latitudes, in the rarest cases there is a nutrient deficiency and, as a result, Diffuse Hair Loss. However, a lack of nutrients can occur due to (also short-term) crash diets, eating disorders (anorexia, bulimia), but also insufficient absorption of nutrients by the intestine in chronic intestinal diseases or after surgery. In the course of severe chronic diseases, infectious diseases such as influenza or scarlet fever, but also after operations with general anesthesia, the hair can also diffuse lightning.
Chemotherapy, radiotherapy: Chemotherapy or treatment with so-called targeted substances against various cancers can (but does not have to) be associated with Diffuse Hair Loss. Not only the hair of the head, but also eyelashes, eyebrows, and body hair can be affected. The hair usually falls out a few days to weeks after the start of therapy and/or breaks off increasingly over the scalp. As a rule, they grow back when the therapy is completed. More about this is in the Extra section below.
If a patient has to undergo radiation therapy as part of cancer treatment and the scalp is in the radiation field, this can also lead to increased Diffuse Hair Loss. In most cases, hair begins to grow again sometime after radiation therapy. With very high doses of radiation, hair roots may also be damaged more sustainably, so that the hair grows back more sparingly.
Medications, poisoning: Diffuse Hair Loss can manifest itself as a side effect of medications, for example, cholesterol-lowering agents, blood thinning agents, retinoids for acne, beta-blockers for hypertension or rapid pulse. Very rare causes can be poisoning, for example, with heavy metals such as thallium. In the rarest cases, these are accompanied exclusively by hair loss, but with other physical symptoms.
Diffuse alopecia areata / Diffuse systemic hair loss: These very rare special forms of the two diseases are difficult to distinguish from other causes of Diffuse Hair Loss. More details can be found in the corresponding chapters in this article (chapters “Plant-related hair loss” and “Circular hair loss”).
Diffuse hair loss: diagnosis
The diagnosis results from the comprehensive medical and family history of the patient (anamnesis), a physical examination of the skin, hair, and nails as well as a plucking test. Of course, the dermatologist looks at the scalp in detail, sometimes using a magnifying glass (dermatoscopy). Depending on the suspected diagnosis, further examinations will follow (see chapter “Hair loss: Overview…what men and women should know”, section: “Hair loss: diagnosis”).
Diffuse Hair Loss: Therapy
If possible, the therapy always depends on the respective cause. If medication is the trigger, another preparation may be prescribed in consultation with the attending physician (attention, do not stop medication on your own!).
In the case of an iron deficiency, for example, it is of course essential to clarify the causes and treat them in a targeted manner. Against anemia with iron deficiency, iron preparations can help. If there is no anemia, treatment with iron is not a proven measure. If there is thyroid disease, it must of course be treated.
If hair loss has arisen due to a diet, it should be stopped and a suitable, balanced diet should be started instead. A different nutrient deficiency is then rarely the cause of Diffuse Hair Loss in this country.
In general, it can be said that Diffuse Hair Loss can persist for two to three months even after the cause has been eliminated. This is due to the fact that a part of the hair has already entered the resting or loss phase (telogen phase, see above) and falls out “stubbornly” after two to three months.
Hair loss during chemotherapy
Chemotherapy, as it is used for cancer, can (but does not have to) be associated with hair loss. Even newer drugs in cancer therapy such as the so-called targeted substances can change the hair. It can become shakier, sometimes fail, and for a longer time (albeit temporarily), since the therapies usually last longer (see also the section above).
There is no uniform pattern. In addition to the head hair, the facial or pubic hair can also fall out. For many patients, especially women, this medication’s side effect in addition to the disease means a great emotional burden.
A scalp cooling with so-called cooling hoods during the administration of medication can help to reduce hair loss. A pump continuously circulates a cooling liquid with a temperature of 3 to 4 degrees Celsius in the area of the scalp. This cools down to about 21 degrees Celsius. The procedure is currently being studied in more detail, but it is already offered in some tumor centers.
Those who are looking for psychological support can, for example, turn to psychologists who specialize in cancer diseases (psycho-oncologists).
If women want to conceal hair loss with a wig, the statutory health insurance usually covers the costs, provided that the doctor prescribes them. For men, the cost of wigs is usually not covered by health insurance.
There are wigs made of human hair and those made of synthetic hair. If the individually prescribed chemotherapy drugs are known to lead to hair loss, it is advantageous to plan a wig – if desired – in advance of the therapy. Special shops can then advise individually and tailor the replacement exactly to your own hair.
After the therapy, about six months later, the scalp hair is normally back in full shape. Structure and color can be changed. Of course, a wig is not a “must”. Many sufferers also refrain from hiding the hair loss, or they use headgear such as hats, hoods, or scarves.
Even tracing the eyebrows and eyelashes as permanent make-up can be an albeit expensive way for some women. There are tailor-made make-up courses (organized by self-help groups, for example) in which those affected can learn to trace missing eyelashes and eyebrows.
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