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Anatomy and Physiology of Hair

Your hair is one of the most important parts of your body. Hair is an outgrowth of filamentous cells, containing keratin, that grows from follicles found in the dermis.The human body, apart from the palms of the hands and soles of the feet, is covered in follicles which produce thick terminal and fine vellus hair ‘ short, fine, lightly colored and barely noticed hair that develop everywhere on the human body.   Hair often refers to two distinct structures: the part beneath the skin is called a hair follicle or when pulled from the head is called a bulb.   How is a typical hair shaft structured? It is essentially nothing but dead shaft seen above the scalp. A typical hair shaft is made up of three essential layers i.e. cuticle, medulla and cortex.   The cuticle is the outermost layer. This protects the medulla and cortex. To put it simply cuticle is a transparent structure and only this layer will give a shiny appearance.   If this outer layer is not healthy then you will still get dull appearance. Medulla is the innermost layer constituted by large size cells. Cortex also constitutes the middle layer. This possesses a protein called keratin and coloring pigments. The cortex determines the shape and size of the hair shaft.  
Keratin- The Main Constituent
Keratin refers to a family of fibrous structural proteins. It is an intermediate filament; when assembled in bundles, it is tough and insoluble forming hard, unmineralized structures found in a variety of species including reptiles, birds, amphibians, and mammals.   Nails are also constituted mainly by keratin. Other constituents of hair include the pigment called melanin (responsible for hair color), certain fat, small quantity of vitamins and traces of minerals like zinc etc.   Hair also includes 10 to 15 per cent of water which helps maintain moisture and balance? biochemical and physiological properties.  
Hair Follicle
The other part of your hair is the hair follicle. Sunk beneath your scalp, it is encircled by two protective sheaths the inner sheath and the outer sheath.   The hair shaft is protected well by these two sheaths. Connected to the hair shaft is a sebaceous gland, a tiny sebum-producing gland found everywhere except on the palms, lips and soles of the feet. Thicker the density of the hair, the more the number of sebaceous glands which can be found.   Sebum(Latin: fat or tallow) is made of fat (lipids), wax, and the debris of dead fat-producing cells. The older you are the less sebum you produce. Women produce lesser sebum as they grow older. Men also produce less sebum but it is more compared to women.   Hair shaft has its root in the follicle. In fact the hair shaft comes out from the follicle. There is a projection called hair papillae at the bottom. Hair papillae have tiny blood capillaries to nourish my hair root. Thickness of the shaft totally depends up on follicle size. Follicle is therefore responsible for the health of the hair shaft.   Follicle can support its nourishment till the shaft is pushed out of the follicle base.  
Hair Follicle Cycle
Hair growth on your scalp is around six inches per year. Hair growth will be around 0.03 to 0.04 mm only. Hair growth is random. Growth is neither cyclical or seasonal. This involves three stages: (1). Anagen, (2). Catagen, and (3). Telogen.  
Anagen
This is the active hair growth phase. Growth of new hairs is done and hair follicles push out club hairs out of your follicles.   Hair grown during this growth phase will remain for about two to six years. Some of you might have felt problem of hair growing beyond certain length. This may be due to short phase of growth (Anagen).   Long hair is due to long phase of growth. Also there is short active hair growth phase on? arm pits, limbs, eyelashes, and eyebrows about 30-45 days. Active phase of growth is not warranted at these regions.  
Catagen
This is the transitional phase. Atagen is the phase that follows active hair growth phase called Anagen.   Once anagen phase gets completed your hair undergoes a transitional stage. About three per cent of your hair undergoes a transitional process at any given period of time.   This phase will lasts for about a period of three to four weeks. During catagen hair growth gets stopped. The outer sheath of your hair root undergoes a shrinking process. Then your hair gets attached firmly.  
Telogen
This is the resting phase. Telogen is the phase that follows a transitional phase called Catagen. There is a resting period for your hair.   About 10-15 per cent of all your hairs undergo a resting process at any given period of time. Telogen is the resting phase and accounts for 10-15% of all hair.   This phase will last for about a period of 100 days (on your scalp) and it will be more than 100 days for hair on your limbs, armpits, eyelashes, eyebrows etc.
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How to Prevent Hair Loss?

es, hair loss can be prevented. It is easy to prevent rather than to treat. With simple measures you can stay away from the baldness. Once you suffer with the baldness it becomes really an embarrassing condition. It is only a physical condition, but it adversely affects the personal, social, and professional life of individual.   The bald people suffer with the lack of self-esteem and confidence due to their hairlessness. Of course there are varieties of the treatments available to cure baldness, but it takes a time to resolve the issue permanently. So, it is always better to prevent the hair loss rather than curing it. Here are some simple tips that would help you to prevent the hairs loss.  

  1. Handle the hair with a proper care. Be soft whenever combing or shaping them. For combing use the hair brush that is soft and has enough space between blades, so that it doesn’t pull the hairs. This will not loosen the grip of hairs over the scalp and the hair loss can be prevented.
  2. Proper nutrition is must to prevent hair loss. So, always feed on the healthy diet. Eat the protein-rich diet as it helps in growth and maintenance of hairs. Eat the diet that includes much amount of raisins as it gives better flexibility to the hairs and prevent them from breaking.
  3. Water is the transport medium for the nutrients to the hairs. So, drink adequate amount of the water regularly. This would help the nutrients to reach the hairs pretty easily. Along with it water also regulates the temperature of the head to be at normal level, which is necessary for the hair growth.
  4. Don’t tie your hair tightly. It is mandatory to prevent hair loss that you avoid tight hair styles like braids, ponytails, or buns. This will reduce the unnecessary pressure on the hairs and allow them to grow freely.
  5. Eat fresh fruits and vegetables as they provide the necessary amount of the minerals and proteins that are required for the healthy hair growth. Fruits like oranges, bananas, apples, apricots, and pineapple must be eaten in enough amounts as they provide the required amount of zinc, iron, Vitamin C, Vitamin A, and calcium required for the healthy hair growth.
  6. Apply the oil on hairs, but only twice in a week. Oil is the necessary nutrient to the hairs that provide the required luster and strengthen the fibers in the hairs. But, applying it daily must be avoided as it blocks the hair pores and make it difficult for the hairs to grow further. The best hair oil is the coconut oil.
  7. Wash the hairs at least twice in a week. Washing helps to clean the hairs. It removes all the dust and dirt accumulated on the hairs. Wash them thoroughly this will reduce the effect of air and water pollution on the hairs. But, don’t wash them regularly because it may loosen the grip of hairs over the scalp.
  8. Use the herbal or naturally prepared hair shampoo for the washing hairs. Never use any synthetic or chemical-based shampoo to wash the hairs. This will make the hairs dry and would promote the hair loss.
  9. Protect your hairs from the harmful sunrays. Wear a cap or a scarp while you go out in the afternoon sun. The high temperature is bad for hairs as it removes the moisture from them, makes them dry. This results in graying and thinning of hairs that breakdown easily, which gradually leads to hair loss. To prevent this dryness use the conditioner that will help to maintain the moisture in the hairs.
  10. Limit the use of the hair dryer or if you want to use it. Please slow the blow of air dryer and keep the temperature at very moderate level. Also, never hold the blow of air continuously at one place otherwise it may harm the scalp and loosen the grip of hairs. It is best to dry the hair by soft towel with a slow rubbing of hairs and then leave them to dry naturally.
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Hair Loss Symptoms

Alopecia or baldness is when there is hair loss on the head and other parts of the body which often results in baldness. Losing between 75 ‘ 150 strands of hair daily is normal but anything beyond this number is bad for hair loss. Hair loss is mainly caused due to two major reasons: Heredity and Illnesses.   Heredity: Most of the time, hair loss is caused by genetic factors. In other words, it is part of a person’s heredity. This is usually called the male pattern baldness or heredity balding. This is one of the most common causes of thinning hair or hair loss.   Illnesses and other physical conditions: Illnesses like high fever, thyroid conditions, childbirth, malnutrition, iron deficiency, cancer treatments and the side effects of many medications can cause hair fall or hair loss. There are two ways of losing hair, it is either patchy hair loss or generalized hair loss. In patchy hair loss patches of skin become exposed due to baldness while there is a good amount of hair in the other parts of the head. In generalized hair loss, hair falls or baldness appears in a uniform manner, all over the head. The medical term for hair loss and baldness is called alopecia and there are different kinds of classifications in alopecia.   Alopecia Areata: This condition is when bald patches appear on the head well defined and clear. This is self healing and hair grows back within twelve months without any treatment.   Alopecia Totalis: This condition is unusual where all the hair on the head is lost. The cause for this baldness is unknown and uncommon and the hair usually never grows back making this baldness permanent.   Alopecia Universalis: This condition is a complete loss of hair from all parts of the body.   Androgenic Alopecia: This is the genetic factor and affects both men and women alike. Genetic baldness can begin as early as in a person’s adolescent, twenties, thirties and even later.Baldness or hair loss can be cured or prevented if the exact symptoms of the hair loss are known.  

Hair loss symptoms in men

When a man starts losing hair, he starts with a receding hairline. The scalp begins to show and hair begins to thin out. Over time some men may either have a bald patch on the top behind the head and sometimes it is not unusual for men to lose hair completely and go fully bald.

Hair loss symptoms in women

Women lose the maximum hair on the crown. It is not usual for women to go absolutely bald but baldness may appear in patches. Complete baldness in women can only result from cancer treatments such as chemotherapy. Otherwise women lose hair in patches or hair thins down dramatically.

Hair loss symptoms in both men and women

Hair thinning overall on the head is a common symptom for both men and women. Both may also lose hair all over the body like the armpits, legs and even the eyebrows. Hair shedding or hair fall is noticed in both especially on clothing, bed linen and brushes. Hair breakage is also a common trait in both, men and women. Using hair styling irons may cause breakage more in women than in men. Hair loss is a gradual process, it does not happen all together. It is easy to notice and you can tell when you have started to lose hair since it is visible and the hair loss is evident. A change in hormones, such as pregnancy or a surgery that could cause stress will encourage hair loss. It is seen that diet plays a very important role in hair loss or re-growth of hair. Protein malnutrition is an important cause for hair to thin or fall. It is notice that an adequate intake of protein and iron supplements may stop you from losing hair. Appropriate treatments for baldness depend on the type of alopecia one is suffering from.   There are home remedies as well as medications available for hair loss in men and women but above all one must ensure he or she is having a nutritious balanced meal along with daily exercises for at least thirty minutes a day. If hair fall or hair loss is still not controlled, see a doctor to assess what is causing the problem and take treatment accordingly. Hair loss can be dampening for our appearance and self confidence. A head full of hair is always more appealing and gives us more confidence about ourselves. With medical options as advanced as today, one does not need to worry much about the re-growth but one must try to seek treatment at the earliest.

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Hair Loss Diagnosis

Hair loss is a gradual process where a person starts losing hair in patches or faces hair fall, hair thinning or premature baldness. The average scalp usually has 100,000 strands of hair of which it is normal to lose 75 ‘ 150 strands daily. Anything more than this needs medical attention and treatment. Hair loss can happen due to physical or psychological conditions. The diagnosis often depends on the doctor who will assess several factors before coming to a conclusion.  

Diagnosis of the disease causing hair loss

Diagnosis of what is causing hair loss depends on the kind of hair loss one is suffering from. A dermatologist may have to consider many possible kinds and types of recognized hair ailments while diagnosing a patient. Most doctors will come across just twenty types of hair related diseases throughout their careers. Of the twenty just four will be the most common for 95% people suffering from hair loss conditions. These are namely, pattern baldness, telogen effluvium, chemical over processing and alopecia areata. When a patient first consults a doctor for his hair ailment the dermatologist will first collect information through questioning him, after which the use of techniques like the hair pluck test may help to understand diseases causing hair loss or baldness.  
Diagnosis of hair loss diseases by questioning
The initial stages of diagnosis include the process of determining whether the hair loss is congenital, genetically inherited or acquired. The loss of hair by congenital hair disease would mean that the disease is present since birth. A genetically inherited disease is one that happens later in life due to genes that are inherited. The acquired form of hair loss disease is the ones that are due to the environment and its effect on the hair. If the doctor feels that the hair loss is congenital, he may ask a few questions to the patient related to his family members and background like he would like to know who else in the family suffer from the same condition and how are they related genetically. If the hair loss disease is acquired then the questions will be based on health and lifestyle. The questions may get more detailed and intense if the dermatologist suspects something more unusual.  
Identifying loss of hair with tools
Tools like the hair pull test determines about the quantity of hair being shed from the scalp. The pull test is done by grasping some hair between the thumb and forefinger clutching about 50 strands of hair. Firmly pulling of the hair or traction is applied without involving any plucking.  
Mechanism of the hair-pull test
The number of strands pulled gives an idea of the number of hair follicles residing in the telogen state. Telogen hairs are easily pulled out than the anagen growing hair. Hence, in the test while the telogen hairs will come out, the anagen hair will remain rooted in the scalp. Usually 5-15 strands of hair can be pulled out from a normal scalp. More than 15 strands suggest that more follicles are in the telogen area. The hair pull test may also be wrong as the number of pulled hair may vary. The fallen hair also depends on how often the person washes or brushes his hair. All activities like this usually involve the telogen hair.  
Hair pluck test
This test is also known as trichogram. Here hair is pulled to examine the roots. It is done with rubber tipped tweezers that can hold upto 50 strands of hair at a time. This test can be a little painful for the patient but is in brief as the hair is plucked out quickly. The plucked out hair are cut out from the upper end to eliminate the extra length. This cutting needs to be done carefully so that the root is kept intact. The studied hair should be 1 cm in length when measured from the root to end.   This cut-off strand is then soaked in a wet microscopic slide and a dye of 4-dimethylaminocinnamaldehyde is applied. This dye will only color the hair root that have the intact internal root sheaths which are present in anagen hair. The telogen hair will not be affected due to this dye as it contains small, unpigmented, ovoid bulbs are do not have healthy internal root sheath. Under the microscope the dermatologist can count the number of telogen and anagen hair strands that are present. He can also identify if there is any abnormality to the roots of the hair that might identify a defect of the hair shaft.  
Laboratory testing to identify hair loss
If the person is suffering from an unexplained hair loss condition, a number of laboratory testing may be recommended. A potassium hydroxide may identify an infectious disease if any and this is specially recommended for people with localized hair loss. Localized hair loss may be Alopecia areata or also might be scalp ringworms. Some skin from the scalp mixed with potassium hydroxide are placed on the slide and tested under a microscope to detect any fungal infection. A positive result confirms ringworms and other tests are carried out by culturing skin in the laboratory to find out what type of bacteria or fungi is present. Other tests may include testing blood looking for viral infections and other inflammations.  
Diagnosis through skin biopsy
Skin biopsies are usually done to diagnose diseases like cicatrical alopecia. A 2-4mm skin is taken from the scalp and put under the microscope for examination. A pathologist then tests the intensity of damage in the hair follicle along with the depth of skin involved and check to see the presence and the location of the inflammation in relation to the hair follicles. Most of the procedures do not take a long time and are straight forward in nature. These tests provide a clear understanding through which the dermatologist can identify the problem. The diagnosis is important to select the route of treatment for the hair loss.   Once the causes of hair loss is determined, treatment is only a while away. Treatments are often successful in the re-growth of hair. The dermatologist will prescribe the best medical option to treat any of the above ailments. Hair should start growing as soon as you start reacting to medication. Diagnosis for hair loss may be intense but not difficult. With modern medical facilities one can dream about getting back the lost hair again. Do make time to visit your doctor as soon as you think you are losing hair, the rest will be taken care by him.