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Springer/Stulberg r2

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No spe. cific treatment for hair loss is required because. normal hair regrowth usually occurs with. time and resolution of underlying causes. ...

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Springer/Stulberg r2Page 1JULY1 2003 / VOLUME68 NUMBER1www.aafp.org/afpAMERICANFAMILYPHYSI CIAN932 to 3 percent of hair follicles.Finallythe telogen phase occurs during which 10 to 15 percent of hair follicles undergo a rest period forabout three months. At the conclusion of thisphasethe inactive or dead hair is ejected fromthe skin leaving a solid hard white nodule atits proximal shaft.2The cycle is then repeated.Evaluation of Hair LossA directed history and physical examination usually uncover the etiology of hair loss.The history should focus on when the hairloss started; whether it was gradual orinvolved handfuls of hair; and if any physical mental or emotional stressors occurredwithin the previous three to six months3(Table 1). Determining whether the patient iscomplaining of hair thinning (i.e. graduallymore scalp appears) or hair shedding (i.e.large quantities of hair falling out) may clarifythe etiology of the hair loss.4The pattern of hair loss especially whetherit is focal or diffuse also may be helpful (Figure 1). The hairpull test gives a rough estimate of how much hair is being lost.24It isdone by grasping a small portion of hair andgently applying traction while sliding the fingers along the hair shafts. Usually one to twohairs are removed with this technique. Thehairs are then examined under a microscope(Table 2).In the hairpluck testapproximately 50 hairsEvaluating and treating hair loss(alopecia) is an important partof primary care yet many physicians find it complex and confusing. Hair loss affects men andwomen of all ages and frequently has significant social and psychologic consequences.This article reviews the physiology of normalhair growth common causes of hair loss andtreatments currently available for alopecia.Normal Hair GrowthEach day the scalp hair grows approximately 0.35 mm (6 inches per year) while thescalp sheds approximately 100 hairs per dayand more with shampooing.1Because eachfollicle passes independe ...

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