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Email to a friend Print this page Most Popular Flattering Hair Cuts Long Face Shapes Photo Gallery Wild Updos Nicole Ritchie What's Hot Mascara Review Great Holiday Hair Best Beauty Gifts Avoid Problems When Having ... Very Dry Hands Related Topics Tattoos / Body Piercings Teen Fashion Weddings Women's Fashion Teen Advice Hottest Celebrity Hairstyles Step-By-Step From Julyne Derrick , Your Guide to Beauty . FREE Newsletter. Sign Up Now! How to Get Nicole Ritchie's Hair Nicole Ritchie Credit: Photo by Lori Conn/ZUMA Press Previous | Next >> We all know Nicole gotten sickly thin, but her hair's never looked better. We love her new grown-up look, which you can get too with the perfect highlights, some volumizing spray & a great (fake!) tan. 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Very Dry Hands hair growth for monthsBBC - Health - Womens health - Hair loss Home TV Radio Talk Where I Live A-Z Index 28 December 2005 Accessibility help Text only BBC Homepage Lifestyle Health Women's health Your body Becoming a woman Breast awareness Menopause Acne and spots Hair loss Cellulite Cosmetic surgery Top beauty tips TV and radio Talk Newsletter Contact Us Like this page? Send it to a friend! Hair loss Dr Trisha Macnair They may not like it, but it's generally accepted that men lose their hair. In fact, hair loss is also common among women as they age. But the stigma can be unbearable. In this article Patterns of hair loss Beware miracle cures Medical treatments Surgery Top tips Patterns of hair loss The most common type of hair loss in women, accounting for over 95 per cent of cases, is androgenetic alopecia, or female pattern baldness. There's a large genetic predisposition, which may be inherited from the father or mother. The cause of hair loss in this condition is a chemical called dihydrotestosterone, or DHT, which is made from androgens (male hormones that all men and women produce) by the action of an enzyme called 5-alpha reductase. People with a lot of this enzyme make more DHT, which in excess can cause the hair follicles to make thinner and thinner hair until they eventually pack up completely. The pattern of hair loss is different to the typical receding hairline and crown loss in men The pattern of hair loss is different to the typical receding hairline and crown loss in men. Instead, there's usually a general thinning of the hair with loss predominantly over the top and sides of the head. It usually gets worse with the menopause. Another common cause of hair loss in women is a condition called alopecia areata, an autoimmune disease that affects more than two per cent of the population. In this, the hair follicles are attacked by white blood cells. The follicles then become very small and hair production slows down dramatically, so there may be no visible hair growth for months and years. After some time, hair may regrow as before, come back in patchy areas or not at all. The good news is that in every case the hair follicles remain alive and can be switched on again; the bad news is that we don't yet know how to do this. Myths about hair loss in women It means you're not a proper women with two X chromosomes. It's caused by washing your hair too often. It's caused by too much brushing or combing. Hair dyes and perms can cause permanent loss. It may result from wearing hats and wigs. Shaving your hair will make it regrow thicker. Standing on your head will help it grow back. It's a sign of an overactive brain. There's a miracle cure out there waiting for you. Beware miracle cures Scan the internet and you'll see all sorts of miracle cures for baldness on offer, from strange herbal lotions to mechanical devices. Perhaps the most useful first step you can take is to avoid the myths. After this there are several options. You can find some way to accept the change and live with it (let's face it, this is a tall order - most men struggle to come to terms with their baldness and for them at least society equates it with maturity and power). You can try cosmetic treatments such as wigs or hair thickeners, or you can try medical therapies. The last option is hair-replacement surgery. Medical treatments The drug minoxidil was first developed for treating high blood pressure, which was found to have the side effect of thickening hair growth in some people. It's now available as a lotion to apply directly to the scalp. No one really knows how it works, however, and it's not effective for everyone. Studies show that only about 20 per cent of women between 18 and 45 have moderate regrowth using the drug, while another 40 per cent experience minimal regrowth. It works best on younger people with early hair loss. A big disadvantage is that you have to carry on using minoxidil indefinitely or the new hair will fall out. Another drug, finasteride, which was developed for treating prostate cancer, has also been found to be effective but is only available for men. Surgery Surgical techniques for restoring hair have improved greatly in the past couple of decades, but this is still an option that requires careful consideration. There are two main options: Hair transplantation - tiny punch-holes of skin containing a few follicles of hair are taken from elsewhere in the body (such as the back of the head, if this is still well covered) and implanted into the thinning areas. Some surgeons use a needle to sew in just one or two hairs. However, as women are more likely to have diffuse loss of hair all over the scalp, this technique may not be possible. There has been little success with implanting artificial fibres. Scalp reduction - devices are inserted under the skin to stretch the areas of scalp that still have hair, then the redundant bald areas are removed. Alternatively, flaps of hairy scalp can be moved around the head. For more on what works and what doesn't see www.fda.gov . Top tips Many causes of female hair loss are temporary - check your general health and be patient. Take a look at your family for an idea of your risk of female pattern baldness. Don't be taken in by claims for wonder products. There is no cure for female pattern hair loss. Many women cope well by using cosmetic products, hats and wigs - persevere until you find your own style. This article was last medically reviewed by Dr Trisha Macnair in August 2005. First published in November 1997. Disclaimer All content within BBC Health is provided for general information only, and should not be treated as a substitute for the medical advice of your own doctor or any other health care professional. The BBC is not responsible or liable for any diagnosis made by a user based on the content of the BBC Health website. The BBC is not liable for the contents of any external internet sites listed, nor does it endorse any commercial product or service mentioned or advised on any of the sites. See our Links Policy for more information. Always consult your own GP if you're in any way concerned about your health. In Lifestyle Complementary treatments for baldness Polycystic ovary syndrome Elsewhere on bbc.co.uk Radio 4 Woman's Hour: Alopecia Radio 4 Case Notes: Baldness Elsewhere on the web NHS Direct: Hair loss and baldness National Alopecia Areata Foundation American Hair Loss Council The BBC is not responsible for content on external websites About the BBC | Help | Terms of Use | Privacy & Cookies Policy permanent hair removal, totallyHairfacts: Hair removal definitions com mercial-free hair removal facts for consumers Keep this site reader supported! Home Methods Definitions D I R E C T O R Y Home Methods Search "Permanent" * Electrolysis * Home electro * Laser * Flashlamp/IPL * Combinations * * see note Hair inhibitors Rx oral meds Vaniqa Temporary Shaving Depilatories Friction Tweezing Waxing Sugaring Threading Rotary epilators Doubtful Electric tweezer Transdermal Transcutaneous Photoepilators Microwaves Dietary products Herbal inhibitors Other topics How to choose Tips Clinical data Manufacturers Regulation Info sources Scams Ripped off? FAQ Glossary Site info Feedback Hair removal: definitions Before we get going, I need to define some terms as they're used in this discussion. It turns out that in the hair removal industry, results aren't the only thing that can be confusing. So let's get precise! "Hair" This might sound silly, but hair needs to be defined. When some people say that their device removes hair, they don't always mean that it removes every type of hair. In fact, it's not possible to remove every type of hair in an area permanently in one treatment. The following are distilled from an excellent summary of the basics [1]. There are three types of hairs you might see on your skin: Vellus : sometimes called "peach fuzz," these are tiny colorless hairs. Intermediate : hairs between vellus and terminal. Thin, but with some pigmentation. Terminal : these are deep-rooted coarse hairs, either pigmented or gray (usually the hairs consumers want removed). In addition, all hairs have a three-stage growth cycle: Anagen : active growing phase Catagen : a brief transitional phase Telogen : dormant phase until shed and replaced by a new anagen hair The amounts of each type of hair and hair growth-cycles vary from person to person. That's another reason why it's tough to compare hair removal results between you and others. Depending on the body area, anywhere from 20% to 85% of hairs are in anagen (this is called the anagen/telogen ratio). Many hair-removal methods have been shown to be more effective on actively growing anagen hair. That means that a single treatment from a device cannot treat all your hairs. One last thing to discuss is potential follicles. Many follicles do not produce a hair, even though they have the potential to do so. Follicles can be activated by hormonal changes (like puberty, pregnancy, aging, etc.) or by other chemicals or medical conditions. That's why even after permanent hair removal, totally new hairs may grow. "Permanent hair removal" Most consumers assume "permanent" means lasting forever. Unfortunately, that's not always the case as it's used in advertising. For instance, a permanent wave in your hair is not really permanent. How much time should elapse before results can be considered permanent? Since waiting forever is out of the question, many people, myself included, have suggested arbitrary definitions of "permanent" when assessing new hair-removal devices. Some of the definitions people use are pretty silly. One manufacturer claims its device is permanent based on results after 9 weeks. It's ridiculous to base a claim on such a short period of observation., but the FDA formerly permitted this to be done [2]. Waxing can last that long, and it's been clinically observed to be temporary [3]. Permanent hair removal can be generally defined as "the complete destruction of a treated hair follicle's ability to generate hair." Here's my personal and unofficial working definition of "permanent hair removal" when assessing new devices: Able to go one year after your final hair removal treatment and still be as clear of hair in the treated area as you were right after your final treatment. This, of course, also means you went a year without having to use any other method to remove or conceal hair in the treated area. This is based in part on one definition for permanent hair reduction (below). However, some hairs have a growth cycle lasting several years [1]. That means a year might not be long enough to determine true permanence, but a lot of consumers would be happy to have one hair-removal treatment a year. " Permanent hair reduction" Another confusing definition. In 1998, the US Food and Drug Administration (FDA) began allowing some manufacturers of hair removal lasers and flash lamps used for epilation to use the term "permanent hair reduction," [4] which the agency defines as: The long-term, stable reduction in the number of hairs regrowing after a treatment regime. The number of hairs regrowing must be stable over a time greater than the duration of the complete growth cycle of hair follicles, which varies from 4-12 months according to body location. Permanent hair reduction does not necessarily imply the elimination of all hairs in the treatment area.[5] For clearance purposes, FDA requires that hair counts be measured at 3, 6, 9, and 12 months following the last treatment [5]. This is one of those complicated things I warned you about! I'll explain "permanent hair reduction" in detail in the section on laser hair removal. "Response rate" Defined here as: the percentage of people who respond to treatment. Medical literature indicates that, for unknown reasons, some consumers don't respond to laser or electrolysis procedures [6,7]. The less clinical data available, the higher the margin of error in the response rate. With Vaniqa , for example, 58% of women responded to the active ingredient [8]. However, if one-third of the subjects were "false positives" as they were in the control group, the actual response rate would really be closer to 25%.That's why you can't rely on the personal experiences of a few people. Response rates must be compared against a large control group to determine that positive results aren't just coincidence, since we're dealing with so many variables. "Regrowth rate" Defined here as: the percentage of hair that returns following one or several treatments. Medical literature indicates that regrowth rates following hair removal vary wildly. This means regrowth rates are virtually impossible to estimate accurately. For instance, from 22% to 100% regrowth has been reported in long-term laser treatment follow-up [9,10]. Even after 125 years of clinical and empirical evidence regarding electrolysis, published estimates still range between 15% to 50%.[11]. Another expert can only estimate regrowth might range from 20% to 30% per treatment under ideal conditions, adding "the exact percentage is unknown." [12] The less clinical and empirical data available, the higher the margin of error in the regrowth rate for each method. Also, what is counted as regrowth must be carefully defined. Appropriately rigorous studies should describe the total numbers of hairs treated, specifying the number of terminal and vellus hairs [13]. Some researchers have suggested a definition of regrowth which only counts terminal hairs.[14]. Although many consumers seeking treatment are primarily interested in removing terminal hairs, this selective definition of regrowth makes treatment results look better at first glance and obfuscates true efficacy rates. Whew! Now that we're all on the same page, let's look at some of the devices and claims out there. References Richards RN, Meharg GE. Cosmetic and Medical Electrolysis and Temporary Hair Removal: A practice manual and reference guide. Toronto: Medric Ltd.,1991, pp 37-40. FDA Docket K892514 , Aug 8, 1990. Following several failed submissions rejected by FDA reviewer Theodore Stevens, electric tweezer maker AHRS submitted an unpublished in-house report on 5 subjects followed for 9 weeks. The new FDA reviewer, Paul Tilton , allowed 9 weeks as a performance standard for permanent hair removal. Subsequently, AHRS (and a clone called GHR, which Tilton cleared in 1991) can claim they are "permanent." The FDA subsequently set a more sensible performance standard and now requires 12 months of clinical follow-up for considering claims of permanent hair reduction. The FDA also stated in 1998 that there are no significant data to substantiate claims of electric tweezer permane nce [Docket 97N-0199 ]. Fo r an extensive critical analysis of the Tilton decision, you can download Docket 99P-1614 . The Tilton decision is an unfortunate footnote in the history of hair-removal regulation and a triumph of quackery over good science. Richards RN, Uy M, Meharg G. Temporary hair removal in patients with hirsutism: A clinical study . Cutis 45:199-202, 1990. FDA Docket K980517 . July 21, 1998. See summary (requires Adobe Acrobat). Richard Felten , personal correspondence, 17 April 2001. Liew SH and others. The effect of ruby laser light on cellular proliferation of epidermal cells . Annals of Plastic Surgery 43:519-522, 1999. Richards RN, Meharg GE. Electrolysis: Observations from 13 years and 140,000 hours of experience . Journal of the American Academy of Dermatology 33:662-666, 1995. Vaniqa package insert . Vani qa TM is a trademark of Bristol-Myers Squibb Company. Lloyd JR, Mirkov M. Long-term evaluation of the long-pulsed alexandrite laser for the removal of bikini hair at shortened treatment intervals . Dermatologic Surgery 226:633-637, 2000. Nanni CA, Alster TS. Optimizing treatment parameters for hair removal using a topical carbon-based solution and 1064-nm Q-switched neodymium:YAG laser energy . Archives of Dermatology 133:1546-1549, 1997. Richards (1991), p. 248 Wagner RF Jr, Tomich JM, Grande DJ. Electrolysis and thermolysis for permanent hair removal . Journal of the American Academy of Dermatology 12:441-449, 1985. Kobayashi T. Electrosurgery using insulated needles: Epilation . Journal of Dermatologic Surgery and Oncology11:993-1000, 1985. Grossman MC and others. Damage to hair follicles by normal-mode ruby laser pulses. Journal of the American Academy of Dermatology 35:889-894, 1996 Was this helpful? This free site is reader-supported. Donate or subscribe today! Still have questions? Ask them at my free HairTell hair removal forum! e-mail this page to a friend! 1996-2005 Andrea James. All rights reserved. Legal Info / Terms of Use Revised 27 April, 2002 . hair growth. Chemotherapy. NotPeople Living With Cancer - Managing Side Effects - Hair Loss (Alopecia) -- Home | About Us | Contact Us | Message Boards Cancer Type: Find detailed information on a specific type of cancer -- Select a Cancer Type ==================== Adenoid Cystic Carcinoma Adrenal Gland Tumor Amyloidosis Anal Bile Duct Bladder Bone Brain Tumor Breast Breast, Inflammatory Breast, Male Breast, Metaplastic Carcinoid Tumor Cervical Childhood --Central Nervous System ----Astrocytoma ----Brain Stem Glioma ----Ependymoma ----Medulloblastoma --Desmoplastic Infantile Ganglioma --Ewing's Sarcoma --Germ Cell Tumors --Leukemia, Acute Lymphoblastic (ALL) --Leukemia, Acute Myeloid (AML) --Lymphoma, Hodgkin --Lymphoma, Non-Hodgkin --Neuroblastoma --Osteosarcoma --Retinoblastoma --Rhabdomyosarcoma --Wilms Tumor Colorectal Endocrine Tumor Esophageal Eye Eyelid Fallopian Tube Gallbladder Gastrointestinal Stromal Tumor (GIST) Gestational Trophoblastic Tumor Head and Neck --Laryngeal and Hypopharyngeal --Nasal Cavity and Paranasal Sinus --Nasopharyngeal --Oral and Oropharyngeal --Salivary Gland HIV/AIDS-Related Islet Cell Tumors Kidney Lacrimal Gland Tumor Leukemia, Acute Lymphocytic (ALL) Leukemia, Acute Myeloid (AML) Leukemia, B-Cell Leukemia, Chronic Lymphocytic (CLL) Leukemia, Chronic Myeloid (CML) Leukemia, Eosinophilic Leukemia, T-Cell Liver Lung Lymphoma, Hodgkin Lymphoma, Non-Hodgkin Mastocytosis Melanoma Meningioma Mesothelioma Multiple Myeloma Neuroendocrine Tumor Ovarian Pancreatic Parathyroid Tumor Penile Pituitary Gland Tumor Prostate Sarcoma Sarcoma, Alveolar Soft Part and Cardiac Sarcoma, Kaposi's Skin Small Bowel Stomach Testicular Thymoma Thyroid Unknown Primary Uterine Vaginal Vulvar Waldenström's Macroglobulinemia Search our site or Advanced Search -- Or use Advanced Search Or try our new BETA Search Sign up for PLWC Updates -- Learning About Cancer Communicating With Your Doctor Managing Your Care Managing Side Effects -- Clinical Trials Cancer Genetics Complementary and Alternative Medicine (CAM) -- You are here: Home > Understanding Cancer > Managing Side Effects > Article Hair Loss (Alopecia) Options Medical Dictionary Printer Friendly Email to a Friend This section has been reviewed and approved by the PLWC Editorial Board , 02/05 A potential side effect of radiation therapy and chemotherapy is hair loss (alopecia). Hair loss may occur throughout the body, including the head, face, arms, legs, underarms, and pubic area. The hair may fall out entirely, gradually, or in sections. In some cases, the hair will simply thin—sometimes unnoticeably—and may become duller and dryer. Losing one's hair can be a psychologically and emotionally challenging experience, and can affect a person's self-image and quality of life. However, the hair loss is usually temporary, and the hair grows back. Causes Radiation therapy and chemotherapy cause hair loss by damaging the hair follicles responsible for hair growth. Chemotherapy. Not all chemotherapy causes hair loss. (A doctor can provide more information regarding which drugs are most likely to cause hair loss.) When hair loss does occur, it is usually not immediate, and the amount of hair loss varies from person to person, even among those taking the same medication. Hair loss most often starts after the first several weeks or rounds of chemotherapy treatment and tends to increase one to two months into treatment. The amount of hair loss depends on the type of drug, dose, and how the drug was given (orally, intravenously, or topically). Hair regrowth following chemotherapy usually occurs one to three months after maintenance treatment starts or intensive chemotherapy ends. Radiation therapy. Radiation therapy only affects the portions of hair that are in the field of radiation. Hair loss depends on the dose and method of radiation treatment. When very high doses of radiation are used to treat cancer, the hair may become permanently lost or thinned in the treated area. If regrowth does occur, patients may find the regrown hair to be different in texture and thickness than the original hair. Management In some cases, hair loss due to cancer treatment is not preventable or treatable with stimulants, solutions, or special shampoos. Therefore, learning to deal with hair loss before it occurs can help a person better adjust to this change in physical appearance. Talking about feelings with a counselor, someone with a similar experience, family member, or friend may also provide comfort. Also, it may be helpful to talk about inevitable hair loss with family and friends, especially children, before it occurs. If children know to expect changes in the physical appearance of someone they are familiar with, it helps reduce feelings of anxiety. Some people recommend cutting the hair shorter before treatment. This not only helps create volume and fullness for the shorter hairstyle, but also is less dramatic of a change when the hair falls out. Furthermore, when the hair begins to regrow, it takes less time to reach the shorter hairstyle. Having a hairstyle similar to the one before chemotherapy can help a person cope with the end of treatment and move forward. Hair and scalp care. The following recommendations may help when caring for the hair and scalp during cancer treatment: Choose a mild shampoo, such as a baby shampoo, to clean the hair. Choose a soft hairbrush and gently style the remaining hair. Use sun protection on the scalp when outdoors, including sunscreen, hats, or a scarf. Cover the head during the cold months to prevent loss of body heat. Avoid blow-drying the hair with high heat. Avoid curling or straightening the hair with chemical products. Avoid permanent or semi-permanent hair coloring. Choose a soft, comfortable covering for the bed pillow. Wig and hairpieces. The following information may be helpful if a patient chooses to wear a wig or hairpiece: Select the wig or hairpiece before the hair falls out if you prefer to match the current hair color and style. A hairdresser can style the wig/hairpiece to the your liking. If shopping for a wig/hairpiece in a retail store is not appealing, there are wig and hairpiece shops specially designed for people with cancer. A home appointment can also be scheduled, or an order can be placed through a catalog or the Internet. If finances are a concern, ask the patient's insurance provider if wigs/hairpieces are covered with cancer treatment or classified as a tax-deductible medical expense. To be covered by insurance, the doctor may have to prescribe the use of a wig/hairpiece with proper documentation. Free or loaner wigs/hairpieces may also be available. Ask an oncology social worker or nurse for resources within the hospital or local community. Be sure to have the wig/hairpiece fitted properly, so that it does not irritate the scalp. Caring for regrown hair. Complete hair regrowth often takes six to 12 months. When new hair regrows, at least temporarily, the texture may feel thinner than the hair that was lost. Pigment cells usually restore themselves, however, and hair usually returns to its original color. When caring for regrown hair: Limit washing the hair to twice a week. Massage the scalp to remove dry skin and flakes. Style hair with care and limit the amount of hard brushing, pinning, curling, or blow-drying with high heat, as new hair will initially be much finer and more prone to breaking than the original hair. Gently use a wide-tooth comb to style the regrown hair. Avoid curling or straightening the hair with chemical products (as in permanent wave solutions) until the hair is at least 3 inches long, or until it is comfortable. Some individuals may need to wait for up to one year before they can chemically curl or straighten their hair. Avoid permanent or semi-permanent hair coloring for at least three months following treatment. 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