|
We regret that we no longer have staff available to maintain this site or respond to requests for help.
We are making the site available as a courtesy, since
some people have found it useful, We reserve the right to remove any or all of the information at any time, and without notice, should this be deemed necessary. |
The process of hair growth and regrowth is a little clearer following a report on investigations into factors influencing baldness. (1)
Healthy hair follicles spend about 18 months growing at about 0.4 mm per day, after which the hair producing cells die off and the follicle is dormant for around 6 months. After this period the hair is shed, a new hair sprouts, and a fresh growth phase begins.
Age trends are important, and, when people go bald naturally, the fresh hairs become progressively finer and less coloured at which point the scalp looks bare. One theory is that each follicle has a limited number of cycles, after which it can only produce miniature hairs. When people go bald the follicles go though the same number of cycles, but do so much faster.
The growth rate can vary from 0.3-0.5 mm per day, between people; and, although the normal cycle is around two years, some people have a cycle of 10 years. A combination of these factors allows some people to grow hair 1.8 m long.
There are differences between men and women in control of natural hair loss, and such losses usually only occur if there is a steady supply of the male hormone dihydrotestosterone. Hippocrates (460-377 BC approx.) observed that eunuchs did not go bald, and scientists now believe that this is because their castration has removed the source of the critical male hormone.
There are also differences between different parts of the body. For example, in men there are usually strong differences in the balding pattern between the top of the scalp and the side of the head. In women age-related hair loss is normally more diffuse throughout the head and much less dramatic.
Against the description above, of natural hair loss and regrowth, it is interesting to reflect on long-term damage, which persists after any hair-pulling behavior has stopped.
It seems that damage varies enormously between individuals. One male sufferer had no apparent permanent damage two years after stopping hair pulling, despite nearly 40 years of scalp pulling. By contrast, a middle-aged female indicated that her hair did not regrow after pulling, and that she wore a wig to cover significant and permanent hair loss (2).
Severe hair loss has been recorded as a result of even infrequent hair-pulling episodes of minimal duration. In addition, the repetitive and prolonged pulling can lead to musculoskelatal problems such as carpal tunnel syndrome. (3, 4)
Changes in hair colour to white or grey have been noted, and these can persist long after hair pulling has ceased. Textural changes have also been recorded, e.g. normally straight hair becoming thick and curly (3).
Trichotillomania patients may develop patterns of avoidant behavior in response to hair loss. These can result in avoiding public activities such as swimming or dancing, and shunning intimate relationships (5). It can also result in avoiding physical examinations by a doctor, which results in decreased opportunities for detection and treatment of other medical conditions (3). There is the potential for these serious problems to diminish substantially, if not completely, when the hair-pulling behavior stops.
Associated skin damage can result inadvertently, or deliberately, by picking with fingernails, tweezers etc, resulting in infection or scarring (3). The long-term recovery will, in these cases, depend on the nature and extent of damage.
Where sufferers regularly ingest whole hair there can be formation of a trichobezoar (hair ball). Such balls can become very large and can have serious, even fatal, consequences. Sufferers should seek medical checkups and support, and, after the hair-pulling behavior has ceased, the problem will remain until adequately deal with. In serious cases surgery is generally needed and is usually successful (6).