Hair Loss1 0 R e a s o n s f o r

Alopecia

Lupus

Hairstyles

Heat & Chemicals

Cornrows

Only For Hair Care

Professionals

Hair LossTop 10 Reasons for

A Medical Guide for Hair Stylists & Hair Care Professionals

Frontal Fibrosing Alopecia

Page 18

Central Centrifugal

Scarring AlopeciaPage 26

Male and Female Pattern

BaldnessPage 28

Alopecia Areata

Page 10

Lupus

Page 13

Traction Alopecia

Page 34

Neuro-dermatitis

Page 38

Telogen Effluvium

Page 44

Lichen Planopilaris

Page 46

Ringworm & Bacterial Infections

Page 32

http://MedicalHairProfessionals.com

If you’re a hair care professional or involved

in the make-up or beauty industry, you know how critical healthy hair is to

your clients.

This magazine, written by a dermatologist,

outlines and illustrates the 10 Most Common

causes of hair loss.

Learn today, so you can help your clients

tomorrow.

About This Magazine

         This  magazine  briefly  covers  an  overview  of  10  common  types  of  hair  loss.    

Master  these,  and  you  will  be  well  on  your  way  to  providing  addi?onal  benefits  to  your  clients  related  to  medical  condi?ons  in  addi?on  to  your  beauty  skills  as  a  hair  care  professional.  

We  look  forward  to  providing  you  more  medical  ?ps  as  part  of  your  Medical  Hair  Professionals  membership.  For  more  informa?on  about  us  please  visit:

   MedicalHairProfessionals.com

Seymour M. Weaver III, M.D.

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Seymour  M.  Weaver,  III  M.DBoard  Cer4fied  Dermatologist

Founder  of  Medical  Hair  Professionals 5

(TOP)  Alopecia  Areata.  This  is  a  type  of  hair  loss  that  occurs  when  your  immune  system  mistakenly  a;acks  your  hair  follicles.  It  is  one  of  the  most  devasta?ng  hair  losses  people  can  experience  because  their  hair  oCen  comes  out  in  clumps,  resul?ng  in  totally  smooth,  round,  hairless  patches  on  the  scalp.  In  rare  cases  total  loss  of  all  body  hair  (eyebrows,  pubic  and  body  hair  as  well  as  on  the  scalp)  occurs.  The  hair  loss  oCen  comes  and  goes.  Hair  may  grow  back,  but  will  oCen  fall  out  in  another  area.  Hair  usually  grows  back  in  6  months  to  a  year,  but  may  be  a  different  texture  and  color.

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How  Can  a  Hair  Stylist  Help  a  Client  with  Alopecia  Areata?

Don’t  Underes?mate  Your  Ability  to  Help  Your  Clients

One  of  the  best  parts  of  being  a  hair  stylist  or  barber  is  that  moment  when  you  spin  that  chair  to  face  the  mirror  and  show  a  client  the  great  hair  style  you’ve  just  done  and  the  client’s  face  lights  up.    

Everyone  loves  to  look  their  best,  and  hair  professionals  get  help  their  clients  achieve  that.    It’s  hugely  sa?sfying,  but  it  can  also  be  hugely  challenging  when  the  client  has  a  condi?on  that  causes  hair  loss,  such  as  alopecia  areata.

Alopecia  areata  causes  the  hair  to  come  out  in  patches,  which  is  obviously  very  upseMng.    What  happens  is  that  the  immune  system  aNacks  the  hair  follicles  leading  to  the  development  of  smooth  bald  patches.    

Alopecia  areata  most  oOen  strikes  men  and  women  in  their  20s,  leaving  smooth,  round  bald  spots,  however  it  can  occur  at  any  age.    

Normally  the  hair  regrows  in  less  than  year,  but  in  some  cases  it  simply  never  returns.    

In  extreme  cases,  it  results  in  complete  baldness  of  the  scalp  which  is  referred  to  as  Alopecia  Totalis.    Hair  regrowth  is  also  less  likely  if  there  is  a  family  history  of  the  condi?on  or  another  autoimmune  disorder.

Stylist to the Rescue

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Alopecia    is  the  medical  term  for  the  loss  of  hair  

from  the  head  or  body.  For  those  suffering  from  the  

loss,  the  psychological  pain  is  far  more  profound  than  

any  physical  pain  they  may  suffer.  

Many  women  and  men  who  suffer  from  this  

condi?on  oCen  turn  to  their  hairstylist  or  hair  care  

professional  before  they  seek  a  doctor’s  diagnosis.  

This  is  why  a  hair  stylist  or  hair  care  professional  is  

oCen  the  cri?cal  person  in  their  client’s  life.  

When  you’re  educated  about  what’s  happening  

with  your  client’s  hair  you’re  in  the  best  place  to  help  

them  get  the  treatment  they  need.

Alopecia Areata

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How  to  Help  a  Client  with  Alopecia  AreataBarbers  and  hair  stylists  are  oOen?mes  the  first  point  of  contact  before  the  doctor.    If  a  client  men?ons  being  upset  about  hair  loss  and  it  sounds  like  he  or  she  has  not  

seen  the  doctor  about  it,  hair  stylists  and  barbers  would  be  doing  that  client  a  big  favor  by  poin?ng  out  that  the  doctor,  specifically  dermatologist  is  the  one  who  helps  with  hair  regrowth  and  even  more  importantly  discover  what  is  causing  the  hair  loss.    

While  It  is  not  the  role  of  the  hair  stylist  or  barber  to  diagnose  anyone,  it  is  perfectly  appropriate  for  you  to  become  familiar  with  medical  causes  of  hair  loss  and  if  you  see  the  signs  of  a  problem,  especially  if  the  client  has  expressed  concern,  you  can  certainly  direct  the  client  to  a   medical  professional.

In  the  mean?me,  barbers  and  hair  stylists  can  do  a  lot  to  help  alopecia  areata  sufferers  cope  with  the  condi?on  by  

guiding  them  to  styles  that  minimize  the  visibility  of  the  bald  spots.    

Perms  and  camouflage  agents  can  help  with  this  in  the  short  term.  It  would  be  best  to  avoid  hair  pieces  since  the  patches  can  appear  anywhere  on  the  scalp  without  warning.

Alopecia Areata

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Alopecia  areata  can  cause  a  lot  of  distress,  especially  when  the  sufferers  are  very  young.  Naturally,  people  in  their  20s  are  more  concerned  with  having  a  great,  trendy  hair  style  than  about  preserving  their  hair  and  can  be  really  shocked  to  see  patches  of  hair  loss  develop.    

A  trusted  and  

knowledgeable  hair  stylist  or  barber  who  can  reassure  them,  encourage  them  to  seek  medical  

aNen?on  and  provide  a  stylish  look  to  keep  them  confident  about  their  

appearance  can  be  a  real  help  to  alopecia  areata  sufferers.

Since  Alopecia  Areata  starts  under  the  skin  surface,  

grooming  and  styling  techniques  do  not  

usually  make  the  condi?on  itself  any  worse.

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Lupus involving hair, scalp and earLupusLupus  is  La4n  for  WOLF.  It  may  sound  like  a  strange  name  to  give  to  a  

disease,  but  considering  the  history  of  it,  it’s  really  not.  Lupus  is  characterized  by  a  dis4nc4ve,  disk  shaped  rash.  Once  the  rash  is  full-­‐

blown,  it  begins  to  heal  from  the  inside  out,  leaving  what  looks  like  a  bite-­‐type  

imprint  as  it  does  so.In  the  18th  century,  when  lupus  was  just  star4ng  to  be  recognized  as  a  

disease,  that  bite  type  mark  was  thought  to  be  caused  by  the  bite  of  a  wolf.  We  know  today  that  Lupus  has  nothing  to  do  with  wolves  and  bites,  but  

everything  to  do  with  an  autoimmune  disease  that  causes  hair  problems  and  

can  oPen  involve  the  scalp,  skin  and  other  parts  of  the  body  as  well.

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What  Do  Hair  Stylists  Need  to  Know  About  Lupus  Related  Hair  Loss?

Hair  Loss  Might  Be  the  First  Lupus  Symptom  that  Pa4ents  Seek  Help  to  Treat

Lupus

The  autoimmune  disease  lupus  has  many  symptoms,  but  some  are  vague  and  sufferers  might  not  seek  help  for  general  fa?gue,  joint  pain  or  a  chronic  low  grade  fever  thinking  they  just  need  to  rest  more.    Hair  loss,  however,  can  light  a  fire  under  people,  especially  younger  people.

Lupus  causes  hair  loss  and  a  rash,  and  there  are  some  special  changes  on  the  scalp  to  look  for.    As  a  hair  stylist,  you  are  likely  to  encounter  clients  with  lupus  sooner  or  later,  so  it’s  best  to  be  prepared  with  some  knowledge.

Two  Types  of  LupusThere  are  two  types  of  lupus,  and  both  are  gene?c  and  not  contagious.    Both  cause  hair  

loss  in  slightly  different  ways.

• Discoid  lupus  is  a  form  of  lupus  that  affects  the  skin  and  a  rash  develops,  oOen?mes  on  the  scalp  associated  with  hair  loss.    The  rash  will  usually  have  red,  brown,  or  white  areas  of  discolora?on  on  the  scalp  as  well  as  enlarged  hair  follicles  with  dark  specks  referred  to  as  follicular  plugging.  When  the  condi?on  progresses  to  scarring  it  prevents  new  hair  growth.    Similar  changes  frequently  occur  inside  of  the  ears  so  it  can  be  possible  to  tell  that  someone  has  lupus  when  the  rash  occurs  there  as  well.

• Systemic  lupus  is  the  form  of  lupus  that  affects  the  internal  organs  of  the  body  with  or  without  skin  involvement.    The  changes  of  discoid  lupus  can  be  present  or  absent  as  well  as  diffuse  shedding  and  thinning  when  the  systemic  disease  itself  flares  up.    The  hair  normally  grows  back  when  the  lupus  is  controlled.    

• Some  of  the  medica?ons  used  to  treat  lupus  can  also  cause  hair  loss,  but  in  those  cases  the  hair  should  eventually  grow  back  if  and  when  the  pa?ent  can  reduce  or  stop  the  par?cular  drug.    Of  course,  the  stress  of  living  with  lupus  and  being  ill  in  general  do  nothing  to  help  promote  healthy  hair  growth.

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More  to  ConsiderLupus  sufferers  can  develop  intense  

rashes,  especially  when  exposed  to  enough  sunlight.    

Those  rashes  primarily  affect  exposed  areas,  including  the  scalp.    If  you  know  a  client  has  lupus,  remember  that  her  scalp  might  be  very  sensi?ve  to  chemical  treatments,  heat  and  brushing.  

 Talk  to  your  client  about  styles  that  minimize  discomfort  when  she  has  a  lupus  rash  on  her  scalp.    While  no  clinical  studies  have  been  done,  I  am  of  the  opinion  that  it  would  be  best  to  avoid  chemicals  and  excessive  heat  as  much  as  possible  for  a  client  with  ac?ve  lupus  lesions  on  the  scalp.

Women  are  more  likely  to  get  lupus  than  men,  and  some  ethnic  groups  are  at  greater  risk  than  others,  but  if  you  are  a  professional  hair  stylist,  you  will  almost  

certainly  have  a  client  with  lupus  at  some  point  during  your  career.    

In  fact,  you  could  even  play  a  role  in  a  client  being  correctly  diagnosed  if  she  comes  to  you  about  hair  loss  before  seeing  her  doctor  about  other  symptoms.

Lupus

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Lupus Follicular Plugging 17

Frontal Fibrosing Alopecia

Receding  Hairline  or  Autoimmune  Disorder?

Can  You  Tell  the  Difference  Between  an  Ordinary  Receding  Hairline  and  Frontal  Fibrosing  Alopecia?

Many  men  expect  their  hairline  to  recede  a  bit  with  middle  age,  but  few  women  have  the  same  expecta?on.    Frontal  Fibrosing  Alopecia  is  a  rare  disorder  that  causes  hair  loss  along  the  front  of  the  hair  line  and  some?mes  affects  the  eyebrows.    

While  it  primarily  affects  women,  men  can  suffer  from  it  as  well.    

One  of  the  characteris?cs  of  this  condi?on  is  that  the  hairline  moves  back  further,  and  further,  and  further  as  ?me  goes  by.

Scien?sts  are  not  sure  of  the  exact  cause  of  this  condi?on,  but  it  appears  

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mostly  in  post-­‐menopausal  women  and  may  be  linked  to  a  hormone  imbalance.    

However,  it  can  also  develop  in  females  in  their  20’s  and  30’s  so  these  ladies  have  to  be  considered  as  well.  

There  is  also  some  evidence  that  it  is  an  autoimmune  response.    It  is  possible  that  Frontal  Fibrosing  Alopecia  is  a  varia?on  of  Lichen  Planopilaris.    

It  is  a  primary  cicatricial  alopecia,  which  means  that  hair  follicles  are  replaced  by  scar  ?ssue  as  the  condi?on  progresses.    This  is  a  very  rare  condi?on,  but  professional  hair  stylists  and  barbers  should  s?ll  be  aware  of  it,  especially  those  whose  cliental  includes  a  lot  of  middle  age  or  older  women.

What  Happens?Frontal  Fibrosing  Alopecia  involves  

inflamma?on  of  the  scalp  around  the  forehead.    The  skin  may  be  slightly  pale,  and  some  scars  may  be  visible.    

If  the  inflamma?on  is  ac?ve,  the  skin  may  appear  reddish,  or  purple  with  puffiness  around  the  hair  follicles.    

The  inflamma?on  damages  the  hair  follicles,  which  become  scarred  to  the  point  where  hair  cannot  grow.    

The  hair  loss  is  very  slow  and  gradual,  and  it  normally  stabilizes.    It  can  affect  the  eyebrows  as  well,  and  even  in  some  cases,  the  armpits.

What  Can  Be  Done?An?-­‐inflammatory  medica?on  may  

help  by  preven?ng  the  condi?on  from  

geMng  worse,  but  there  is  unfortunately  no  real  cure  at  this  point.    

However,  early  treatment  and  interven?on  can  help  heal  the  damaged  areas  and  save  as  much  hair  as  possible.

In  a  nutshell,  medical  science  can’t  offer  an  answer  as  to  why  your  clients  are  suffering  from  Frontal  Fibrosing  Alopecia,  but  hair  stylists  can  help  by  guiding  their  clients  to  styles  that  make  the  hair  loss  less  obvious.    

The  last  thing  to  do  is  wear  styles  that  can  cause  more  hair  loss  by  risking  trac?on  alopecia.    Instead,  styles  that  keep  the  hair  loose  at  the  front  of  the  scalp,  par?cularly  with  bangs,  can  do  a  lot  to  boost  the  client’s  confidence  and  self-­‐esteem.

Hair  loss  can  be  a  real  blow  to  anyone,  and  women  generally  take  pride  in  their  hair.    Combine  hair  loss  and  signs  of  aging  such  as  menopause,  and  a  woman  can  begin  to  feel  quite  down  about  her  appearance.    

That’s  where  a  good  stylist  has  a  chance  to  make  a  real  difference.    Your  clients  depend  on  you  to  look  good  and  feel  good  about  how  they  look.    

When  they  are  hit  with  hair  loss,  you  will  be  their  first  point  of  contact  for  real  help.  

Knowing  that  condi?ons  such  as  this  exist  and  the  benefit  of  early  diagnosis  and  treatment  can  help  you  to  guide  your  clients  along  the  right  path.

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Scalp Pyoderma and Secondary Impetigo

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Frontal Fibrosing Alopecia

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Female Pattern Baldness

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Central Centrifugal Alopecia

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No longer called hot comb alopecia

It affects thousands of women, but researchers still don’t know what causes it . . .

Central Centrifug

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al Scarring Alopecia

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If  you’ve  never  heard  the  term  central  centrifugal  scarring  alopecia,  it  doesn’t  mean  you’ve  never  seen  this  type  of  hair  loss  condi?on.    

Thousands  of  women,  many  of  African  American  heritage  silently  suffer  with  this  condi?on,  and  the  numbers  are  increasing  on  a  daily  basis.    Men  can  get  it,  but  that  is  rare.  

The  name  has  changed  as  science  has  learned  more  about  this  type  of  hair  loss,  but  researchers  have  yet  to  pin  down  a  single  or  simple  cause.    

This  type  of  hair  loss  has  gone  by  many  names  since  first  being  iden?fied  in  the  1950s.    Hot  comb  alopecia  was  the  first  term  used  because  it  appeared  to  be  caused  by  burns  from  hot  oil.    

Researchers  later  realized  that  some  African  Americans  who  never  or  only  rarely  hot  combed  their  hair  experienced  the  condi?on  and  renamed  it  follicular  degenera?on  syndrome.    

Today  it  is  known  as  central  centrifugal  scarring  alopecia  or  central  centrifugal  cicatricial  alopecia.    

By  any  name,  this  type  of  hair  loss,  which  involves  scarring  and  hair  loss  spreading  from  the  top  of  the  head  in  a  symmetrical  paNern,  is  extremely  upseMng  and  unwelcome.

Possible  Causes  and  Contribu4ng  Factors

While  there  is  not  conclusive  proof,  many  researchers  suspect  that  hair  straightening  methods  that  involve  chemicals  or  heat  are  at  least  par?ally  to  blame.    Gene?cs  are  another  possible  factor.    

It  seems  likely  that  women  with  a  gene?c  predisposi?on  to  central  centrifugal  scarring  alopecia  can  trigger  the  condi?on  by  using  harsh  chemicals  or  heat  on  their  hair  regularly  for  a  long  period  of  ?me.    

While  overly  ?ght  braids  and  styles  can  cause  trac?on  alopecia,  they  are  not  responsible  for  this  type  of  hair  loss,  which  involves  scarred  hair  follicles.    

Tight  braiding,  however,  can  aggravate  central  centrifugal  scarring  alopecia  and  it  is  possible  for  an  individual  to  have  both  

What  Hair  Professionals  Need  to  Know  about  Central  Centrifugal  Scarring  Alopecia

It’s  Gone  by  Many  Names,  but  the  Cause  Is  S?ll  Uncertain

Central Centrifugal Scarring Alopecia

26

together.    Some  researchers  have  also  suggested  that  African  American  hair  is  par?cularly  vulnerable  to  damage  because  it  is  fragile.    

Central  centrifugal  scarring  alopecia  is  a  progressive  condi?on  without  a  cure.    Once  it  starts,  it  will  get  worse  over  ?me.    

Many  individuals  recall  no?cing  a  small  area  of  hair  loss  about  the  size  of  a  dime  which  progressed  over  a  period  of  years  to  involve  40%  to  60%  of  the  middle  por?on  of  the  scalp.    

In  extreme  cases,  80%  of  the  hair  on  the  scalp  can  be  lost.  Clearly  this  is  a  situa?on  where  preven?on  isn’t  just  beNer  than  a  cure,  it  is  the  only  op?on.    And  with  what  is  known,  that  means  geMng  a  medical  diagnosis  as  early  as  possible  and  not  overdoing  the  heat  and  chemical  straighteners.

It’s  a  compelling  argument  for  natural  hair.      Once  the  damage  is  done  it  is  permanent,  so  op?ng  for  natural  hair  won’t  cause  the  hair  to  regrow,  but  it  can  drama?cally  slow  the  progress  of  the  hair  

loss.    Free  hair  styles  can  also  minimize  the  appearance  of  the  bald  area.  A  hair  stylist  familiar  with  working  with  natural  African  American  hair  can  do  a  lot  to  help  clients  avoid  central  centrifugal  scarring  alopecia.    

One  word  of  cau?on,  I  recently  cared  for  a  pa?ent  who  never  used  chemicals  and  wore  her  hair  natural,  but  s?ll  developed  a  severe  version  of  this  condi?on.

This  is  one  condi?on  you  should  learn  to  recognize  as  early  as  possible;  your  clients  need  your  help!  

Avoid  the  tempta?on  to  give  your  client  a  quick  fix  by  covering  up  these  spots  with  a  hair  piece.    

Untreated  the  condi?on  will  con?nue  to  spread  and  one  day  there  will  not  be  any  hair  leO  to  aNach  the  hair  piece  to.

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Male Pattern Baldness

Baldness is Not Just

Male  PaUern  Baldness  Not  Just  for  Men

Don’t  Be  Fooled  by  the  Name  –  Androgenic  Alopecia  Affects  Women  Too

Androgenic  alopecia  is  the  medical  term  for  what  most  of  us  know  as  male  paNern  baldness,  but  it  affects  women  too  in  the  form  of  female  paNern  baldness.

Call  it  what  you  like  –  male  paNern  baldness,  female  paNern  baldness  or  androgenic  alopecia  –  no  one  likes  losing  hair!    As  a  hair  stylist  or  barber,  you  may  be  the  first  person  a  client  shares  his  or  her  concern  with.    In  fact,  given  your  vantage  point  as  you  work  on  a  client’s  hair,  you  might  even  no?ce  the  hair  loss  before  the  client  does.

What  Exactly  Is  Androgenic  Alopecia?

This  type  of  hair  loss  is  gene?c,  so  people  who  know  what  their  parents’  hair  looked  like  past  middle  age  should  not  be  too  surprised  to  find  themselves  following  suit.    It  can  start  at  a  younger  age,  as  early  as  the  20s.    

For  the  most  part,  men  start  to  show  signs  of  androgenic  alopecia  earlier  than  women,  who  don’t  oOen  experience  this  condi?on  un?l  their  40s.

Although  the  term  androgenic  alopecia  is  used  to  describe  this  type  of  gene?c  hair  loss  in  both  men  and  women,  it  does  not  follow  the  same  course  for  both  sexes.

• Male  PaNern  Baldness:  In  men,  the  hair  loss  generally  begins  much  earlier,  in  the  20s  and  30s.    It  is  characterized  by  a  receding  hairline  and  thinning  hair  that  progresses  to  areas  of  complete  baldness  in  a  variety  of  paNerns.

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Female Pattern Baldness

a Worry for Men

• Female  PaNern  Baldness:  In  women,  the  hair  begins  to  thin  in  the  30s,  40s  or  later.    The  hair  thins  primarily  in  the  middle  third  of  the  scalp,  but  does  not  usually  become  completely  bald  as  it  does  in  men.  Many  females  complain  of  being  able  to  see  through  their  scalp  as  a  result  of  this  condi?on  and  that  is  what  really  bothers  them  the  most.

CombaYng  Androgenic  Alopecia  

Unfortunately,  there  is  no  way  to  prevent  this  type  of  hair  loss,  but  those  affected  can  minimize  the  problem  through  a  few  different  approaches.    Some  people  with  androgenic  alopecia  will  have  some  success  with  different  approaches,  and  some  will  only  see  very  minimal  results.

•No  lifestyle  change  will  prevent  androgenic  alopecia,  but  one  can  certainly  make  some  improvements  to  make  sure  nothing  else  is  promo?ng  hair  loss.    

Following  a  healthy  diet,  geMng  enough  rest  and  relaxa?on,  and  avoiding  anything  that  damages  the  scalp  will  help  anyone  keep  their  hair  as  healthy  as  possible.

•The  right  hair  style  can  make  the  thinning  areas  less  no?ceable,  but  clearly  the  comb-­‐over  fools  no  one  when  hair  loss  has  reached  a  certain  point.    

•Topical  Minoxidil  is  an  FDA  approved  treatment  for  androgene?c  alopecia  and  is  available  in  a  variety  of  products  usually  in  a  2%  concentra?on  for  females  and  5%  

concentra?on  for  males.  The  earlier  this  product  is  used,  the  beNer.    Once  complete   29

baldness  is  present  the  response  rate  becomes  very  low.    Over  the  counter  remedies  can  be  applied  to  the  scalp,  and  

• Addi?onal  prescrip?on  medica?ons  can  be  taken  orally  by  men  with  fairly  good  success.  But  the  medica?ons  available  to  women  do  not  provide  the  same  degree  of  improvement  as  with  men  and  cannot  be  used  in  women  trying  to  get  pregnant,  because  of  the  risk  of  birth  defects.

• Laser  treatments  in  the  form  of  combs  and  hoods  are  another  FDA  approved  treatment  process  that  can  be  of  benefit.    Again,  the  earlier  treatment  is  started,  the  beNer.  

• Hair  graOs,  toupees  and  wigs  can  also  be  used  to  disguise  baldness,  but  some  

people  will  actually  look  beNer  with  less  hair  than  with  a  hairpiece.

• Of  course,  many  men  who  develop  androgene?c  baldness  choose  to  shave  their  heads  completely  and  go  with  a  bald  masculine  look.    This  hair  style  has  not  caught  on  with  women.

Barbers  and  hair  stylists  are  on  the  front  lines  with  clients  who  are  concerned  about  hair  loss  of  all  types,  including  androgenic  alopecia.    

But  it  is  gra?fying  to  be  able  to  boost  someone’s  confidence  with  the  right  hair  style  and  moral  support.

Male & Female Pattern Baldness

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“Anyone can be confident with a full head of hair , but a

confident bald woman? There’s your diamond in the rough.”

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Ringworm & Bacterial Infections

Hair  loss  has  many  causes,  and  one  of  them  is  infec?on.    If  the  scalp  and  hair  follicles  become  infected,  alopecia  can  be  the  result.    

This  type  of  hair  loss  is  treatable,  but  it  is  also  contagious.    Hair  care  professionals  need  to  be  aware  the  types  of  infec?ous  alopecia  and  take  care  to  properly  clean  equipment  and  protect  themselves  from  exposure.

Different  types  of  fungal  and  bacterial  infec?ons  can  lead  to  hair  loss,  and  these  condi?ons  need  medical  aNen?on.    In  an  otherwise  healthy  person,  they  are  normally  not  that  difficult  to  treat  although  it  gets  trickier  if  they  spread  through  a  large  family.

Ringworm  or  Tinea  Capi4s

Ringworm  is  very  contagious  and  can  be  spread  by  contaminated  combs  as  well  as  skin  to  skin  contact,  but  thankfully  it  does  not  involve  worms!    

Also  known  as  ?nea  capi?s,  this  fungal  infec?on  is  caused  by  organisms  similar  to  those  that  cause  ringworm  infec?ons  on  the  

body.    Hair  is  lost  in  a  ring  shape,  hence  the  name.    

It  isn’t  preNy.    Ringworm  symptoms  include  scaly,  red  patches  on  the  scalp  that  blister  and  ooze.    The  hair  becomes  extremely  briNle  and  breaks  off  as  the  follicles  become  damaged.    

The  most  common  organism  that  causes  ringworm  infec?ons  of  the  scalp  can  also  cause  patches  that  are  dry  like  dandruff,  without  the  ring  shaped  hair  loss.  So,  you  should  be  aware  that  other  possible  versions  exist.

The  treatment  depends  on  which  of  many  possible  funguses  are  involved,  however  oral  medica?on  for  4,  6,  or  8  weeks  is  usually  necessary  to  clear  this  type  of  infec?on  from  the  scalp.

Folliculi4s

Folliculi?s  is  usually  recognized  by  the  presence  of  pustules  with  a  hair  follicle  in  the  middle.  While  not  all  types  of  folliculi?s  are  infec?ous,  the  majority  of  the  ?me  a  bacterial  infec?on  is  usually  to  blame  for  this  

Do  You  Know  the  Two  Common  Types  of  Infec4ous  Alopecia?

Use  Care  with  These  Contagious  Condi?ons

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condi?on.    Folliculi?s  looks  like  acne,  and  in  severe  cases  the  hair  follicle  can  be  permanently  damaged,  which  leads  to  small  bald  spots  and  scarring.    

Of  par?cular  concern  is  the  presence  of  methicillin  resistant  staph  aureus  (MRSA)  infec?ons  of  the  scalp  in  a  significant  number  of  individuals  with  folliculi?s.    These  infec?ons  are  fairly  contagious  and  can  cause  significant  pain  and  irrita?on.  

A  bacterial  culture  from  the  scalp  is  necessary  to  iden?fy  these  organisms  as  well  

as  the  proper  type  of  an?bio?c  treatment  required  to  get  the  infec?ons  to  clear.  

If  you  have  a  client  with  pustules  or  crusted  areas  around  the  hair  follicles  on  their  scalp,  encourage  them  to  get  medical  evalua?on  right  away.    

These  condi?ons  are  par?cularly  challenging  for  hair  care  professionals  because  they  are  contagious  and  pose  a  risk  of  spreading  to  the  stylist  by  direct  contact.  

(Top) Ringworm on the skin (Right) Infectious Alopecia

Bacterial and fungal infection

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Many popular hairstyles that involve tight braids, ponytails or other techniques that can lead to Traction Alopecia look great—until it’s too late.

Traction Alopecia

“Traction alopecia is one of the most common forms of hair loss among

women, particularly among African American women, but the good news

is that it is entirely preventable.”

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Trac?on  Alopecia:  The  Good  News  and  the  Bad  News

How  to  Help  Your  Clients  Before  It’s  Too  Late 35

  Every  hair  stylist  has  seen  the  damage  done  to  hair  by  wearing  it  ?ghtly  braided  or  pulled  back  over  a  long  period  of  ?me.    

The  receding  hairlines  and  ever-­‐widening  parts  are  typical  of  trac?on  alopecia.    

Although  trac?on  alopecia  is  most  prevalent  among  African  American  women  because  of  the  popularity  of  ?ghtly  braided  styles,  it  can  affect  anyone  of  any  ethnic  group  who  wears  her  hair  pulled  back  with  too  much  force,  whether  it  is  in  a  single  ponytail  or  elaborate  cornrows.

Many  women  grew  up  with  the  no?on  that  hair  styling  hurt,  and  they  just  had  to  put  up  with  it.    

As  liNle  girls,  their  hair  was  pulled  ?ghtly  and  their  complaints  ignored.    

It  was  simply  considered  part  of  the  female  experience.    

Those  no?ons  are  changing  as  knowledge  about  trac?on  alopecia  is  growing.  

Also,  as  more  men  wear  braided  hair  styles  this  condi?on  is  being  seen  in  them  as  well.

The  Good  News  about  Trac4on  AlopeciaTrac?on  alopecia  is  one  of  the  most  

common  forms  of  hair  loss  among  women,  par?cularly  among  African  American  women,  but  the  good  news  is  that  it  is  en?rely  preventable.    There  is  no  gene?c  or  hormonal  factor.    

It  is  not  related  to  any  problem  with  the  hair  growth  cycle.    It  really  is  down  to  the  hair  being  pulled  out.    

Trac?on  alopecia  can  be  prevented  with  proper  hair  care  and  styling.

It  is  easy  to  tell  if  a  hair  style  is  too  ?ght.    

If  it  hurts,  it  is  too  ?ght.    If  you  see  liNle  bumps,  with  scaling,  flaking  or  pustules  along  the  parts,  it  is  too  ?ght;  this  represents  a  condi?on  called  trac?on  folliculi?s.    

If  the  hairline  is  receding  and  the  parts  seem  wider,  it  is  too  ?ght.    

Traction Alopecia

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Happily,  it  is  not  necessary  to  give  up  braiding  to  prevent  trac?on  alopecia.    Simply  leave  the  braids  a  liNle  looser  close  to  the  scalp.    

Likewise  for  puffs  or  ponytails  –  just  leave  them  a  liNle  looser.    

They  may  need  to  be  redone  more  oOen,  but  that’s  a  small  price  to  pay  to  prevent  hair  loss.    Leaving  the  hair  free  and  out  of  a  style  for  a  day  or  two  between  styles  will  also  help.    

Early  medical  treatment  for  trac?on  folliculi?s  can  help  to  stop  the  inflamma?on  and  get  the  scalp  to  heal  before  scarring  occurs.

The  Bad  News  About  Trac4on  AlopeciaThere  is  no  real  cure.    If  the  hair  style  

is  not  changed  when  the  bumps  first  start  developing  around  the  hair  follicles,  then  things  can  take  a  turn  for  the  worse.  It  is  not  simply  a  maNer  of  the  hair  being  pulled  out.    

Over  ?me,  the  hair  follicles  become  scarred,  and  once  that  happens  they  will  

never  return  to  their  former,  undamaged  state.    

Taking  a  different  approach  to  hair  styling  can  prevent  further  damage  and  make  the  hair  loss  less  obvious,  but  there  is  no  pill  or  po?on  that  will  make  it  grow  back  to  its  pre-­‐damaged  state.    

Extensions,  weaves  and  wigs  can  disguise  trac?on  alopecia,  but  these  tac?cs  should  be  used  with  care  to  avoid  making  the  hair  loss  worse.

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Severe Neurodermatitis of Posterior Scalp

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Neurodermatitis may begin with something as simple as something that rubs, irritates, or scratches the skin, such as clothing. The irritation and itching causes the person to rub or scratch the affected area which results in more itching which results in more scratching. This then causes the skin to thicken making the skin itch, causing more scratching, causing more thickening. One affected area can rapidly spread through the body.

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It  can  start  as  a  nervous  habit  or  a  reac?on  to  an  irrita?ng  tag  on  clothing,  an  insect  bite  or  something  else  that  rubs  the  skin,  but  when  a  person  scratches  that  spot  too  much,  it  causes  further  irrita?on  and  develops  into  a  stubborn  itchy  rash  called  neuroderma??s.  

For  unknown  reasons,  the  scalp  is  a  very  common  loca?on  for  this  disorder  to  occur.    It  isn’t  an  easy  cycle  to  break,  and  neuroderma??s  of  the  scalp  is  a  par?cularly  tough  problem.

If  you  are  working  on  someone’s  hair,  you  will  no?ce  if  they  have  a  serious  case  of  neuroderma??s  of  the  scalp.  However,  when  the  problem  first  starts,  the  scalp  can  look  perfectly  normal,  even  though  the  itching  can  be  extremely  severe.    

With  chronic  ac?vity,  the  skin  

becomes  thick,  darkened  and  irritated  in  patches.    Neuroderma??s  of  the  scalp  and  on  any  other  parts  of  the  body,  tends  to  involve  limited  localized  spots  rather  than  spreading.    With  con?nued  scratching  on  the  scalp,  hair  loss  develops  with  patches  of  short  broken  off  hair.

Breaking  the  Cycle  of  Neuroderma44s  of  the  Scalp

This  is  a  problem  for  a  doctor,  but  it  is  helpful  for  barbers  and  hair  stylists  to  know  about  neuroderma??s  of  the  scalp  and  how  it  is  treated.    Be  aware  that  many  ?mes  your  client  will  complain  about  itching  and  the  

scalp  looks  ok.

•Stress  is  oOen  an  underlying  factor.    The  

scratching  becomes  a  

Neurodermatitis of the Which  Comes  First,  the  Itch  or  the  Scratch?

40

Scalp: A Cycle

nervous  habit,  and  people  don’t  realize  they  are  doing  it.    So  iden?fying  stress  factors  and  finding  solu?ons  for  stress  management  is  an  important  part  of  stopping  the  itch/  scratch  cycle  of  neuroderma??s.

• Itchiness  is  a  factor  too,  and  needs  to  be  addressed.    Topical  medica?ons  are  prescribed  to  be  applied  to  the  scalp  as  well  as  oral  an?-­‐itch  meds  plus  injec?ons  of  an?-­‐inflammatory  medica?on  into  the  bothersome  spots.  The  goal  is  to  control  the  itching  so  sufferers  can  work  on  stopping  the  scratching  and  leMng  the  skin  heal.

• Avoiding  irritants  is  important  because  they  will  increase  the  itching  and  also  irritate  the  sore  skin  of  affected  areas,  causing  further  damage.    Be  very  careful  selec?ng  hair  products  to  use  on  clients  with  neuroderma??s  of  the  scalp.

Itchiness  and  sore  irritated  skin  are  not  the  only  problems  caused  by  

neuroderma??s  of  the  scalp.    If  the  scratching  isn’t  controlled,  the  skin  can  become  thickened  and  darkened.      

Tackling  neuroderma??s  of  the  scalp  early  is  the  best  plan  so  scarring  and  hair  loss  –  as  well  as  a  lot  of  misery  from  itchy,  sore,  infected  skin  –  can  be  prevented.    

While  a  doctor’s  care  (and  prescrip?on  pad)  are  usually  necessary  to  cure  this  condi?on,  a  suppor?ve  hair  stylist  or  barber  can  make  sure  not  to  cause  any  further  irrita?on  by  avoiding  harsh  chemicals  or  excessive  brushing  and  combing  while  the  skin  is  sore  or  in  the  process  of  healing.

Once  the  condi?on  is  under  control,  hair  strengtheners  and  condi?oners  can  help  protect  the  new  hair  growth  un?l  it  catches  up  with  the  normal  areas  of  growth.

Neurodermatitis of Posterior Scalp

41

Is it simply A Dry Scalp orthat could cause your

Permanently Bald?

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If you’re a Stylist or a Hair Care

Professional, You’re a Hero and a

Life saver.

Your clients depend on you to tell them when their hair isn’t as healthy as it could be, or when it appears to

be getting thinner, or looks “off” somehow. They turn to you for

advice when they think they have dandruff, or when their scalp just

won’t stop itching.

Did you realize that what looks like “no big deal,” could be the

beginning of your client’s permanent hair loss?

Find out the signs, symptoms and causes of the 10 ten reasons for

hair loss on the Internet at:

www.MedicalHairProfessionals.comand

www.DrSeymourWeaver.com

Dr. Weaver is a Board-Certified Dermatologist in Houston, Texas

something client to go

It  is  not  exactly  news  to  most  professional  hair  stylists  and  barbers  that  hair  grows  in  cycles,  and  that  each  hair  follicle  has  its  own  cycle,  which  includes  periods  of  growth  and  periods  of  rest.    

But  as  we  age,  those  cycles  slow  down  and  if  a  large  percentage  of  our  hair  hits  the  res?ng  period  –  the  telogen  period  –  at  the  same  ?me  the  short-­‐term  result  can  be  thinning  hair.    And  that  can  cause  clients  to  panic.

When  a  client  sheds  hair  excessively,  it’s  great  to  be  able  to  reassure  them  that  their  hair  is  going  through  a  phase,  although  it  is  a  bit  longer  than  a  bad  hair  day!    

Telogen  is  characterized  by  the  loss  of  200,  300  or  more  hairs  per  day  and  can  last  eight  to  twelve  months,  which  can  feel  a  lot  longer  to  a  client  wai?ng  for  that  new  growth  to  start  showing  up  while  seeing  more  hair  going  down  the  drain  with  every  shampoo  or  shower.  

Telogen Effluvium: No Reason to PanicThis  Condi?on  Is  UpseYng  –  But  Temporary

44

Typically  the  hairs  that  are  lost  have  white  ?ps  on  the  end  which  are  characteris?c  of  club  hairs.    

A  number  of  condi?ons  can  contribute  to  this  type  of  hair  loss  including,  childbirth,  illnesses  with  high  fever,  rapid  weight  loss,  surgical  opera?ons,  thyroid  disease,  and  anemia.    

Telogen  Effluvium  Do’s  and  Don’ts

• Do  help  clients  find  a  way  to  style  their  hair  that  makes  the  shedding  of  hair  loss  as  unno?ceable  as  possible.

• Don’t  agree  too  quickly  to  a  radical  change  such  as  hair  weaves  or  extensions  that  can’t  be  quickly  undone.    

• Do  reassure  them  that  telogen  effluvium  is  a  common  and  temporary  problem  that  will  probably  solve  itself  in  a  period  of  months  as  long  as  the  original  cause  is  corrected.

• Don’t  discourage  clients  from  seeing  a  doctor  about  the  condi?on,  no  maNer  how  certain  you  are  that  it  is  just  plain  old  telogen  effluvium.    

• Do  encourage  your  client  to  enjoy  a  healthy  lifestyle  with  enough  of  the  right  proteins  and  stress-­‐bus?ng  ac?vi?es.    Some  type  of  major  stress  to  the  body  is  always  associated  with  Telogen  Effluvium.    

• Don’t  make  light  of  the  upset  this  can  cause  some  people.    Excessively  shedding  hair  can  trigger  a  host  of  worries  about  appearance  and  aging.    Some  of  your  clients  might  be  genuinely  upset  about  telogen  effluvium.

• Do  try  to  monitor  how  long  the  hair  thinning  con?nues.    If  it  goes  on  longer  than  several  months,  encourage  your  client  to  see  a  doctor  about  it.

Telogen  effluvium  isn’t  fun,  but  it  not  a  reason  to  panic.    If  the  excessive  shedding  of    hair  really  is  due  to  this  condi?on,  there  is  no  reason  for  a  client  to  rush  out  looking  for  extensions.

That  won’t  really  help  the  problem.    Telogen  effluvium  is  normally  a  short  term  problem,  so  a  short  term  solu?on  is  all  that  is  needed.    

45

Lichen  Planopilaris:Scien4sts  Are  S4ll  Struggling  to  Find  the  Cause  of  

Planopilaris

Whatever  the  Cause,  the  Effects  Are  Clear

46

Lichen  Planopilaris  is  a  category  of  hair  loss  that  remains  mysterious.    Researchers  have  yet  to  find  a  specific  cause,  although  it  seems  to  be  an  autoimmune  problem.      

What  is  well  understood  is  that  in  these  disorders,  called  primary  cicatricial  alopecias,  the  hair  follicles  become  inflamed  and  develop  scar  ?ssue,  which  prevents  the  hair  from  growing.  

 A  skin  biopsy  of  the  scalp  is  necessary  to  make  this  diagnosis.    The  inflamed  scalp  can  itch,  develop  tenderness  or  the  condi?on  might  be  more  subtle  with  

no  symptoms  at  all.    The  hair  loss  is  usually  gradual,  and  the  person  might  not  no?ce  it  in  the  early  stages.    

Lichen Planopilaris

It  can  be  quite  a  shock  for  a  person  to  suddenly  realize  she  has  lost  a  great  deal  of  hair  and  they  are  even  more  surprised  when  a  medical  evalua?on  reveals  that  the  condi?on  is  causing  scarring  of  their  scalp  that  can  cause  permanent  baldness.    

A  hair  stylist  may  well  no?ce  the  problem  before  the  client,  since  most  clients  only  become  aware  of  the  condi?on  when  the  hair  is  too  thin  to  wear  a  par?cular  hair  style.    

The  details  of  how  this  condi?on  presents  may  vary,  but  the  boNom  line  is  that  it  causes  hair  loss  that  can  spread  across  the  en?re  scalp  and  does  not  respond  well  to  treatment,  although  steroids  and  other  medica?ons  can  help  slow  it  down,  and  that  makes  those  who  have  it  unhappy.

Who  Is  Likely  to  Get  Lichen  Planopilaris?

As  with  many  forms  of  scarring  hair  loss,  middle  aged  women  are  most  likely  to  suffer  from  lichen  planopilaris,  it  can  occur  in  the  teens,  twen?es,  and  thir?es.  It  seems  downright  cruel.    

Women  between  the  ages  of  40  and  60  have  many  physical  and  life  changes  to  cope  with,  and  hair  loss  can  be  a  real  blow  to  a  woman’s  self-­‐image.    Between  menopause  

and  slowing  metabolism,  women  can  feel  a  bit  overwhelmed  by  the  rate  of  change  –  when  you  put  hair  loss  into  the  mix,  it  can  become  depressing.    

Many  women  of  menopausal  age  automa?cally  assume  that  any  hair  loss  is  due  to  hormone  changes  when  in  fact  the  scalp  is  being  scarred  and  damaged  by  this  disease  process.

That’s  where  an  informed  hair  stylist  can  really  help.    

When  you  are  able  to  recognize  this  condi?on  and  alert  your  clients  to  the  possibility  of  lichen  planopilaris  then  they  can  get  medical  evalua?on  and  treatment  as  early  as  possible.    

That  way  they  are  not  alone,  and  you  can  help  them  create  a  new  look  that  disguises  the  hair  loss  without  aggrava?ng  the  medical  condi?on,  it  can  give  those  clients  and  their  self-­‐esteem  a  boost.

Researchers  con?nue  to  search  for  the  cause  of  lichen  planopilaris,  and  it  seems  likely  there  is  more  than  one  factor  at  play.    Gene?cs  and  stress  may  play  a  role,  as  they  seem  to  in  many  autoimmune  disorders.    Hopefully  one  day  this  will  be  beNer  understood  and  beNer  treatments  will  be  discovered.

Lichen Planopilaris

48

Resources for Hair Care ProfessionalsSeymour M. Weaver III, M. D.

Board Certified Dermatologist

(281)-712-7002Houston Location

7700 South Main Suite 310Houston, TX 77030

(281)-712-7002Katy Location

22028 – C Highland KnollsKaty, TX 77450

www.MedicalHairProfessionals and www.DrSeymourWeaver.com

Your clients trust

http://MedicalHairProfessionals.com

http://DrSeymourWeaver.com

Earn their trust by learning more about medical hair care at:

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you...

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