Doctor Pierre Bouhanna’s interview on medisite.fr

Le Dr Pierre Bouhanna interviewé sur les liens entre santé et chute capillaire
On November 13, 2020, Medisite, a consumer health website, published a special feature entitled “What your hair reveals about your health”.
The co-founder of the CMCC, Dr. Pierre Bouhanna, a dermatologist and exclusive scalp surgeon, was asked to comment on the content of the article.
This is an opportunity to review how hair works and the health problems that can cause pathological hair loss.

At what point should hair loss be considered pathological?

Losing hair is normal, as journalist Sophie Raffin reminds us in her article.
During its life cycle, hair goes through three phases:
  • The anagen phase: this is a phase during which the hair grows continuously. It lasts between two to five years. This period depends on the person and gender (it can last longer for women).
  • The catagen phase: during this phase, the hair stops growing, but remains attached to the scalp for about three more weeks.
  • The telogen phase: the hair is gradually pushed out of the capillary dermis by a new hair follicle that will eventually take its place. The expulsion lasts about three months. After three months, the hair falls out in a completely natural way.
Most of our hair – between 100,000 and 150,000 – is in its anagen phase and only a tiny minority is in its telogen phase. On a healthy head of hair, it is normal to lose close to 50 hairs per day (this number can temporarily increase in the fall or spring).
You should consult a dermatologist when you experience significant hair loss or a significant decrease in hair volume. Dr. Pierre Bouhanna reminds us that these symptoms can point to more or less serious health problems.

What are the causes of pathological hair loss?

There are many causes that can lead to pathological hair loss.

Nutritional deficiencies

As Dr. Pierre Bouhanna explains to Medisite, deficiencies in iron, vitamin D, zinc, copper, vitamin A and beta-carotene can cause abnormal hair loss or loss of vitality and shine.
This is why the doctor may ask the patient suffering from alopecia to have a complete blood test. If a deficiency is proven, then he can prescribe food supplements. He will also suggest a balanced diet to avoid relapses.

Infectious diseases

Some infectious diseases – especially when they result in a high fever (39.5° C and above) and last several days – take a toll on the body and the hair.
It is not uncommon for patients with the flu, typhoid fever, scarlet fever or, more recently, Covid-19 to experience telogen effluvium, i.e. a diffuse but temporary hair loss.
In the most serious cases, hair loss will be massive, with patients losing hair in handfuls. Patients who already suffer from androgenetic alopecia will experience telogen effluvium, which will accelerate the balding process.
While telogen effluvium usually resolves spontaneously, patients may need to be prescribed hair loss lotions, Minoxidil treatments, light therapy or stimulation injections.

Stress

Stress can affect hair like an infectious disease. It will cause a disruption of the hair cycle that will lead to telogen effluvium.
Once again, hair loss can be massive, which can be very disturbing for the patient.
Anti-hair loss lotions or treatments by injection or LED laser can be prescribed to patients to stimulate hair growth, as in the case of infectious diseases.

Medications or therapeutic treatments

As Dr. Pierre Bouhanna reminds us, some medications, which are sometimes taken as self-medication, can have the side effect of causing alopecia.
In particular :
  • ibuprofen ;
  • some anticholesterolemic drugs
  • some antidepressants;
  • contraceptive pills with an androgenic effect;
  • some treatments for tyroidism, epilepsy or migraines.
Generally, hair loss stops when the medication is stopped.
However, alopecia will sometimes be permanent in some patients, such as those receiving new breast cancer therapies. In this case, a hair transplant is the only solution to correct hair loss.

Hormonal imbalances

Alopecia can be a symptom of hormonal imbalances, especially in women who produce excess male hormones.
This is particularly true during menopause, as estrogen levels drop drastically, or in the case of polycystic ovary syndrome.
Endocrine disorders of the thyroid gland can also cause hair loss.

Autoimmune diseases

Finally, hair loss can also be a sign of an autoimmune disease, such as lupus or lichen planus pilaris.
The disease causes inflammation of the hair follicles and it is important to act quickly to prevent their permanent destruction.
While there is no effective long-term treatment for these diseases, scarring can be prevented.
When these diseases are established, a hair transplant is the only solution to correct alopecia permanently.

What to do in case of pathological hair loss?

As Dr. Pierre Bouhanna reminds us, it is important to consult a specialist as soon as hair loss is significant or lasts more than four months.
It may reveal a health problem that needs to be treated. In addition, it’s important to act quickly to prevent alopecia from developing too much or lasting too long.
You can contact CMCC if you would like more information on solutions to fight pathological hair loss at 01 84 83 14 00. You can also make an appointment by clicking here.