The way in which the normal hair growth cycle works means that everyone sheds some of their hair every day. This is totally normal and is nothing to be worried about, unless of course the hair loss is excessive.
To define whether you should be concerned that you have a hair loss condition, it can be useful to know more about the normal hair growth cycle.

Hair growth cycle – key facts:

• Approximately 85- 90 per cent of all your hair is growing at any one time. This hair is in the anagen (growth) phase.

• The anagen phase generally lasts between two and six years, but can be as much as eight

• Hair grows at a rate of around 0.5 inches (1.25cm) per month. This equates to 6 inches (15cm) a year. The speed at which hair grows slows as you age.

• Around 10-15 per cent of your hair follicles are in the resting (telogen) phase at any one time. This phase lasts for one to four months, at the end of which the telogen hairs fall out.

• Normal hair shedding results in the loss of around 50 – 100 hairs a day. Hair should not fall out in clumps; if it does, you should see your GP.

• When a hair falls out, it is replaced by a new hair and the cycle begins again

Hair loss is often associated men of a certain age, which is why hair loss in women can be so upsetting. Potentially even worse than female hair loss, however, is when a hair loss condition occurs in children.
There are many causes of hair loss in children, including:

• Alopecia areata –an autoimmune disorder which causes patchy hair loss
• Tinea capitis (ringworm) – a contagious fungal infection which shows up as scaly, round patches of hair loss on the scalp
• Telogen effluvium – a hair loss condition caused by sudden or severe stress interrupting the normal hair growth cycle
• Trichotillomania – a compulsive disorder in which the child feels the urge to pull out their own hair
• Nutritional deficiency – a less common occurrence, a lack of B vitamins (i.e. biotin) or zinc in the diet can cause hair loss
• Endocrine problems – conditions such as hypothyroidism, where the thyroid is underactive, can cause hair loss

Baby hair loss

Hair loss in very young children and babies can have non-medical causes, which often go away on their own. These causes include rubbing (friction with car seat or crib mattress) and newborn hair loss, where the hair falls out to be replaced by permanent hair.

Female hair loss can have many causes and it can often take some time to identify which ones are really to blame. One common cause is medication, which can cause side-effects including loss or damage to hair.

The way in which medication damages hair is in interrupting the natural hair growth cycle. This cycle has two main phases – anagen and telogen. The anagen phase is when the hair follicles grow, and it can last for three to four years. The telogen phase is the resting stage, when the hair follicles recover for around three months before falling out.

Medication can interfere with this cycle, either stopping the anagen phase in some way or sending too many hairs into the telogen phase. This can cause mass shedding, where a lot of hair falls out at once.

Medications

There are many medications which could cause hair loss as a side-effect in some cases. Always check with your doctor if you have any concerns.

• Anticoagulants (blood thinners)
• Epilepsy medications
• Oral contraceptives
• Acne medication
• Antidepressants
• Antifungal medications
• Antibiotics
• Hormone replacement therapy (for women – progesterone or oestrogen)
• Steroids
• Mood stabilisers
• Chemotherapy medications
• Thyroid medications
• Immunosuppressant medications
• Cholesterol-lowering medication

Most people are aware that chemotherapy treatment for cancer causes hair loss, but the side effects of other cancer treatments such as radiotherapy are not well known or often discussed.

Although both treatments are used to eradicate cancer cells, radiotherapy differs from chemotherapy in that it is generally a more localised treatment. Whereas chemotherapy floods the body with cancer-killing chemicals, radiotherapy focuses solely on the cancerous area. However, chemotherapy and radiotherapy are often used together in conjunction with other treatments to give the patient the best chance of defeating their illness.

Similarly to chemotherapy, one of the most noticeable side effects of radiotherapy is hair loss. However, patients undergoing radiotherapy may experience hair loss (medically known as epilation) some months after their treatment has finished. This differs to chemotherapy, where hair loss is often evident after just two courses of treatment.

In line with the way in which the treatment works, hair loss after radiotherapy is generally localised, occurring in hair bearing skin within the radiation field. Hair loss after cancer treatment is not usually permanent, but it does occur in some cases where radiotherapy doses are very strong.

Hair loss conditions can sometimes be difficult to diagnose, mainly because there are many different contributing factors and causes. The exact causes of hair loss vary from person to person, and in some people are never pinpointed.

Proper diagnosis of hair loss is made even more difficult when the condition is rare. One of these conditions is tufted folliculitis, an uncommon disorder which can cause hair loss and scarring of the scalp.

Symptoms

People with tufted folliculitis often have patches of scarring alopecia accompanied by something known as doll’s hair-like bundling of follicles. This means that multiple hairs emerge through expanded follicular orifices. This causes the ‘tufting’ effect, along with the retention of telogen hairs in the follicles and a fibrosing process.

Associated conditions

Tufted folliculitis is a symptom of a number of scarring diseases and conditions, including:

• Graham-Little syndrome
• Chronic lupus erythematosus
• Folliculitis decalvans
• Chronic staphylococcal infection
• Acne keloidalis nuchae
• Dissecting cellulitis
• Lichen planopilaris
• Immunobullous disorders

Treatment

At present, no definitive curing treatment for tufted folliculitis has been found, although there are measures sufferers can take to reduce discomfort and improve the appearance of the scalp.