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หน้าหลัก | สุขภาพดี | สุภาพสตรี | การแปลผลเลือด | โรคต่างๆ | วัคซีน
ผมร่วง Hair loss
อาการผมร่วงเป็นอาการที่พบบ่อยเมื่ออายุย่างสามสิบปี สาเหตุจากพันธุกรรม จากยา จากการดึงหรือเกิดจากเชื้อรา
ผมร่วงหมายถึงการที่ผมหลุดร่วงก่อนกำหนด สาเหตุของผมร่วงก็มีมากมายตั้งแต่ฮอร์โมน การติดเชื้อการเจริญของเส้นผม
การเจริญของเส้นผมของคนแบ่งออกเป็นสามระยะได้แก่
ปรกติเส้นผมจะร่วงไม่เกิน 100 เส้นจะถือว่าผิดปรกติ
ชนิดผมร่วง
ผมระยะเจริญร่วง Anagen Effluvium
หมายถึงผมที่ร่วงในระยะที่เซลล์ผมกำลังมีการเจริญอย่างมาก มักจะเกิดจากการได้รับการรักษาด้วยเคมี การฉายแสง อ่านที่นี่ Anagen effluviumAnagen effluvium is widespread hair loss that can affect your scalp, face and body. One of the most common causes of this type of hair loss is the cancer treatment chemotherapy. In some cases, other cancer treatments – including immunotherapy and radiotherapy – may also cause hair loss. The hair loss is usually noticeable within a few weeks of starting treatment. However, not all chemotherapy drugs cause hair loss and sometimes the hair loss is so small it's hardly noticeable. It may be possible to reduce hair loss from chemotherapy by wearing a special cap that keeps the scalp cool. However, scalp cooling is not always effective and not widely available. In most cases, hair loss in anagen effluvium is temporary. Your hair should start to grow back a few months after chemotherapy has stopped.
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ผมระยะหยุดพักร่วง Telogen Effluvium
หมายถึงการที่ผมร่วงในระยะ telogen มักจะเกิดจากยาหลายชนิด อ่านที่น Telogen effluviumTelogen effluvium is a common type of alopecia where there is widespread thinning of the hair, rather than specific bald patches. Your hair may feel thinner, but you're unlikely to lose it all and your other body hair isn't usually affected. Telogen effluvium can be caused by your body reacting to: In most cases of telogen effluvium, your hair will stop falling out and start to grow back within six months. |
Androgenetic alopecia
เป็นการร่วงของผมเนื่องมาจากฮอร์โมน ทำให้เกิดผมร่วงแบบผู้ชาย และผู้หญิง พบว่าผู้ชายและหญิงร้อยละ 50จะมีผมร่วงชนิดนี้ อ่านที่นี่ Male- และหญิงศีรษะล้านแบบ ชายศีรษะล้านแบบเป็นชนิดที่พบบ่อยที่สุด ของการสูญเสียเส้นผมที่มีผลต่อรอบครึ่งหนึ่งของมนุษย์ทุกคนโดย 50 ปีของอายุ ก็มักจะเริ่มรอบยี่สิบปลายหรือวัยสามสิบต้น และคนส่วนใหญ่มีระดับของการสูญเสียเส้นผมบางอย่างโดยวัยสามสิบปลายของพวกเขา มันมักจะเป็นไปตามรูปแบบของเส้นผมถอยตามผอมบางของผมบนมงกุฎ และวัดออกจากรูปเกือกม้ารอบหลังและด้านข้างของศีรษะ บางครั้งก็สามารถดำเนินการให้เสร็จสมบูรณ์ศีรษะล้านแม้นี่จะเป็นเรื่องผิดปกติ ชายศีรษะล้านแบบกรรมพันธุ์เป็นซึ่งหมายความว่ามันทำงานในครอบครัว ก็คิดว่าจะเกิดจากรูขุมขน oversensitive เชื่อมโยงกับการมีมากเกินไปของฮอร์โมนเพศชายบาง ตลอดจนส่งผลกระทบต่อคนบางครั้งมันก็สามารถส่งผลกระทบต่อผู้หญิง (หญิงศีรษะล้านแบบ) ในช่วงศีรษะล้านหญิงรูปแบบผมมักจะมีเพียงเรทด้านบนของหัว มันไม่ชัดเจนว่าหญิงศีรษะล้านแบบกรรมพันธุ์เป็นและสาเหตุที่มีความเข้าใจน้อยดี แต่ก็มีแนวโน้มที่จะเห็นได้ชัดเจนขึ้นในผู้หญิงที่ได้รับการผ่านวัยหมดประจำเดือน (เมื่อระยะเวลาของผู้หญิงคนหนึ่งหยุดที่รอบอายุ 52) บางทีอาจเป็นเพราะพวกเขามีฮอร์โมนเพศหญิงน้อย |
ผมร่วงเป็นหย่อม Alopecia Areata
โรคผมร่วงหย่อม เป็นโรคพบที่่หนังศีรษะหรือคิ้ว หนวดผมที่ร่วงส่วนใหญ่งอกกลับคืนมาภายใน 1 ปี สาเหตุยังไม่แน่ชัด ไม่เกี่ยวกับความเครียด วิตกกังวล การดูแลรักษา 60% ของคนไข้จะหายได้เอง การรักษาส่วนใหญ่ใช้สเตียรอยด์ในรูปทาหรือฉีดเข้าใต้ ผลการรักษาจะดีถ้ามีอาการน้อยกว่า 1 ปี อ่านที่นี่ |
ผมร่วงแบบมีแผลเป็น Scarring Alopecia
ผมร่วงจากแผลเป็นที่หนังศีรษะ แผลเป็นเกิดได้จากหลายสาเหตุ ส่วนใหญ่เกิดจากอุบัติเหตุ หรือจากไฟไหม้ น้ำร้อนลวกหรือสารเคมีอื่นๆ โรคของหนังศีรษะบางชนิด การติดเชื้อจากแบคทีเรียหรือไวรัส ก็เป็นสาเหตุของแผลเป็นได้ การดึงรั้งของผมนานๆ (Traction alopecia) ก็เป็นสาเหตุหนึ่งมี่ทำให้ผมร่วงถาวร การถอนผมตัวเอง (Trichotillomania) ก็เช่นกัน ี่ Scarring alopeciaScarring alopecia, also known as cicatricial alopecia, is usually caused by complications of another condition. In this type of alopecia, the hair follicle (the small hole in your skin that an individual hair grows out of) is completely destroyed. This means your hair won't grow back. Depending on the condition, the skin where the hair has fallen out is likely to be affected in some way. Conditions which can cause scarring alopecia include: Scarring alopecia occurs in both males and females, but is less common in children than adults. It accounts for about 7% of hair loss cases.
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ผมร่วงจากการดึงรั้ง Traction Alopecia
เกิดจากการดึงรั้งของเส้นผมนานๆ พบได้บ่อยในคนที่ถักผม มัดจุก ไว้หางม้า ผูกเปีย ผมร่วงมักเป็นตามแนวไรผมด้านหน้า ขมับ คนที่ใส่วิกผมโดยใช้วิธีผูกยึดหรือติดกิ๊บไว้ ผมบริเวณนั้นจะร่วงเป็นหย่อมจากแผลเป็น การรักษา ควรหลีกเลี่ยง การดึงรั้งผมนานๆ กรณีมีผมร่วงถาวรแล้วต้องอาศัยการศัลยกรรมปลูกผม |
ผมร่วงจากการถอนผม Trichotillomania Trichotillomania
เป็นนิสัยหรือพฤติกรรมที่ย้ำคิดย้ำทำ โดยการดึงหรือบิดผม อาจทำโดยที่ไม่รู้ตัว เมื่อทำไปนานเข้าทำให้ผมบางเป็นวงๆหรือเป็นหย่อม การรักษา อธิบายถึงสาเหตุและแนะนำให้หยุดถอนผม ในบางรายที่มีปัญหาทางจิตมากควรปรึกษาจิตแพทย์ |
ผมหงอก หรือ หัวหงอก
หมายถึงการที่เส้นผมไม่สร้างเม็ดสี ทำให้สีผมจางกว่าปกติซึ่งหากเป็นมากสีผมจะเป็นสีขาว หัวหงอก |
How is hair loss treated?
More common types of hair loss, such as male-pattern baldness, don't need treatment because they're a natural part of ageing and don't pose a risk to your health.
However, any type of hair loss can be distressing, so you should see your GP if you're worried about it.
Your GP should be able to diagnose your type of hair loss by examining your hair. They can also discuss possible treatments with you so it's advisable to visit your GP before trying a private consultant dermatologist (skin care specialist).
If you want treatment for male-pattern baldness for cosmetic reasons, two medications called finasteride and minoxidil can be used. Minoxidil can also be used to treat female-pattern baldness.
However, these treatments don't work for everyone and only work for as long as they're continued. They are not available on the NHS and can be expensive.
Alopecia areata is usually treated with steroid injections, although it's sometimes possible to use a steroid cream, gel or ointment. A treatment called immunotherapy may also be used. This involves stimulating hair growth by causing an intentional allergic reaction in the affected areas of skin.
If you have significant hair loss of any type, you may decide to wear a wig. Wigs are available on the NHS, but you may have to pay unless you qualify for help with charges.
There are also some surgical options for hair loss, including a hair transplant and artificial hair implants.
Read more about treating hair loss.
Emotional issues
Hair loss can be difficult to come to terms with. The hair on your head can be a defining part of your identity. If you start to lose your hair, it can feel as if you're losing part of your identity. This can affect your self-confidence and sometimes lead to depression.
Speak to your GP if you're finding it difficult to deal with your hair loss. They may suggest counselling. You may also benefit from joining a support group or speaking to other people in the same situation – for example, through online forums.
A number of charities, such as Alopecia UK, have support groups and online forums where you can talk to others who are experiencing hair loss.
Treating hair loss
Although hair loss rarely needs to be treated, many people seek treatment for cosmetic reasons.
Many cases of hair loss are temporary (for example, due tochemotherapy), or are a natural part of ageing and don't need treatment. However, hair loss can have an emotional impact, so you may want to look at treatment if you're uncomfortable with your appearance.
If hair loss is caused by an infection or another condition, such as lichen planus or discoid lupus, treating the underlying problem may help prevent further hair loss.
Male-pattern baldness
Male-pattern baldness isn't usually treated, as the treatments available are expensive and don't work for everyone.
Two medicines that may be effective in treating male-pattern baldness are:
Neither treatment is available on the NHS.
You may also want to consider wearing a wig or having surgery.
Finasteride
Finasteride is available on private prescription from your GP. It comes as a tablet you take every day.
It works by preventing the hormone testosterone being converted to the hormone dihydrotestosterone (DHT). DHT causes the hair follicles to shrink, so blocking its production allows the hair follicles to regain their normal size.
Studies have suggested finasteride can increase the number of hairs people have (hair count) and can also improve how people think their hair looks.
It usually takes three to six months of continuously using finasteride before any effect is seen. The balding process usually resumes within six to 12 months if treatment is stopped.
Side effects for finasteride are uncommon. Less than one in 100 men who take finasteride experience a loss of sex drive (libido) or erectile dysfunction (the inability to get or maintain an erection).
Minoxidil
Minoxidil is available as a lotion you rub on your scalp every day. It's available from pharmacies without a prescription. It's not clear how minoxidil works, but evidence suggests it can cause hair regrowth in some men.
The medication contains either 5% or 2% minoxidil. Some evidence suggests the stronger version (5%) is more effective. Other evidence has shown this is no more effective than the 2% version. However, the stronger version may cause more side effects, such as dryness or itchiness in the area it's applied.
Like finasteride, minoxidil usually needs to be used for several months before any effect is seen. The balding process will usually resume if treatment with minoxidil is stopped. Any new hair that regrows will fall out two months after treatment is stopped. Side effects are uncommon.
Female-pattern baldness
Minoxidil is currently the only medicine available to treat female-pattern baldness.
Minoxidil lotion may help hair grow in around one in four women who use it, and it may slow or stop hair loss in other women. In general, women respond better to minoxidil than men. As with men, you need to use minoxidil for several months to see any effect.
Alopecia areata
There is no completely effective treatment for alopecia areata. However, in most cases the hair grows back after about a year without treatment. So "watchful waiting" is sometimes best, particularly if you just have a few small patches of hair loss.
Some treatments for alopecia areata are outlined below.
Corticosteroid injections
Corticosteroids are medicines containing steroids, a type of hormone. They work by suppressing the immune system (the body's natural defence against infection and illness). This is useful in alopecia areata because the condition is thought to be caused by the immune system damaging the hair follicles.
Corticosteroid injections appear to be the most effective treatment for small patches of alopecia. As well as your scalp, they can also be used in other areas, such as your eyebrows.
A corticosteroid solution is injected several times into the bald areas of skin. This stops your immune system from attacking the hair follicles. It can also stimulate hair to grow again in those areas after about four weeks. The injections are repeated every few weeks. Alopecia may return when the injections are stopped.
Side effects of corticosteroid injections include pain at the injection site and thinning of your skin (atrophy).
Topical corticosteroids
Topical corticosteroids (creams and ointments) are widely prescribed for treating alopecia areata, but their long-term benefits are not known.
They are usually prescribed for a three-month period. Possible corticosteroids include:
These are available as a lotion, gel or foam depending on which you find easiest to use. However, they cannot be used on your face, for example on your beard or eyebrows.
Possible side effects of corticosteroids include thinning of your skin and acne.
Corticosteroids tablets aren't recommended because of the risk of serious side effects.
Minoxidil lotion
Minoxidil lotion is applied to the scalp and can stimulate hair regrowth after about 12 weeks. However, it can take up to a year for the medication to take full effect.
Minoxidil is licensed to treat both male- and female-pattern baldness, but is not specifically licensed to treat alopecia areata. This means it hasn't undergone thorough medical testing for this purpose.
Minoxidil is not recommended for those under 18 years old. It's not available on the NHS, but can be prescribed privately or bought over the counter.
Immunotherapy
Immunotherapy may be an effective form of treatment for extensive or total hair loss, although fewer than half of those who are treated will see worthwhile hair regrowth.
A chemical solution called diphencyprone (DPCP) is applied to a small area of bald skin. This is repeated every week using a stronger dose of DPCP each time. The solution eventually causes an allergic reaction and the skin develops mild eczema (dermatitis). In some cases, this results in hair regrowth after about 12 weeks.
A possible side effect of immunotherapy is a severe skin reaction. This can be avoided by increasing the DPCP concentration gradually. Less common side effects include a rash and patchy-coloured skin (vitiligo). In many cases, the hair falls out again when treatment is stopped.
Immunotherapy is only available in specialised centres. You'll need to visit the centre once a week for several months. After DPCP has been applied, you'll need to wear a hat or scarf over the treated area for 24 hours because light can interact with the chemical.
Dithranol cream
Similar to immunotherapy, dithranol cream is applied regularly to the scalp before being washed off. It causes a skin reaction, followed by hair regrowth in some cases.
However, it hasn't been proven that dithranol cream is significantly effective in the long term. It can also cause itchiness and scaling of the skin and can stain the scalp and hair. For these reasons, dithranol is not widely used.
Ultraviolet light treatment
Two to three sessions of light therapy (phototherapy) are given every week in hospital. The skin is exposed to ultraviolet (UVA or UVB) rays. In some cases, before your skin is exposed to UV light you may be given a medicine called psoralen, which makes your skin more sensitive to the light.
The results of light therapy are often poor. The treatment can take up to a year to produce maximum results and responses vary, with a high relapse rate. It's often not a recommended treatment because side effects can include:
Tattooing
For many people, it's possible to replicate hair with a tattoo. This is known as dermatography and generally produces good long-term results, although it is usually expensive and can only be used to replicate very short hair.
This is usually carried out for eyebrows over a few hourly sessions and can even be used as a treatment for scalp hair loss caused by male-pattern baldness.
Wigs
Wigs can be a useful treatment for people with extensive hair loss.
Synthetic wigs
The cheapest wigs are made from acrylic and can cost anywhere between £60 and £300. As of April 2014, an NHS stock acrylic wig costs £66.70.
Acrylic wigs last for six to nine months. They're easier to look after than wigs made of real hair because they don't need styling. However, acrylic wigs can be itchy and hot, and need to be replaced more often than wigs made from real hair.
Read about wigs and fabric supports costs for information on who is entitled to free wigs on the NHS, and who can get help with costs.
Real hair wigs
Some people prefer the look and feel of wigs made from real hair even though they are more expensive, costing anywhere between £200 and £2,000. As of April 2014, an NHS partial human hair wig costs £176.65 and an NHS full human hair wig made to order costs £258.35.
Real hair wigs last for three to four years, but are harder to maintain than synthetic wigs because they may need to be set and styled by a hairdresser and professionally cleaned.
A human hair wig is only available on the NHS if you're allergic to acrylic, or if you have a skin condition made worse by acrylic. You may wish to buy your wig privately.
Alopecia UK has useful information about synthetic wigs and human hair wigs, including advice about choosing the right wig and how to care for it.
Complementary therapy
Aromatherapy, acupuncture and massage are often used for alopecia, but there isn't enough evidence to support their use as effective treatments.
Hair loss surgery
Most men and women considering hair loss surgery have male-pattern or female-pattern baldness. However, surgery is sometimes suitable for a range of alopecia conditions.
Surgery for hair loss should only be considered after trying less invasive treatments, and it's not usually available on the NHS.
The success of hair loss surgery depends on the skill of the surgeon, as complications can arise. It's best to speak to your GP for advice before seeking out a surgeon in the private sector.
The main types of hair loss surgery are explained below.
Hair transplant
Under local anaesthetic (painkilling medication), a small piece of scalp (about 1cm wide and 30-35cm long) is removed from an area where there's plenty of hair. The piece of scalp is divided into single hairs or tiny groups of hairs, which are grafted onto areas where there's no hair.
Stitches are not needed to attach the grafts because they are held in place by the clotting (thickening) action of the blood when the hairs are inserted. Fine hairs are placed at the front of the scalp and thicker hairs towards the back in a process called grading. This helps achieve a more natural result. Within six months, the hair should settle and start to regrow.
Hair transplants are carried out over a number of sessions. There should be a break of nine to 12 months between procedures. As with any type of surgery, there is a risk of infection and bleeding, which can lead to hair loss and noticeable scarring.
Hair transplantation isn't provided by the NHS. It can be expensive and take a long time.
Scalp reduction
Scalp reduction involves removing pieces of bald scalp from the crown and the top of the head to move hairy parts of the scalp closer together. This can be done by cutting out loose skin and stitching the scalp back together, or it can be done by tissue expansion.
Tissue expansion is where a balloon is placed underneath the scalp and inflated over several weeks to expand the skin in stages. The balloon is then removed and the excess skin is cut out.
Scalp reductions are not suitable for hair loss at the front of the scalp because it can cause scarring. There is also the risk of infection in the area.
Scalp reduction isn't usually used for male-pattern baldness, but it's available on the NHS to people with scarring alopecia. Surgery should only be carried out after any underlying conditions have cleared up.
Artificial hair
Artificial hair implantation is marketed as a treatment for male-pattern baldness. It involves implanting synthetic fibres into the scalp under local anaesthetic. The technique is not available on the NHS.
Artificial hair implantation carries serious risks of infection and scarring, but clinics may be reluctant to inform people of the possible complications to avoid losing potential clients.
Artificial hair implantation isn't recommended by dermatologists because of the risk of complications such as:
People considering hair loss surgery should explore more established treatments, such as hair transplantation and scalp reduction, because the advantages and disadvantages of these techniques are better understood.
Cloning
The latest research into hair loss treatments is studying hair cell cloning. The technique involves taking small amounts of a person's remaining hair cells, multiplying them, and injecting them into bald areas.
Cloning is intended to treat both male- and female-pattern baldness. However, the science behind the technique is new and more trials are needed before it can be fully assessed.
Emotional support
If you need emotional support following hair loss, you can contact the charity Alopecia UK. An online forum is available where you can talk to other people with alopecia, and a network of support groups exists across the country.
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