By CHARLOTTE DOVEY
10:43am 15th August 2006
We all lose around 75 to 100 hairs every day, although we hardly notice it. But a staggering 4.8 million women suffer from serious hair loss, with dramatic results.
It can start as patchy thinning or in more extreme cases the hair falls out in clumps — and hair all over the body, including eyelashes and under the arms, can be affected.
Hair loss is a well-known side-effect of chemotherapy, while post pregnancy, around 50 per cent of women lose more hair than usual.
In both cases it will eventually grow back. However, there are lesser known and understood conditions such as alopecia and trichotillomania — a compulsive disorder where sufferers pull out their own hair — where the hair loss can be permanent.
Alopecia affects an estimated one million people in the UK, around half of them women. It is an auto-immune hair loss disease — the body's immune system mistakenly attacks the hair follicles, preventing them from growing, explains Dr Susan Macdonald-Hill, a dermatologist and spokesperson for the British Skin Foundation.
'The exact cause isn't really known, although there might be a genetic of tendency towards the condition and acute stress can sometimes be a trigger.'
Alopecia can affect men, women and children of any age. If you have alopecia areata (patchy hair loss) there is a 98 per cent chance that your hair will grow again; but with alopecia totalis (loss of scalp hair) or universalis (loss of all body hair), re-growth is unlikely.
And the longer there has been no hair, the less likely it is to happen, although there have been rare reports of regrowth after 30 years. In a society which values beautiful, healthy locks, losing your hair can have a profound effect on a woman's confidence, and many choose to keep their baldness hidden under wigs and hats.
But here five inspirational women who suffer from permanent hair loss bravely share their stories with Good Health.
JULIA JACKSON, 32, a corporate lawyer, lives in North London. She was diagnosed with Alopecia totalis, total loss of hair on the scalp, four years ago.
She says: To lose something you take completely for granted isn't easy. Initially, in August 2002, I thought the extra hair in my brush was nothing — but two months later as my hair became noticeably thinner, I knew there was a problem. My GP referred me on to Dr Helene Du Peloux Menage, a consultant dermatologist on Harley Street, and within seconds of walking through the door she diagnosed me with alopecia, something nobody in my family had ever had.
The cause, although never certain, might have been stress — my mum hadn't been well for months.
Putting a name to it felt comforting, as though we could now do something about it. At that appointment, all paid for by health insurance, she injected steroids directly into the patches to stimulate the hair follicles back into growth and, although nothing was guaranteed, things were hopeful because at that stage the hair loss was just patchy.
Ridiculously, it didn't occur to me that I might lose all my hair. How wrong could I have been? The steroids had no effect at all and by January my hair had all gone. Staring in the mirror, I saw a bald head staring back.
This wasn't a person I knew. At the time I had decided to travel the world, so I left the UK and spent the next 17 months trying to get used to being bald. I shunned wigs but found, strangely, being in foreign countries made it a bit easier — you're different anyway when you're abroad.
But when I came back to the UK, it started to hit home again and I became very low. My refusal to wear wigs and my gung-ho 'accept me for who I am' attitude went out the window.
People stared and presumed I was unwell, so again I tried to find a cure. After doing some research on the internet and grasping at straws, I suppose, I went to see Dr David Fenton privately at St Thomas' Hospital at a cost of £200. He told me straight — because I had also lost my eyebrows by then the likeli-hood of hair re-growth was 10 per cent.
He also said that with any treatment I might try there was a 50 per cent chance of hair coming back, but also a 50 per cent chance of it falling out again. I had nothing to lose, so I paid £50 for a course of steroid pills to shut down my immune system. My hair did re-grow but horrifically, as warned, it then all fell out.
I had always been a girlie girl, but suddenly I felt totally unfeminine. I was emotionally destroyed for months, but then knew I had to let it go. My family suggested I take the pressure off myself and wear a wig. So I bought some Dermalite wigs, made out of human hair and costing from £900 to £1,200.
I also had my eyebrows tattooed on and my family was right — it did help. Another major emotional boost was meeting my boyfriend, Andy, 30, an archaeologist who didn't see my baldness as an issue. In fact when I first showed him, he simply gave me a hug which meant so much.
It's certainly not always easy being bald, but as my consultant dermatologist said when she diagnosed me: "It's not the hairs on the head that make you the person you are."
ZAINEB AL HASSANI, 22, is single and studying journalism at Caledonian University, Glasgow.
She has suffered from alopecia totalis since the age of seven, and says: I HAVE had no hair for as long as I can remember, and, weird as this might sound, in some ways that makes me very lucky. I've never had to go through the hell of clumps of hair coming out in my brush, because I've never known anything else.
According to my mother, both her great-grandmother and great-aunt suffered from alopecia which came on in their teens. It skipped two generations, but one day when I was around four years old, my parents noticed a bald patch in my auburn hair.
My mother knew what it was instantly and took me to see a GP, who referred me to a consultant dermatologist. The diagnosis was alopecia areata — patchy hair loss. My prognosis was irritatingly sketchy — hair might grow back, but the dermatologist couldn't guarantee anything.
All he did know was that losing it before puberty and my family's genetic predisposition to the condition decreased my chances somewhat.
For around three years the hair loss followed a cycle. In the winter clumps would fall out, while in the summer it would start to grow back — nobody knows why.
There are no proven remedies, but my parents spent thousands of pounds on treatments. Creams were rubbed into my head daily, and I was given herbal remedies — they even tried a couple of sessions of hypnosis, but nothing made any difference. And when I turned seven, I went completely bald.
Of course, I was teased a bit initially and asked if I had cancer, but then everyone got used to the idea. And despite my parents buying me loads of wigs over the years, they are so terribly hot on my head that I rarely bother.
I know my mum feels guilty for passing on the condition through her side of the family, but she really shouldn't because it just doesn't bother me that much.
I'd be fooling myself if I still thought my hair was going to grow back, but I try the odd treatment, just in case. Herbalists have told me to rub ginger and olive oil on my head (neither worked) plus a few years ago I paid £75 every fortnight to see a Chinese doctor. He gave me pills and lotions which I used for nearly seven months, but again nothing worked.
The only thing that bothers me about not having hair is that I've never had a boyfriend — I've sabotaged any dates by not speaking. I rationalise it by saying I'm picky, but I think it's more like self-preservation and fear of rejection.
But overall I'm fine about the way I look. I'm not ill, after all. I simply don' t have hair.
CLAIRE CONROY, 26, a legal assistant, suffers from trichoillomania, an impulse control disorder, in which hair is regularly pulled out from the roots. She lives in Salisbury, Wiltshire, with her boyfriend Andrew Malloy, 24, a biomedical engineer. She says:
While some toddlers might suck their thumbs or have a comfort blanket, I pulled out my hair. It's difficult to understand why this happened now, but I think I simply picked up on stress vibes — my mother had a miscarriage which was hugely trauma atic and affected the whole family.
I've been told I st topped doing it for a while, but then start ted again aged eight. Whenever I was bor red, I started pulling hairs out at the roo ots. It was strangely satisfying, like scrat ching an itch.
Initially you couldn n't see the difference but after a while a b ald spot, the size of a 50p piece, appeare ed on the top of my head. And as the yea ars passed, more and more appeared.
My mother, who t hought I'd grow out of it, started to get c concerned, but I told her it wasn't a prob blem and covered up the patch with mor re of my dark brown hair, a large headban nd or a hat.
Deep down, howev ver, I knew it wasn't right. When I wa as around 18, and unknown to my mo other, I'd been doing some research and discovered d what I did had a name. I went t to see a trichologist in Liverpool and showe ed her my hair.
To her credit, she knew that I needed counselling, not hai r-loss treatments, so for £40 a week for ab bout a year we met for chats. She wasn't a qualified psychotherapist, but just talking seemed to help. During that period I stopped pulling out my hair, but on moving down to London in 2003, the compulsion — or addiction, as I sometimes call it — started again.
Some research on the internet led me to trichologist Lucinda Ellery. Her solution was a volumiser system. Basically a full head of extensions is attached to what's left of the hair through a fine mesh.
This not only acts as a bridge over the bald bits, but also acts as a barrier to the real hair so further damage can't be done.
Before this was possible, however, she said I needed to see a psychotherapist to get to the cause of the problem.
Trichotillomania is related to obsessive-compulsive disorder (OCD) and is often brought on by depression, anxiety — or in my case, stress. So for six weeks, I underwent Cognitive Behavioural Treatment to help me understand the reasons behind the compulsion.
I was also taught better coping skills (so I wouldn't immediately reach to my hair in times of boredom or anxiety). Whenever I did feel that compulsion, I was told to think of a reward I could give myself for not doing it, such as a holiday or a good night out.
The same therapist gave me hypnotherapy, too. The whole process was hugely helpful. I didn't pull out any hairs during that period and haven't done it since.
The mesh, which took nine hours to put on my head and cost £1,600, was then put in place. I have to go back every six weeks for a 'tidy-up' at a further cost of £150 and take sea kelp and skin, hair and nails vitamins to give my real hair as good as chance as possible.
The longer you pull out the hair, the more damage to the follicle and the less likely it is that the hair will grow back. But the therapy combined with the volu-miser system has been a lifesaver.
Gradually, day by day, I feel my compulsion dying and, although I know there are a couple of spots that will never grow back, I'm hopeful that I will have a full head of my own hair relatively soon.
NATALEIGH STRASBURG, 25, a social worker, lives in North London.
Three years ago she was diagnosed with alopecia universalis — which means she has no body hair at all. She says:
The day I asked my father to shave off what was left of my hair is one I'll never forget. The remains of my shoulder-length blonde mane fell to the floor and a complete stranger stared back at me from the mirror. I felt my beauty had gone along with my self-esteem.
Although I'm resigned to the fact that my hair probably won't grow back, I continue to try any treatments available. Over the years I've tried creams, sprays, Rogaine — which is used for male baldness — even steroids, but all they've seemed to do is delay the inevitable.
With no history of alopecia in the family it came out of the blue. During my school years I had some patchy hair loss which simply grew back. Then, in 2002, I noticed the whole texture of my hair was changing. Perhaps it was the stress of my last year at school or the fact I lost my grandfather, but my shoulder-length hair started to thin drastically.
Over a six-month period I found more and more hair in my brush and in the shower. I had to start wearing a bandana to cover everything up — it was horrific.
Extremely worried, I went to see a dermatologist who told me, bluntly, that it wasn't looking too good. She put steroid injections into the bald patches. They were meant to suppress the body's immune reaction, allowing the hair follicles to function normally again and for hair to re-grow.
Unfortunately I found they simply hurt like hell and didn't work. I also had extensions put in to try to cover things up, but they ended up pulling out more hair.
That summer, my parents sent me for acupuncture and reiki healing — desperately trying to find a solution that would work. But nothing did. I realised I was holding on to something that wasn't meant to be, so I asked my dad to shave the hair off.
The pair of us cried the whole time. It was so traumatic, but it was also a bonding experience I'll never forget. I then bought a wig and tried to get on with life, but I had further blows in autumn 2003 when my eyebrows, eyelashes and all other body hair fell out.
Utterly destroyed, I felt my last link with femininity had gone. But my friends and family gave me the support I needed, as did my boyfriend Julian, 34, who runs his own computer business and sees my alopecia as no big deal.
I keep trying treatments, just in case, and although I've been told the prognosis isn't great, my NHS dermatologist, Dr David Fenton at St Thomas' in London, is trying a new skin irritant treatment: basically, a chemical is painted onto the scalp every week to cause an allergic reaction.
The theory is that the immune system will be so busy dealing with the allergy that it will forget to attack the hair follicles. I've been having the treatment for six months and it seems to be working — I have peach fuzz on my scalp.
I accept what the experts say and realise I might be setting myself up for further disappointments. But deep down, wrongly or rightly, I still have hope that my hair will grow back.
VICKY SPENCER, 25, is a client support executive.
She is single and lives in Reading and was diagnosed with alopecia universalis, total body hair loss, three-and-a-half years ago. She says:
With no history of alopecia in my family, I can only think that the stress of my finals at university in 2003 was the trigger for my hair loss. It was my hairdresser who first spotted it. There was a patch, about the size of a 10p piece, at the back of my head.
Initially I put it to the back of my mind — I knew someone with patchy hair loss and it had all grown back. But after my finals, I became concerned.
Four months after the first patch appeared, the hair loss was so obvious that I had to wear a hat permanently. My dermatologist, Dr Robert Sarkany, at St George's Hospital, in London, was very honest with me.
After doing blood tests to check for any underlying conditions such as thyroid or lack of iron (neither of which was a problem for me), he said the chance of my hair growing back was poor, but that oral steroids to suppress the immune reaction and give the hair follicles a chance to function normally again were the best option. Despite side-effects including lack of sleep, extreme hunger and lack of concentration I went for it and was treated on the NHS.
The elation I felt when hair started to grow back was soon dashed, when the course of drugs finished and it fell out again.
Still desperate to solve things I tried another course, yet the same thing happened.
My emotions during this period were extreme - especially as my eyelashes, eyebrows and all my body hair also started to fall out. This wasn't an easy time. I felt very self-conscious and relied on the support of my boyfriend, who I've since split up with, and friends and family. My last-ditch attempt was paying £150 for a private appointment to see a dermatologist. His reaction was fairly conclusive.
The chance of my hair re-growing was basically nil. Yes I could try treatments, yet they might do nothing else but give me false hopes. It was a fairly blunt assessment, but I appreciated the honesty. I decided the time had come to accept my lack of hair and get on with my life.
I now get my wigs from the NHS and have paid £500 to have my eyebrows tattooed by Debra Robson-Lawrence based in Harley Street. There are times when I feel self-conscious, but then most people don't have a clue I'm bald.