Ben Affleck caught the eye of the media and public when recent photos revealed a bald spot on the back of his head, referred to as the Vertex or crown region. While many adoring fans may think Ben’s bald spot is temporary, the truth is this bald spot represents a permanent loss of hair.
Did you know you can shed up to 100 hair follicles per day? Or you may see more hair loss at certain times of the year than others? While there are many causes for hair loss, a common type of hair loss affecting men and women is called “effluvium.” To understand male hair loss, or what Mr. Affleck may be facing, it is important to understand the hair folicle cycle.
Hair follicles are not always in the active growth stage. A hair follicle cycles through a growth (Anagen) phase that can last two (2) to seven(7) years, then the hair follicle transitions to a regressing (Catagen) phase lasting a couple of weeks. Afterwards, the hair follicle enters the last and final phase (Telogen) for up to two to four months. The hair follicle then is shed when the hair follicle root re enters a new growth cycle. At any time on a healthy human scalp, about 80% to 90% of the hair follicles are growing hair. That leaves up to 10% to 20% percent of scalp hair follicles in a resting state.
Telogen effluvium (TE) is probably the second most common form of hair loss. Generally speaking, TE happens when there is a change in the number of hair follicles currently growing. If the number of hair follicles producing hair significantly decreases for any reason during the resting (telogen) phase, there will be a significant increase in dormant hair follicles. This is known as TE hair loss.
TE hair loss can be more severe in some areas of the scalp than others. It is uncommon to have hairline recession with TE hair loss, except in a few rare chronic cases.
The hairs that begin to shed are typically telogen hairs, which can be identified by a small bulb of keratin on the root end.
People with TE never completely lose all their hair, but the hair can be noticeably thin in severe cases. TE is often limited to the scalp and is fully reversible. The hair follicles are not permanently or irreversibly affected; there are just more hair follicles in a resting state than there should normally be.
How Does TE Start?
- Environmental condition or injury that “shocks” the growing hair follicles. If the trigger is short-lived, then the hair follicles will return to their growing state and start producing new hair fibers pretty quickly. This form of TE usually lasts less than six months and the affected person has a normal scalp hair density again within a year.
- The second form of TE develops more slowly and persists longer. The follicles enter their normal resting phase but instead of returning to a new anagen hair growing state after a month or two, they remain in their telogen state.
In this form of TE, there may not be much noticeable hair shedding, but there will be a slow thinning of the scalp hair. This form of TE is more likely to occur in response to a persistent trigger.
- In a third type of TE, the hair follicles do not stay in a resting state but rather cycle through shortened growth cycles. When this happens, the individual experiences thin scalp hair and persistent shedding of short, thin hairs.
What Stress and Diet Cause TE?
TE can affect women after giving birth to their child, this is called Postpartum Alopecia. It is caused by a sudden change in hormone levels at birth but most women regrow their hair quickly.
Vaccinations, crash dieting, physical trauma, and having surgery can sometimes precipitate hair follicles to go into hibernation or the resting phase. Some prescription drugs may also induce TE, especially antidepressants which resolves after a prescription change.
Chronic illness or metabolic disorders may lead to TE. The two most common problems are chronic stress, thyroid disorders and diet deficiency. There does seem to be a link between stress, a change in hair follicle biochemistry, and more hair follicles entering a resting (telogen) phase.
Dietary changes can cause a deficiency of required nutrients for the hair follicle causing TE. A deficiency in thyroid hormones can be treated with hormone supplements.
What can Ben do for that bald spot?
The best method for treating hair loss is finding the cause. This will require either a well-trained primary care physician who has the time to evaluate your medical condition, or a hair restoration specialists, or a dermatologist.
However, a specific cause may not always be identified.
“Mr. Affleck’s choices are intially based upon medical stabilization of any hair loss with medications and photostimulation therapy with a Laser Cap,” says, Irvine hair restoration surgeon, Dr. Ken Williams, of OC Hair Restoration Center. After Ben’s hair loss is stabilized according to Dr. Williams, he would then recommend the “no scar hair loss” restoration surgery using the automated FUE device called NeoGraft. He says, “it is considered the best technology available that will not leave any scar in the back of your scalp.”