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BRITISH BROADCASTING CORPORATION
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Programme No. 2 - Hair
RADIO 4
THURSDAY 29/11/07 1500-1530
PRESENTER:
BARBARA MYERS
CONTRIBUTORS:
+
ANN ROBINSON
PRODUCER:
BETH EASTWOOD
NOT CHECKED AS BROADCAST
MYERS
Hello. Well everybody, I suspect, has the occasional bad hair day - I know I do. But what if it's always a bad hair day? Does it have to go thin and wispy as we grow older? It can fall out altogether if we're ill or having certain medical treatments. Too little hair is a problem but so is too much. Men, I think, can get away with matted body hair but women find excess body hair rather embarrassing. Bleaching can work, so can lasers but they're not for everyone. So have you found anything that works for you or have you found a way of living with it or without it?
Dr Ann Robinson is my guest in the studio today, she's a general practitioner and she's here to take your calls and e-mails. And we've certainly opened up the floodgates with the subject today. Let's go to Wolverhampton first and Miss South, who's waiting to speak to us about hair loss in patches. What's happening with you Miss South?
SOUTH
Well it started really last year, I started losing hair, first of all, round the side of my head and then later on, earlier this year, I lost a patch in the middle of my head. And I went to the doctor about it and I was to be referred but he said just to see how it went and if it's growing back. It's growing back a little bit but I just wanted to know if there was any product I can use that can make it grow back because obviously on the side of my head like when I do my hair in certain styles it looks bald.
MYERS
So you're feeling a bit uncomfortable with the way it's looking are you?
SOUTH
Well a lot uncomfortable to be honest.
MYERS
Alright, well let's see if we can get some answers for you from our GP today, Ann Robinson, what would you say to help?
ROBINSON
Oh hi Miss South. I mean all the indicators are that this is going to turn out fine for you. The fact that your hair didn't carry on falling out, the fact that you've even started to see a bit of re-growth now is all really, really positive. It sounds as though what you've got is a mild form of alopecia where you do lose hair in patches. And in its most extreme forms people sometimes even lose all their body hair. But if that hasn't happened to you yet it's very unlikely that it will. We don't know exactly what triggers it but it can be stress, so if you've been stressed being a student or whatever that can trigger it, but it's nothing that you've done. And to be honest there's not a lot you can do that's going to make it grow back quicker than nature itself. Just remember though that hair does grow at about half an inch a month, so if you're looking - if your hair's about let's say six inches long it's going to be a year till you get back the full head of hair. But it's sounding really, really optimistic and there's nothing that you should or shouldn't be doing.
MYERS
Just be patient. Thanks for that call. And we'll go to Stratford now where Melissa wants to talk to us and she also is complaining about hair loss but I think you probably know why, which is to say you've got a little baby with you, so perhaps it's related to pregnancy?
MELISSA
Yes that's right. When I was pregnant my hair thickened up as it tends to do and then about - when my daughter was about four months old I noticed that as I combed my hair in the morning - well there was a lot of hair on the pillow. And that's kind of continued on and off. My daughter's a year now but I'm breast feeding her and I just wondered is there any supplements that I could take. It's not falling out at such a rate that I have any bald patches luckily but I feel that I ought to be doing something to improve the condition.
MYERS
Not looking at its luxuriant best.
MELISSA
No exactly.
MYERS
Ann, what would you say to help Melissa?
ROBINSON
Hi Melissa. Well first of all congratulations on a great result and it's very interesting what's happened to you and I don't know whether actually just understanding the process will help you make - make you feel better about it. But it's interesting because hair normally is in one of three phases - so maybe a third of our hair will be growing at any time, a third will be resting and a third will be shedding - and it's not quite those proportions but that's how it really works. And then for some reason with the sort of surge of hormones that we get in pregnancy all those phases can line up together and that's probably why you noticed that your hair was particularly luxuriant during pregnancy, because luckily for you instead of all your hair suddenly resting or shedding it all grew. So it looked fantastic. But because it was all in sync unfortunately as the cycle then - they all went through the cycle together they all shed, well they don't all shed luckily but you know a lot more than usual all shed in one go. So in a way, a funny way, you're sort of paying the price for the luxuriance of pregnancy now.
MYERS
Though we're talking a year on.
ROBINSON
Yes, well it takes ages, I mean you have to wait for the hormones of pregnancy to go back to normal and obviously if you're breast feeding those hormones remain high, which is great, so the whole process takes longer and as you tail off breast feeding your hormone levels - they'll probably be returning to normal by now anyway. So the fact is that now your hair won't be in sync anymore, it'll be back into its three phases and sometime before your child's second birthday, all being well, your hair will be back to what it was in its pre-pregnancy state. But as I say what happened was it was ultra luxuriant and now it's a little bit thinner than usual and by the time the child's two it'll be back to where it was.
MYERS
Melissa you were asking about supplements - is there any point...
MELISSA
Yes I just wondered if there was anything that I could take that would help?
ROBINSON
Yeah and it's a really, really good question and obviously when you're breast feeding for a long time it's very easy after childbirth as well to become deficient in iron, become a little bit, even if not actually anaemic but to have very low iron stores and that can affect your hair. So it's well worth getting your GP not just to test for anaemia but also specifically to test for your iron stores and if they're on the low side you can boost them.
MELISSA
Okay thank you.
MYERS
Thanks Melissa. And to Stourbridge now where Brenda's waiting to speak to us and is concerned about her thinning hair. What's the story Brenda?
BRENDA
Well I'm in my early 60s and my hair is going very thin on top and at the sides. I do have a thyroid problem, which I've had for, what, 15-20 years which is controlled with Thyroxin. It over the years has got thinner but in the last six months it's dreadful and I feel very, very conscious of it and wondered if there's anything I could take, like you say, that could help me restore it or because of the illness is it just not going to come back and do I resort to a wig?
MYERS
Well it's a good question. Is this then, do you think Ann, to do with the underactive thyroid or is it to do with the treatment, it's not quite clear, does it connect with this thyroid problem?
BRENDA
Well if I'm on the Thyroxin I would have thought that that would have put the balance of the thyroid back into sync - I'm on quite a high dosage of it.
MYERS
Let's see what Ann has to say about that.
ROBINSON
Hi Brenda. Can I just ask whether you've had your thyroid levels checked in a blood test quite recently?
BRENDA
Yes I have.
ROBINSON
And were they okay?
BRENDA
And they were alright, yes.
ROBINSON
Well I suspect then that the fact that you've got an underactive thyroid that's being treated is in a sense a bit of a red herring because as you correctly say if it's being adequately treated it shouldn't really be impacting on your hair. But I think to be honest what you're describing is what is incredibly common, probably pretty much universal to all us as we get older, I mean the combination of getting older and our own family tendency mean that all of us are prone to our hair getting thinner as we get older. In men that happens in the particular male pattern, which means that they end up just with tufts of hair at the back and round the sides. But in us women it tends to be more sort of generalised, so we don't lose hair - luckily for us really - we don't end up with a bald patch in the middle so much, but we tend to end up with thinner hair. And most of us when we're 60 will have thinner hair than say when we were 20 and sometimes it happens rather suddenly as well, so you know you're fine till you're 58 and then suddenly you notice a change. So I think that that's what's happening to you. And the honest truth of it is that because it's a combination of age and of family tendency and our own reaction to the hormones in our body there's not really a lot you can do about it. I think the best person to consult is not a doctor but a really skilled hairdresser because it's amazing what a different style or a different way of setting the hair can do and sometimes just having it cropped in a different way makes all the difference.
MYERS
Okay, good luck with that, thank you very much for calling us.
On the question of hair loss perhaps relating to deficiencies of various kinds, I think you mentioned earlier the possibility of anaemia perhaps following pregnancy and there was a question there about the thyroid, we've had a call from Lynn Jackson who says that she suffered hair loss for 18 months and was treated for iron deficiency and miraculously the loss stopped. So if you can reverse some of these deficiency syndromes then you can get your hair back - is it as simple as that Ann?
ROBINSON
I think it is unless, as Brenda just said, it's not really about that deficiency anyway and that's just a little bit of a red herring. But I can't see if you're worried about your hair thinning I think you'd always want to go to your GP and ask specifically to have your iron stores and your thyroid checked. I think unless they showed a specific deficiency I personally wouldn't go down the road of seeking very expensive nutritionist's help because I think the evidence is often a little bit ropey there.
MYERS
Let's go to another caller: Katrina Teale is in Northamptonshire and again hair loss. What's your particular worry and what's causing your hair loss, as far as you know Katrina?
TEALE
Hello. Last year I had a brain haemorrhage and I noticed when I came back from hospital and was recuperating my hair was falling out all over and my GP and my husband, who are both bald, just laughed and I thought that's very sensitive. I had really a thick head of hair and I've probably got about - it's about a quarter has fallen out and I'm just worried now a year on.
MYERS
So you've recovered from the brain haemorrhage which is extremely good news and - but the hair loss and your - the men folk have been a bit - well a bit dismissive which seems rather unfair. But in truth will the hair come back do you think Ann, after this particular problem that Katrina's talked about?
ROBINSON
Yeah, and Katrina congratulations on your recovery and commiserations about the reactions of the men there. Your hair will grow back, it'll grow at half an inch a month, which is what everyone's hair grows at, and it'll grow back.
TEALE
Oh thank - because it is tied up to the brain haemorrhage you would ...
ROBINSON
No it's tied up to the fact that your body had a major shock and major shocks, whether they're psychological or physical or both, as I'm sure it was in your case, can just cause all the hair to suddenly go into shedding mode, so it all falls out - not necessarily immediately, sometimes about six weeks after the trauma.
TEALE
That was the time it did yes.
ROBINSON
And then it grows back and there's no reason why it shouldn't.
TEALE
Oh fantastic.
MYERS
Good news, thank you very much indeed. [Indistinct words] Absolutely you've definitely got our sympathy and I'm sorry your doctor, at least, wasn't more sympathetic. Let's go to Wokingham and Nina who I think also has hair loss, again [dogs barking] - the dog's not at all sure about this. Okay Nina yes what's the particular problem you wanted to tell us about?
NINA
Yes I'm 42, can you hear me?
MYERS
We can indeed yes.
NINA
I'm 42 and all of a sudden I've got a sort of - well balding patch at the front of my head, about an inch from where my hair stops growing and I did have very long hair and I did go to the hairdresser and I've had my hair cut and we carefully positioned the hair over but I'm just concerned - my GP - a bit like the other lady's - said well you won't go as bald as me and he suggested it was male pattern baldness.
MYERS
Male pattern baldness in a woman, is that a good diagnosis would you say Ann?
ROBINSON
Well far be it from me to go against another GP but it doesn't sound like male pattern baldness or female pattern baldness, which would be more appropriate in your case since you sound female. It sounds like alopecia, where you've lost a patch of hair. And if it's just the patch, a bit like our first caller, there's no reason why it shouldn't grow back and if not continuing to fall out that's a really good sign. I mean where it's a patch of hair that really isn't typical of female pattern baldness which is the sort we discussed with Brenda where the hair just tends to thin out as you get older. So it doesn't sound like that at all.
NINA
I haven't got an actual bald patch, I've just got a patch of about - well a 50p I suppose where it's suddenly gone very, very thin.
ROBINSON
Yeah, I mean that's - it still sounds like alopecia, where it's a patch it's just that probably not all the hairs have fallen out, that's why it suddenly looks thin, but it pretty much has to be alopecia in that respect. And there are three treatments that people use, sometimes you can rub a steroid cream on, you can have a steroid injected into the patch and sometimes people have some ultraviolet light. But where it's just one patch and these treatments are not fantastically effective I personally would be inclined to just wait and let it grow back. But if you feel you'd like to do something about it just ask your GP to refer you to a skin specialist or hair specialist who can give you one of those three treatment options.
MYERS
Good, I'm glad that's been helpful. We'll go for our first call about male baldness I think. Have we got Tony Brown on the line?
BROWN
Yes I'm here.
MYERS
Yes Tony you're our first male caller and you've got a problem with your hair?
BROWN
No I haven't got a problem with my hair, I've hardly got any.
MYERS
Ah but that's not a problem?
BROWN
I've grown quite bald. And - well actually I didn't meet my wife until I was bald and it didn't seem to make her recoil in horror. I just feel as though very often status seems to come in, frustration and suffering follows and image, instead of content, seems to be the celebrity culture now.
MYERS
So you're saying big it up for bald men because it's fine, you haven't got much hair and it's not a problem?
BROWN
Yeah it's different for men I believe, for women it might be a bit more important but I don't really think that it carries much weight when it's the inside that counts - in men and women.
MYERS
Well that's a very good point to make, thank you very much for making that point and I'm sure that's right. But it may not always be consolation. We've got I think Nicola on the line in London who wants to tell us about her son I think who is bald and perhaps not very happy with it, even given - notwithstanding what Tony's just said. Tell us about your son.
NICOLA
Absolutely. He's just turned 23 and he started to go bald at the age of 19, which seems disproportionately young to start going bald, and he now has very little hair left on the top of his head. He suffered very badly as a baby from what I believe is called cradle cap and has subsequently consulted a GP a couple of times in the last two or three years and has been prescribed what I would call palliative, a product known as Selsun, which is a treatment for dandruff and contains a product called selenium sulphide which I don't imagine will make any difference at all and I just feel it's such a shame for a young man to lose his hair at such an early age.
MYERS
And is it literally all gone, I mean shiny bald head?
NICOLA
Oh no, there is still sort of a thin residue.
MYERS
Ann, what would you say to help here?
ROBINSON
Hi Nicole, can I just ask whether - whether your son's father lost his hair at a young age?
NICOLA
There is no male baldness in either side of the family.
ROBINSON
And he didn't lose hair on the rest of his body?
NICOLA
No he's extremely hairy everywhere else.
ROBINSON
And what about on your side of the family - is there hair loss - early hair loss?
NICOLA
On neither side of the family has there been male hair loss or female hair loss for that.
ROBINSON
I mean it's interesting because I mean obviously upsetting for him - do you know if he's bothered by it?
NICOLA
Yes he is, I mean that's why he's consulted his GP.
ROBINSON
Right, I mean is - it's interesting because it doesn't quite fit to any particular pattern because normally the male pattern baldness does happen - I mean it can start very young, a quarter of men start losing their hair significantly by the age of 30 and two thirds of men by the age of 60. But obviously, as you say, starting at 19 is unusually young.
NICOLA
It has been suggested that it might have been stress that caused it.
ROBINSON
Well if we're talking about stress then we're talking about alopecia, which again if it were as extensive on the hair of his head you might expect him to have lost hair elsewhere on his body as well.
NICOLA
Certainly not.
ROBINSON
Yeah I mean it doesn't sound very typical of alopecia either. I think probably the fact that he had extensive cradle cap as a child is probably not relevant because most babies have cradle cap and it doesn't in any way seem to be associated. And you are right in the sense that if you have significant problems with your scalp, skin problems like fungal infections for instance, then it can make you lose some hair but normally that's very obvious and you wouldn't normally lose all the hair.
NICOLA
There was a suggestion from that after the first time he went to see his GP that he might have caught some fungal infection from his hairdresser.
ROBINSON
I think that as you're suggesting by your sceptical tone of voice all sounds rather unlikely and what I would do, if I were him and I were concerned, is I would get a referral to a dermatologist and what the dermatologist will do is they'll take a very small biopsy, which is a sample of the actual scalp and by examining it under the microscope they will at least be able to tell him and you what the underlying problem is. So even though they might not be able to promise to make his hair re-grow, which they probably won't, at least you'll have some idea as to what caused this, what the best course of action is and he won't be encouraged to waste his time perhaps with anti-fungal shampoos like Selsun.
MYERS
Nicola, that's probably as far as we can take it but thank you for sharing that with us. We've got Martin Rice in Scotland, who's wondering whether there are any cures, any lotions or potions that might work on hair loss, is this for yourself Martin?
RICE
Yeah.
MYERS
Tell us about it, what is your problem?
RICE
Well I'm the only male member of my family to suffer from hair loss - a couple of my grans did unfortunately and both wore wigs. And I'm wondering whether there any liquid lotions will do any good, like Nourkrin or are they an absolute con?
MYERS
Right well there are a lot of things out there on sale, what are to be recommended, if any, let's ask Ann Robinson.
ROBINSON
Hello Martin. Well there are two things that do work a bit but they both come with quite a heavy proviso and the proviso is that they only work while you're using them. And you need to use them for six months till you start to see a result because of what we said about the rate of growth of hair. So they're expensive and one of them potentially has side effects and they only work for as long as you use them and then when you stop using them all the hair falls out again. So in a sense if you go down that road you have to commit to using them I suppose for at least six months, otherwise you're not going to see whether they're working or not, and then if they are working if you want to carry on with the hair then you have to carry on using the stuff pretty much forever and that's why lots of men don't bother. But I'll tell you what they are and I don't want to be too negative because you may well feel you want to give it a try. One is a lotion called Regain or Minoxidil, which was originally developed as a blood pressure product funnily enough but it doesn't affect your blood pressure and it's a lotion and you can get it on private prescription or buy it in the chemist, it's quite expensive. And the other one that's being developed, and is not yet widely available but people buy it on the internet, is called Propecia and it's a tablet and it blocks the male hormone in your scalp, so - because that's why certain hairs fall out. But you have to take a tablet everyday and it's not really licensed for the use yet in England. Personally I wouldn't take it if I were a male. But you may want to try Regain, which is a lotion so at least you're not putting anything into your body.
MYERS
Martin, thanks for the call, I hope that's been helpful to you. And we've got the opposite problem now I think from Lester, who's very hairy but perhaps not on your head, I'm not sure what your particular issue is, Lester it's over to you.
LESTER
Yes hello. Well I'm not a hairy monster and it doesn't affect my health but I'm 56 and I've had a hairy torso all my adult life and I wonder why it is that some men are hairy and some have no body hair at all. A bit like learning algebra at school it seems, my body hair seems to have been no use at all in adult life.
MYERS
Well hair's supposed to keep us warm, so in sort of evolutionary terms it played its part but yes when it starts sprouting out of ears and noses and such like, it's not ...
LESTER
Well exactly, you know, and the eyebrows grow bigger and they don't seem to have any purpose and I just wondered why these things happen.
MYERS
I don't know if Ann's got the answer to that.
ROBINSON
Hi Lester, well I mean it comes down to our ethnicity really that we were all born with slightly different numbers of hairs and if you're from Mediterranean stock, for instance, you will have more hair follicles than if you're originally from the Asian subcontinent ethnically, so there are differences in that. And there are also differences to the sensitivity of different hair follicles to your circulating male hormones and that is why paradoxically if the hair follicles on your scalp are very sensitive to your male hormones you end up losing hair on your head while gaining more hair in the places you don't really want it - like your ears and your nose. It's the most peculiar thing - some hair follicles grow more when they're exposed to the male hormones and some fall out.
MYERS
And what's the answer to dealing with them and in fact we've had an e-mail from a woman who's got excessive nasal hair, is it a matter of - I don't know - trimming it or can you remove with electrolysis or any other treatment?
ROBINSON
If you've got a huge area of hair that you don't like you're best off with laser, if it's an area like a moustache you're better off with electrolysis but if it's in your nose you don't want to mess about with bleach or anything like that you can only just trim the hairs.
MYERS
Thank you very much indeed. There we will have to leave it too little, too much.
Thanks very much to my guest today Dr Ann Robinson. Thank you very much to all of those of you who've e-mailed and phoned us and there have been plenty of you. If we haven't managed to answer your question please contact our free and confidential helpline, the number is 0800 044 044. You can get more information on our website, go to bbc.co.uk, follow the prompts to Check Up. You can listen again there or you can download this programme as a podcast. And join me again next week, if you will, we'll be taking your calls and your e-mails about painful shoulders.
ENDS
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