Ever wanted long hair like a mermaid?

Question:  How come I just can’t seem to grow my hair long? It just never gets past a certain length and then either breaks off or never gets longer. Why is that?

shutterstock_197763182Answer:  Every little girl and subsequent teenager has, at some point or another, wanted to grow their hair out as long as possible.  Many characteristics about how your hair grows are fixed and genetic and then there could also be some environmental reasons your hair is not growing as long as you wish.

To grow your hair as long as possible, it helps to understand that hair growth occurs in a regular repeating cycle which can be disrupted by many things.

The normal hair growth cycle:

  • Anagen Phase: This is the active growing phase of your hair which lasts for an average of 3 years (1000 days), but can be anywhere from 2-6 years and determines the length of your hair. The longer the growth cycle, the longer hairs can grow before being shed. The reason you cannot see hair growing is because the average growth rate is just 0.37mm per day.
  • Catagen Phase: During this time, lasting 1-2 weeks on average, hair follicles undergo a transition from the growing phase to a resting phase during which all growth activity ceases. Whatever length the hair is, it will not grow any longer.
  • Telogen Phase: This is the final resting phase and hair follicles remain in this phase around 3-4 months, or 100 days on average, before they are pushed out by new hairs growing underneath or pulled out by a hairbrush or other mechanical action causing friction such as shampooing.

Your scalp normally contains 100,000 hairs, and the average number of hairs shed daily is 100-150.  Hair (unlike nails) does not grow continuously but stops growing after a pre-determined period of time and is replaced by new hair. While many things can disrupt the normal growth cycle, halt hair growth and increase fall out, nothing, including medications, shaving techniques or menstruation can make hair grow faster. And, since the number of hair follicles is pre-determined in utero and does not increase after birth, there’s nothing you can do to increase the amount of hair that you have, despite what many websites and products may have you believe.

Hair grows normally, and at different rates, on all skin surfaces except palms, soles of hands and feet and specific genital areas. In addition, terminal (dark, course) hair is always present on men’s face, chest and abdomen. The duration of hair growth cycles (and hair length) vary with the anatomical location of the hair, for example, scalp growth lasts for 3-5 years and the eyelash cycle averages just 3-5 months.

Lifestyle factors that can affect your hair growth cycle

Aside from a genetic set point that determines your personal hair growth cycle and hair length, here are some other factors that may be inhibiting your hair’s growth and health:

  • Unnecessary roughness. Sometimes hair doesn’t appear to be growing because it breaks off in the middle or at the ends. This can be caused by rough treatment in shampooing, toweling wet hair, combing and brushing, tight pony tails and braids and use of heated appliances all causing hair to weaken as it ages (the ends) and simply break off. Any injury such as a burn or laceration to the scalp can also cause a scar resulting in permanent hair loss to the area contributing to a shorter look.
  • Telogen Effluvium. Any physical or emotional trauma can shock your body (and your hair follicles) which halts the hair growth phase and pushes it straight to the telogen phase causing a shedding of a larger than normal amount of hair (which thankfully and  usually reverses).  Some of the most common causes are extreme crash diets, child birth, menopause, chemotherapy and even a prolonged high fever along with emotional traumas such as death of a loved one or a traumatic divorce or other life change.
  • Hair loss diseases. Systemic, skin disease and deficiencies can affect the scalp, the hair shaft and the hair follicles. These include folliculitis (an infection of the hair follicles which can involve just one inflamed follicle or spread to others), autoimmune conditions such as alopecia areata, psoriasis or lupus that result in patchy hair loss, seborrheic dermatitis, fungal infections and even trichotillomania (a compulsive disorder characterized by a secret compulsion to pull hair out from the head and body parts), among other skin and hair diseases.
  • Medications. Some medications are known to have the side effect of diffuse (all over the head) hair loss.  These include beta-blockers (blood pressure medications), certain oral birth control pills, isotretinoin (for treatment of acne), antidepressants (serotonin reuptake inhibitors, or SRIs) and some cholesterol-lowering drugs. Hair loss will not occur in everyone, but if you experience it, work with your doctor to evaluate different medications and dosages to improve or stop the hair loss.

How a dermatologist diagnoses hair loss conditions:

  • Hair care and lifestyle evaluation. We can determine the causes of telogen effluvium or medication side effects and educate you about treating hair gentler.
  • Hair pull test. If a gentle tugging of the hair produces more than 6 hairs at a time we consider that an abnormal hair loss condition.
  • A thorough visual examination. This is how we rule out skin and scalp hair loss diseases.
  • Scalp biopsy and culture. If we notice any lesions, papules or pustules we will culture and biopsy the area to rule out scalp infections, fungal infections and carcinomas.

So, while you may never have hair as long as a mermaid, you can make the best of the hair you have by maintaining a healthy lifestyle of nutrition and exercise and being gentler on your hair at all times.

-Jodi

 

Little known topical ways to prevent and treat skin cancer

Question:  My dermatologist gave me a topical cream with special ingredients to prevent skin cancer where he thought it might be forming. How is that even possible?

Answer:  It is now possible and FDA-approved.  There are some new topical medications that target different mechanisms to halt cancer cells from growing.

5-fluorouracil (5-FU):  This long-standing chemotherapy drug has been used internally and is also now FDA-approved for use on top of the skin to prevent and treat superficial Basal Cell Carcinoma (BCC). It is the active ingredient in proprietary topical skin cancer prevention formularies and several prescription creams with 5-FU or related medications available by prescription.

When applied on the skin topically, 5-FU selectively targets and destroys only cancerous or precancerous skin cells damaged by sun and aging while leaving normal skin cells alone. It’s something you can use at home, under a doctor’s supervision, on many parts of the body  such as chest, neck, hands, legs and back.

A course of treatment usually lasts approximately 14 days.  After several days of initial application,  the appearance of redness, scaling, and eventually crusting occurs on treated areas and indicates that precancerous cells are dying; how soon they appear and their severity depends on the strength of the 5-FU product and how often it is applied. The end result is a healthier looking, more attractive skin with a reduced tendency to develop skin cancer.

Imiquimod:  This cream is FDA-approved to treat superficial BCC’s that works by stimulating the immune system and causing the body to produce interferon, a chemical that attacks cancerous cells. The cream is rubbed in the  the lesion 5 times a week for 6-8 weeks (sometimes longer).  This treatment can also produce some discomfort, redness, irritation and inflammation.

Cure rates for both are 80-90 percent because they kill active cancerous or precancerous cells over time instead of all-at-once.

Never self-diagnose or try to use these medications without a doctor’s supervision, as in the rare case a BCC is locally advanced or  metastasizes (spreads), the cancer can become dangerous, even life-threatening.

Have you tried 5-FU or any of the topical skin cancer prevention treatments?

 

 

 

 

 

 

 

 

 

 

Can you mistake skin cancer for something else?

Question:  I’ve noticed a small sore like a scab on my left upper arm that will not go away. What could that be? What should I do about it?

Answer:   Your sore could be a Basal Cell Carcinoma (BCC), so don’t take it lightly.

Sometimes a BCC can resemble something else like a mole, psoriasis or eczema,  a scar or any irritation. My rule of thumb is to watch it for one month:  If it does not go away or it enlarges or changes get it check out by a dermatologist, for an accurate diagnosis. The reason is because BCC is the most common type of skin cancer we see and anyone with a history of sun exposure is at risk of developing BCCs. A BCC is medically defined as any abnormal, uncontrolled growth or lesion that occurs in the skin’s basal cells (which line the deepest layer of the epidermis, the outermost layer of skin). They can start out as a barely noticeable lesion or rough patch, and while they rarely metastasize (spread) to larger organs beyond the original tumor site, they can be highly disfiguring and destructive to surrounding skin, if allowed to grow.

Who is at risk for BCCs? Aside from extensive exposure to UV sun rays such as in workers or athletes or even those who spend a lot of leisure time outdoors, we consider those with fair skin, blond or red hair, and those with blue, green or grey eyes to be at highest risk.

BCCs have generally been seen in older people but lately it seems the patients we are treating are younger and younger. And men have historically outnumbered women, although the number of women under age 40 diagnosed with BCC has more than doubled in the last 35 years.

There are five warning signs of a basal cell carcinoma; two or more are usually present in one tumor:

  1. Any non-healing open sore that bleeds, oozes or crusts and remains open for more than 3 weeks can be a very early sign of BCC.
  2. Any reddish or irritated area on the face, chest, shoulders, arms or leg which can be patchy or crusty may itch or hurt or may not have any sensation at all.
  3. Any pink growth that is slightly elevated with a rolled border and a crusted indentation in the center. If left to grow, tiny blood vessels may develop on the surface as it enlarges.
  4. Any shiny bump or nodule, often confused with a normal mole, that is pearly or clear, pink, red, white or even tan, black, or brown, especially in dark-skinned, dark-haired people.
  5. A scar-like area that is white, yellow or waxy and often has poorly defined borders or skin that looks shiny and taut, which indicate an aggressive, invasive BCC that is larger than appears on the surface.

BCCs are easily treated when caught early and cure rates are close to 100 percent, so any lesion that has been around for one month should be checked as soon as possible and treated and monitored by a dermatologist.

Do you have a growth that worries you? What does it look like?

 

 

Inaugural post … and croissants!

Wow…today is the inaugural blog…I don’t really know what to say. I guess, Welcome! Welcome to my blog! I will certainly try to give you my honest opinion, feedback and of course, answers to your skin care concerns and questions. Anything having to do with skin, hair and nails are up for grabs here…so ask away! Additionally, I will try and keep you up to date with the latest news and media reports on dermatology. I hope you enjoy it all!

BTW…today is National Croissant Day! In addition to being a skin care guru, I’m also a foodie. At our office, we love to celebrate anything having to do with food. No food holiday goes unnoticed!