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Countdown to Hair Loss

Study offers method to gauge whether you're bound for baldness

MONDAY, June 16 (HealthDay News) -- Want to know how much hair you're losing?

Start counting -- the hairs on your comb, not on your head.

In the June issue of Archives of Dermatology, scientists demonstrate that a so-called "60-second hair count" is a simple and reliable away to get a grip on whether you're balding and, if so, how fast.

The procedure, which can be carried out in the convenience of your own home, may reassure the adult male -- or not.

"Hair loss is fraught with emotions... Here is a hair count that allows the person to get a handle as to what's going on with their hair," said Dr. Jeffrey Miller, senior author of the study and associate professor of dermatology at Penn State College of Medicine in Hershey, Penn. "With something like the 60-second hair count, you can participate and monitor in an objective fashion what's going on with your hair."

"The reality is that hair loss is incredibly common among men and women. Fifty percent of both genders will have hair loss by the age of 50. That's a big number," added Dr. Doris Day, an attending physician in dermatology at Lenox Hill Hospital in New York City. "It affects how you're perceived, your ability to date and climb that corporate ladder."

Both the media and dermatology experts are fond of proclaiming that shedding 100 hairs a day is normal. (That's probably too high, Miller said.) But there is little scientific evidence for that number, which is based on the assumption that the average scalp holds 100,000 hairs, 10 percent of which are at any one time in the telogen, or resting, phase.

Not only do experts not know how much hair loss is normal, they also don't have any standardized way of assessing the amount of hair lost on an average day.

"We keep saying the same things over and over, that it's normal to lose 100 hairs a day," Day said. "The question is, how normal is it and what is normal in terms of hair loss."

The "wash test" involves washing one's hair over a sink five days after the last shampoo, a waiting period some might find objectionable.

A more up-to-date method is the 60-second hair count, used in this study.

Sixty healthy men aged 20 to 60 without evidence of baldness participated. All were white and all but one had straight hair. (The authors excluded, for the most part, men with curly hair and long hair "because of the difficulty of running a comb through the hair, which would lead to increased numbers of broken" hairs, which weren't counted.)

The men washed their hair three mornings in a row with Neutrogena T/Sal shampoo. On the fourth day, they were issued identical combs and instructed to comb their hair forward over a towel or pillowcase of contrasting color. They were then asked to count the hairs that had dropped out. This comb-and-count procedure was repeated on the next two days and the number of hairs was validated under a microscope.

After six months, the participants repeated the full procedure.

Based on these results, the authors concluded that losing 10 hairs is "normal." In younger men (aged 20 to 40), the shedding range was 0 to 78 hairs with a mean of 10.2 hairs. In the older men, the range was 0 to 43 hairs with a mean of 10.3 hairs.

Here are instructions on how to perform the count:

  • Comb your hair for 60 seconds over a pillow or sheet of contrasting color before shampooing. Pull the comb from the back top of the scalp forward to the front of the scalp for 60 seconds. "That 60 seconds allows you to dislodge any of the resting hairs that are supposed to be shed," Miller said.
  • Repeat the procedure before three consecutive shampooing sessions, always using the same comb.
  • Count and record the number of hairs in the comb and on the pillow or sheet.
  • Repeat the procedure every month and discuss results with your dermatologist.

The study was funded by Merck & Co. and Miller has received consulting fees from drug company Pfizer Inc.

The authors will be releasing comparable data for women in the near future, they said.

When to start panicking over hair loss? Miller counsels men who lose more than 50 hairs a day (as counted in the 60-second period) to check with their physician.

"The hair acts like a window to the inside of the body," he said. "If there's something going on inside the body that is not right, for example, low thyroid output or low iron, your hair can react by shedding more. So if you notice that you're shedding a lot of hair on the 60-second hair count, it would be worthwhile to be evaluated by physician to rule out underlying medical causes."

Sudden changes in the amount of hair you lose should also be evaluated, he said.

More information

Visit the American Academy of Family Physicians for more on hair loss.

SOURCES: Jeffrey J. Miller, M.D., department of dermatology, Penn State College of Medicine, Hershey, Penn.; Doris Day, M.D., attending physician in dermatology, Lenox Hill Hospital, New York City; June 2008, Archives of Dermatology

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