What is the most useless dermatological treatment


Our headdress is a blessing because it protects the sensitive scalp and the underlying brain from strong sunlight and cold. In addition, the scalp hair significantly shapes our external appearance. A full head of hair has always been a symbol of strength, health, youth and eroticism. With this in mind, it is no wonder that the soul usually suffers from hair loss.

Important protective functions are fulfilled not only by the hair on the head, but also by the eyelashes, which protect the eyes from the ingress of foreign bodies, and the fine nasal hairs, which prevent dirt particles and small animals from entering the airways. But why the rest of the body is more or less hairy, does not make much sense to many people.

They sprout all over the body In contrast to our ancestors, for whom their “thick fur” served as protection against the cold and other environmental influences, modern humans of the 21st century have only sparse body hair - but they are still a long way from being naked. On the contrary: apart from the soles of the feet, palms of the hands, lips, nails and mucous membranes, hairs sprout on our entire body surface. The approximately five million hair follicles are created in the unborn child, no more are added after birth.

No hair grows forever Our hair, which has neither nerves nor blood vessels, belongs - like fingernails and toenails - to the skin appendages. Each hair consists of a hair shaft that protrudes from the skin and a hair root anchored in the skin that ends in the bulbous bulb of hair. Hair does not grow indefinitely, but has a limited lifespan.

Hair growth is divided into three phases: the growth phase, the transition phase (catagen phase) and the resting phase (telogen phase). Once the hair has gone through all three phases, it falls out. The growth phase for scalp hair lasts several years, whereas for most of the other hair it only takes a few months. This explains why the body hair (apart from the man's beard hair) remains quite short even without a shave.

Much of the body surface is covered in vellus hair, a short, thin, usually unpigmented fluff. Until puberty, vellus hair - apart from scalp hair, eyebrows and eyelashes - makes up all body hair. If the production of sex hormones begins during puberty, part of the vellus hair is converted into pigmented terminal hair by the influence of androgens. Pubic and armpit hair, hair on the extremities and the male beard hair belong to the terminal hair, among other things. It varies from person to person in terms of expression and pigmentation.

Nevertheless, body hair is a thorn in the side of many people. A study conducted in 2008 at the University of Leipzig among young adults showed that more than 97 percent of women and 79 percent of men remove at least part of their body hair. Basically, a distinction is made between temporary depilation methods, in which the hairs sprout again after days or weeks, and permanent methods, in which the unwanted growth is put to an end in the long term.

Get rid of annoying hairs One of the temporary methods is shaving, which is particularly quick and painless. That is why women and men alike use the practical razor. A shaving gel or foam should be applied beforehand so that the blade glides smoothly over the skin. Disadvantage of the procedure: the annoying hairs are back after a few days. On the other hand, the common misconception that shaving would cause more hair to grow back is wrong.

A possible alternative to shaving is to use depilatory cream or foam. These preparations usually contain the active ingredient thioglycolic acid, which dissolves the keratin in the hair so that it can simply be "wiped off" after a short exposure time. The effects last for about a week. It is important to know that depilatory creams should not be used over a large area (e.g. on the hairy back). They are also taboo in the event of irritation, inflammation or sunburn.

It is also possible to get rid of annoying body hair with warm or cold wax. The hair is pulled out of the root with a strong pull against the direction of growth, which means that the skin remains smooth for a few weeks. Disadvantage: The method is painful and therefore not the right thing for sensitive contemporaries. The same applies to hair removal with the epilator. Here, hairs are also removed right at the root with rotating “mini tweezers”.

If you want to get rid of body hair permanently, you can have a laser treatment carried out in specialized practices and institutes or use the lightning flash technology (IPL) to kill the hair. Both methods are effective, but also costly.

Loss with consequences The psyche usually suffers particularly badly from dwindling hair and bald spots on the head. While some men can still come to terms with the fact that their scalp hair is increasingly thinning and at some point will belong to the group of bald people, hair loss is a huge problem for women. They often even experience the loss of their headdress as a loss of their femininity.

But no matter whether women or men are affected: No one has to and should simply come to terms with hair loss, medical alopecia. As a rule of thumb, if more than 100 hairs are lost every day, those affected should consult a dermatologist to investigate the causes of the problem. The right therapy depends on the type of hair loss.

Malefactor: DHT Most people who are plagued by hair loss suffer from the hormonal-hereditary form, in technical jargon it is called androgenetic alopecia. The cause of the condition is a genetically determined hypersensitivity of the hair roots to the endogenous hormone dihydrotestosterone (DHT), which is formed from the male hormone testosterone. This hypersensitivity causes the growth phase of the headdress to be significantly shortened and the hair follicles to shrink.

Both men and women can suffer from androgenetic alopecia, with men being affected much more often. With them, the hair loss often leads to a receding hairline and balding hairline at a young age, then later to tonsure and sometimes also to completely baldness. In affected women, the hair usually falls out in the crown area. For them, the dreaded clear-cut often begins in the menopause, when the body's estrogen production decreases. The reason: the female sex hormone can protect the hair and extend its growth phase.

Treatment with brains There are a number of effective drugs used to treat androgenetic alopecia. The 5-alpha-reductase inhibitor finasteride, which is only approved for men, requires a prescription. It blocks the 5-alpha reductase enzyme that converts testosterone into DHT. Good to know: The active ingredient finasteride is approved in higher doses for the treatment of benign prostate enlargement.

For women, systemic treatment with antiandrogenic contraceptives is an option. The active ingredient minoxidil has proven itself for local therapy. It was originally developed to treat high blood pressure. In the patients treated with it, increased hair growth was found as a side effect, which also made the substance interesting for the indication of “hair loss”.

Today there are 5 percent minoxidil hair tinctures for men with androgenetic alopecia and 2 percent for women. The over-the-counter preparations must be applied to the scalp regularly and over a longer period of time, although the first treatment successes can be expected after about twelve weeks. Treatment with alfatradiol-containing solutions, which are also applied to the scalp, is also possible if the hair loss caused by hormones is mild.

In the consultation, point out that perseverance is crucial for the success of the therapy. Androgenetic alopecia can only be stopped by consistently applying the dermatological agent.

Specialists are needed Circular and diffuse hair loss differ from hormonally hereditary hair loss. As the name suggests, the circular hair loss (Alopecia areata) draws attention to itself through approximately coin-sized round to oval bald spots on the head.

The hairless areas are often located on the back of the head, but also on the sides. Quite possible that they will enlarge or even all of your hair will fall out. Circular hair loss is an autoimmune disease in which the body's own immune cells attack the hair roots. People of all ages can be affected by the disease, and children often suffer from it.

Treatment is often difficult and always belongs in the hands of experienced specialists. Corticoids can be prescribed to stop the underlying inflammation. In diffuse hair loss (alopecia diffusa), the hair thins overall. This type of hair loss is triggered by a disruption in the growth of the hair roots. There are very different causes in question, such as infectious diseases, thyroid dysfunction, hormonal change processes, nutritional deficiencies and the use of certain medications.

It goes without saying that in the case of diffuse hair loss it is essential to search for the causes of the problem. If the underlying disease or disorder is treated, the headdress often grows again. If diffuse hair loss is due to a lack of certain nutrients, targeted supplementation can be used to counteract this. To stimulate hair growth, for example, preparations with cystine and B vitamins can be helpful.

Disturbing wild growth Hair is splendid - as long as it grows on your head. “Dense fur” on the back, very hairy feet and a woman's beard, on the other hand, are real disturbances. Especially with women, the suffering is enormous when hair sprouts on parts of the body where it should only grow in men. If pigmented, solid hair suddenly appears on the upper lip, chin, cheeks or on the chest and stomach, affected women are understandably appalled and usually have only one wish: to get rid of the cosmetically disturbing and psychologically extremely stressful wild growth quickly and as permanently as possible.

"If more than 100 hairs are lost every day, those affected should see a dermatologist."

Increased body hair in women, which corresponds to the male hair pattern, is what doctors call hirsutism. The term is derived from the Latin word "hirsutus", which means something like "shaggy" or "bristly". Hirsutism only affects women. Hypertrichosis is different. Experts understand this to mean a general excessive hair growth on individual parts of the body (e.g. on a birthmark) or on the whole body. Women and men alike can suffer from it.

Hypertrichosis can have different causes, including genetic or other diseases. Long-term treatment with certain medications (e.g. with corticoids, minoxidil, ciclosporin) can result in general excess hair. Research into the causes is always required. If medication is the trigger for excessive hair growth, switching to other preparations may help.

Hirsutism and hormones It is estimated that every 20th woman is affected by the former, although the typical male hair pattern occurs more frequently in some families. Women with dark hair suffer from a woman's beard and Co. more often than light skin and hair types. Excessive hair growth very often begins during puberty, and the hairiness can increase significantly over the years.

Often the hormones or an increased “hormone sensitivity” are to blame for the fact that the hair sprouts in abundance. As a reminder: Even in women, the hormone glands produce not only female but also male sex hormones - albeit in small quantities. These androgens, which also include testosterone, are produced in women in the ovaries and adrenal cortex.

In the majority of women tormented by hirsutism, the body produces normal or only slightly increased amounts of testosterone, but the hair follicles probably react very strongly to the male hormone. Result: Firm terminal hair sprouts on parts of the body where it really has no place in women. However, in some affected women, the endocrine glands make too many male sex hormones. Experts then speak of endocrine or symptomatic hirsutism.

A comparatively common cause is polycystic ovary syndrome, or PCOS for short. Behind this is a hormonal disorder, which is characterized by an increased formation of androgens in the ovaries. In addition to excessive body hair, symptoms such as weight gain, blemished skin (acne) and an irregular menstrual cycle are typical of the polycystic ovary syndrome. Other possible causes of excessive body hair are side effects of drugs and, in very rare cases, tumors of the adrenal glands or ovaries.

The list makes it clear: Research into the individual causes is essential in order to be able to successfully treat hirsutism and to exclude serious diseases that must be treated immediately.

Medicines and cosmetics Treatment depends on the causes. In the case of endocrine hirsutism, therapy with ovulation inhibitors can be successful. The use of gestagens with an anti-androgenic effect (e.g. cyproterone acetate) also makes sense. In order to alleviate the suffering of affected women - regardless of the cause - various methods of hair reduction and removal have proven effective. In the case of locally limited excess hair, it is sometimes enough to optically hide the annoying hairs by bleaching. It is of course also possible to tackle unwanted hair growth with a razor blade, depilatory cream, wax or an epilator.

The disadvantage is that these hair removal measures have to be repeated regularly. Dermatics containing the prescription-only active ingredient eflornithine can inhibit hair growth. Corresponding creams that are approved for women with hirsutism on the face usually have to be applied to the affected areas of the skin twice a day. Dermatological treatment with high-energy flash lamps or lasers is an option to permanently control troublesome body hair.

The article can also be found in Die PTA IN DER APOTHEKE 02/14 from page 148.

Andrea Neuen-Biesold, freelance journalist