MangoPeel Final

1. Issue 01 // May 2025 by Dr. Skin Why Do You Have Hair Loss? Why you should see a Dermatologist early? Healthy Diet For Healthy Hair The Impact of Nutritional Deficiencies on Hair. 10 Rules to Revive Your Strands The Haircare Commandments The Hair Edition Skin, Science & Stories Within. 1

2. IN THIS ISSUE OF MANGO PEEL: Editor in Chief Dr Geethu Gangadharan Sub Editors Dr Sona Ann Sunny Dr Neenu Prasad Curator Renjini Thampi Design & Execution Noel Saju Antony Romal Read our latest blogs 2

3. 05 Know Your Hair Dr. Ancy Varghese 08 Healthy Diet for Healthy Hair Dr. Keerthy Joy Irimpan 12 Why Do You Have Hair Loss? Dr. Annie Ommen 16 Beyond the Scalp: Uncovering the Hidden Causes of Hair Loss Dr. Liji Isac 20 Behind the Flakes: A Deeper Look At The Scalp Health Dr. Berdy Jose 24 Am I Going Bald? Dr. Sameeha Hamza Chenganasseri 30 From Thin to Thick: PRP & GFC Bring Your Hair Dreams to Life! Dr. Neethu Sunny 36 Bald Today, Bold Tomorrow Dr. Anisha K Janardhanan 40 Excessive Hair Growth Bother- ing You? Dr. Geethu F Alappatt 44 10 Rules to Revive Your Strands Dr. Sahiba Rafi 50 Hair Myths Busted Dr. Tony Kuncheria Contents 01

4. EDITOR’S NOTE Welcome to MangoPeel, a whiff of freshness in this age of information abundance! We live in a time of social media and artificial intelligence, when ‘answers’ are just a tap away. Yet, in this flood of information, the real challenge lies in finding what’s trustworthy, accurate, and relevant for you—especially when it comes to our skin, health and lifestyle. MangoPeel is created in this backdrop, by doctors with a passion for science and a heart for the people. This magazine is our effort to deliver reliable, updated, and read- able scientific content about various dermatologic concerns. In this issue, we focus on hair. Hair often reflects what’s happening beneath the surface—whether in our body or in our mind. It’s a part of our iden- tity, a connection to culture, and at times, a mirror of our well-being. We begin by helping you understand hair itself, and then walk you through common concerns like hair loss, excessive hair growth, and the impact of underlying medical conditions on hair health. From nutrition and hair care practices to medications and modern procedures, we aim to provide clarity and scientifically sound opinions. At Dr. Skin, we believe that knowledge empowers care. And through every strand of insight in this issue of MangoPeel, we hope to help you better understand your hair — and yourself. DR GEETHU GANGADHARAN Editor-in-Chief, MangoPeel Clinical Director - R & D, Dr Skin 02 Editor's Note

5. FOUNDERS' NOTE Welcome to the inaugural issue of MangoPeel – our very own space where we share our view on Skin, Science and Stories Within. We believe skin health is not just a journey but a celebration. At Dr. Skin Clinic, our journey began more than a decade ago with a single mis- sion - to make Advanced Dermatological care accessible to everyone. As we’ve grown, so has our understanding of skin—an organ so intricate, so uniquely ours, and yet so universally important. With a dedicated team of experts, we’ve cre- ated a space where knowledge and compassion go hand-in-hand, empowering individuals to not just care for their skin, but to love it. Skin health is much more than just aesthetics—it’s a reflection of one’s inner wellness. That’s why we’ve always believed in a holistic approach to treatment. Whether you’re here for a routine check-up, dealing with a long-term condition, or looking for cutting-edge treatments, we strive to provide personalized, scien- tifically-backed solutions. MangoPeel is a direct reflection of our vision - To educate, inspire, and share the stories that make skin health a beautiful experience. From groundbreaking advancements in dermatology to personal stories of transformation, this maga- zine is a platform where we can explore the dynamic world of skincare together. We are thrilled to share with you not only the science behind skin but also the passion and purpose that drives us each day. Thank you for being a part of this journey. Here’s to Healthy, Glowing YOU —inside and out!! Stay with us and trust the process!!! Warm regards, DR. PRASANTH VENNIYIL MD - DVL Founder & Director, Dr.Skin Clinic MRS. PARVATHY S. PILLAI Co-Founder & Director, Dr.Skin Clinic Founder's Note 03

6. 04

7. KNOW YOUR HAIR BY DR. ANCY VARGHESE “Anyone can be confident with a full head of hair, But a confident bald man- there’s your diamond in the rough” Hair growth is an essen- tial part of body’s cycle of regeneration. Our hair grows in cycles. An insight into these cycles can help us understand normal hair growth pattern and take proactive steps to nurture it. - LARRY DAVID Notwithstanding the above mentioned saying, hair serves significant biolog- ical, social and cultural role in humans. Apart from biological roles like pro- tection, regulation of body temperature and enhance- ment of sensations, it also acts as a powerful tool of self expression and cultural identity. Hair grows from tiny struc- tures called hair follicles. These follicles form and mature during our fetal development (before birth). Hair growth happens when the follicles make new cells at the base, pushing older cells upward to form a strand of hair (hair shaft; the part of hair visible outside). DID YOU KNOW? • We have upto 1-2 lakh hairs on our head! • Everyday we lose upto 50-100 hairs! • Hair grows from roots and not the ends. So cutting hair does not affect your hair growth! • A single hair can hold upto 100 g of weight! • Our hair grows faster in warm weather. Know Your Hair 05

8. Hair growth cycle consists of 4 stages: Anagen, Catagen ,Telogen & Exogen. nants of hair growth pattern. The genes you inherit affect your hair density, texture, co- lour and growth rate. 1. Anagen Phase This is the active growth phase, and typi- cally lasts from 2-8 years. During this phase, hair grows at a rate of half an inch per month. The cells of hair follicle divide rap- idly forming hairshaft. This is the longest of the 4 phases, and the length of this phase determines the length of your hair. B) Hormones Hair follicles are sensitive to the changes in levels of hormones in blood. Androgens, growth hormone, thyroid hormone, prolac- tin, insulin like growth factor 1 have signifi- cant influence on normal hair growth. 2. Catagen Phase This is a short transitional phase lasting 2-3 weeks. The hair stops growing, hair follicle shrinks and stops producing new cells. This phase allows hair to prepare for shedding process. C) Age As you age, your hair growth slows down. The hair cycle shortens ie; hair spends less time in growth phase and more time in rest- ing phase leading to thinning and slower re- growth. Additionally, hair loses its pigment, turning grey. 3. Telogen Phase This lasts around 3-4 months. During this phase, hair is not growing but remains in the follicle until it sheds naturally. D) Nutrition A proper nutrition is paramount for healthy hair. A diet rich in vitamins, minerals and proteins supports hair growth. Caloric or nutritional deficiency can negatively im- pact hair structure, growth and pigmenta- tion. Key nutrients for maintenance of hair health include: 4. Exogen Phase At the end of telogen phase, old hair is shed and new hair begins to grow in its place. This marks the beginning of a new anagen phase. • Vitamins- vitamin A, vitamin B (niacin, biotin, folic acid), vitamin D, vitamin E. • Iron • Zinc • Selenium • Omega 3 fatty acids • Protein Throughout the scalp and body, 85-90% of your hair is in the angaen phase, 10-15% is in the telogen phase and only a small per- centage is in the catagen phase. The rate at which the hair grows and the duration of each of these phases can be influenced by several factors such as genetics, hormones, age, nutrition, stress, lifestyle and hair care practices. E) Stress Stress triggers the release of hormones like cortisol, which can disrupt the natural hair growth cycle where hair prematurely enters A) Genetics Hereditary factors are significant determi- 06 Know Your Hair

9. the resting phase, resulting in increased hair shedding. F) Lifestyle Regular physical activity improves circula- tion and relieves stress thereby contributing to healthier hair. Smoking and excessive alcohol consump- tion can hamper nutrient absorption and blood circulation thus negatively impact hair growth. Poor sleep is associated with increased hair shedding. G) Hair care practices Gentle handling of hair, avoiding tight hair style, minimising friction and using mild shampoos and conditioners can promote hair health. Whereas, excessive heating, chemical treat- ments, usage of harsh shampoos can weak- en hair cuticle (outer layer of hair), causing loss of lustre and easy breakage. H) Medications The most notable among medications influ- encing hair cycle are cancer chemotherapy drugs. These drugs though intended only to inhibit rapidly dividing cancer cells, may also inhibit other rapidly dividing cells like hair follicles (due to lack of selectivity) leading to rapid hair loss. This loss is reversible once the patient is off therapy. Hair growth pattern is influenced by a com- bination of these factors. Addressing modi- fiable factors among these can bring a sig- nificant change in hair health. It is always best to consult your dermatologist if you are concerned about excessive hair loss or slow hair growth. 7

10. HEALTHY DIET FOR HEALTHY HAIR BY DR. DR. KEERTHY JOY IRIMPAN Hair is often considered a reflection of overall health, with nutrition playing a vital role in maintaining its strength, shine, and growth. While factors such as age, genetics, overall health, medications, and environmental influences also affect hair growth, diet is one of the few aspects you can actively control. Hair follicles are among the most metabolically active structures in the body, making them highly sensitive to nutritional deficiencies. A lack of essential nutrients—such as proteins, vitamins, and min- erals—can impact both hair structure and growth. 8 Healthy Diet For Healthy Hair

11. The Impact of Nutritional Deficiencies on Hair Caloric and protein malnutrition, as well as micronutrient deficiencies, can con- tribute to hair loss conditions, including: Acute Telogen Effluvium (TE): A condition characterized by sudden hair shedding, often triggered by rapid weight loss or inadequate protein intake. Chronic Telogen Effluvium: Prolonged hair shedding associated with ongoing nutritional imbalances. Malnutrition, a global health concern, is particularly prevalent among children, the elderly, individuals with eating dis- orders, and those with malabsorption conditions. However, nowadays various diet regimens are popular due to the influence of social media influence. Crash dieting and all diet regimens except those planned by a dietician can lead to hair loss. Hence dieting should be done under the guidance of an expert. Androgenetic Alopecia (AGA): A heredi- tary form of hair loss influenced by diet. Female Pattern Hair Loss (FPHL): Linked to hormonal changes and possible nutri- ent deficiencies. Alopecia Areata (AA): An autoimmune disorder associated with deficiencies in key nutrients.

12. Key Nutrients for Hair Health Zinc Zinc is a trace element vital for protein syn- thesis and cell division. It also plays a role in alopecia areata, as decreased activity of the zinc-dependent enzyme superoxide dismutase has been observed in affected individuals. Zinc deficiency can lead to hair loss and brittle hair, but excessive supple- mentation may cause toxicity and should only be taken when a deficiency is con- firmed. Zinc-rich foods include: Vitamin B12 (Cobalamin) Vitamin B12 is essential for DNA synthesis, neurological function, and red blood cell production. While rapidly dividing hair folli- cles could theoretically be affected by B12 deficiency, limited research directly links it to hair loss. B12 is primarily found in ani- mal-based foods, including: • Fish • Meat • Dairy products • Eggs • Fortified plant-based alternatives (cere- als, nutritional yeast, plant-based milk) • Oysters • Red meat • Poultry • Shellfish • Nuts and seeds • Dairy products • Whole grains • Legumes Vitamin D Vitamin D plays a crucial role in hair follicle health and growth. It is obtained through diet and synthesized in the skin when exposed to sunlight. Research suggests that individuals with hair loss conditions tend to have lower vitamin D levels. Defi- ciency has also been linked to alopecia areata. Good dietary sources of vitamin- D include: Iron Iron is essential for DNA synthesis, and its deficiency is the most common nutrient deficiency worldwide. Low iron levels can cause increased hair shedding, thinning, brittleness, and slow growth. Natural iron- rich foods include: • Lean meats • Seafood • Beans & lentils • Spinach • Dark chocolate • Sardines • Salmon • Egg yolks • Fortified dairy & cereals Biotin (Vitamin B7) Biotin is a coenzyme involved in the metab- olism of glucose, fatty acids, and amino acids. It is commonly included in hair supplements, but scientific evidence sup- porting its role in preventing or treating hair loss is limited. Biotin deficiency is rare in individuals consuming a balanced diet. Natural sources include: Protein Hair is primarily composed of keratin, a type of protein. A deficiency in protein can result in finer, more brittle hair and, in some cases, hair lightening. Children and the elderly are at greater risk of protein deficiency. Protein-rich foods include: • Eggs • Lean meats • Fish • Beans & lentils • Tofu • Nuts • Nuts • Legumes • Whole grains • Egg yolks 10 Healthy Diet For Healthy Hair

13. Other Important Nutrients for Hair Health Other vitamins and minerals that may influence hair growth include: Vitamin C – Supports collagen produc- tion and iron absorption. Vitamin A – Regulates sebum production and scalp health. Selenium – Acts as an antioxidant, pro- tecting hair follicles. Folate and Riboflavin (B vitamins) – Play a role in cell division and hair follicle function. Copper – Supports hair pigmentation and strength. The Risks of Unnecessary Supplementation Many individuals experiencing hair loss turn to vitamin supplements without con- sulting a doctor. However, supplementing without a diagnosed deficiency does not consistently lead to improved hair growth and can sometimes result in toxicity or other unintended health complications. While nutrition is an essential factor in main- taining healthy hair, it is only one piece of the puzzle. Conclusion While nutrition is an essential factor in maintaining healthy hair, it is only one piece of the puzzle. Other underlying causes must also be considered to ensure the best approach to hair health and treatment. If you are experiencing hair loss, it is advisable to seek professional medical guidance before making dietary changes or taking supplements. Healthy Diet For Healthy Hair 11

14. WHY DO YOU HAVE HAIR LOSS? Your Scalp Might Be Telling a Story! BY DR. ANIE OMMEN Hormonal Imbalances Hormonal imbalances can wreak havoc on your hair. Conditions such as polycystic ovary syndrome (PCOS), thyroid disorders, and pregnancy can lead to fluctuations in hormone levels, which in turn affect hair growth. For instance, during pregnancy, elevated levels of estrogen prolong the growth phase of hair, leading to thicker locks. However, after childbirth, estrogen levels drop, causing a significant amount Let’s dive into the root (pun intended) causes of hair fall. Hair fall is a common concern that affects millions of people around the globe. While it’s normal to lose 50-100 hairs a day, excessive hair fall can be alarming and often indicates an under- lying issue. There are numerous reasons why one might experience hair fall, ranging from genetic factors to lifestyle choices. Hair loss can occur in a diffuse manner or in a particular pattern. Let’s explore some of the most common causes. Genetics One of the most significant factors contrib- uting to hair fall is genetics. Androgenetic alopecia, also known as male or female pattern baldness, is a hereditary condition that affects both men and women. In men, it typically presents as a receding hairline and thinning at the crown, while women usually experience overall thinning without a receding hairline. This condition occurs due to the miniaturization of hair follicles, which results in shorter, finer hairs and eventually, the cessation of hair growth. There are numerous reasons why one might experience hair fall, ranging from genetic factors to life- style choices. 12 Why Do You Have Hair Loss?

15. 13

16. Nutritional Deficiencies A balanced diet is crucial for maintain- ing healthy hair. Deficiencies in essential nutrients such as iron, zinc, vitamin D, and biotin can lead to hair fall. Iron deficiency anemia, in particular, is a common cause of hair loss, as iron plays a vital role in pro- ducing hemoglobin, which carries oxygen to hair follicles. Without adequate oxygen, hair follicles can become weak and brit- tle. Additionally, crash diets and extreme weight loss can deprive your body of essential nutrients, further contributing to hair fall. Stress Stress is an inevitable part of life, but chronic stress can have detrimental effects on your hair. Telogen effluvium is a con- dition where stress pushes a significant number of hair follicles into the resting (telogen) phase, resulting in increased shedding and hair thinning. This condi- tion is usually temporary, and hair growth resumes once the stressor is removed. However, prolonged stress can lead to more severe forms of hair loss, such as alopecia areata, where the immune sys- tem attacks hair follicles, causing patchy hair loss. condition often helps in mitigating hair fall. Medications Medications used to treat various health conditions can have side effects that include hair fall. Chemotherapy drugs are well-known for causing hair loss, as they target rapidly dividing cancer cells, but also affect hair follicles. Other medica- tions that can cause hair fall include blood thinners, antidepressants, beta-blockers, and drugs used to treat high blood pres- sure and arthritis. If you suspect that your medication is causing hair fall, consult your doctor to discuss alternative treatments. Medical Conditions Certain medical conditions can directly or indirectly cause hair fall. Scalp infections, such as ringworm, can damage hair fol- licles and lead to hair loss. Autoimmune diseases like lupus and alopecia areata can also cause hair to fall out. Ringworm and alopecia areata can cause circumscribed hair loss. In addition, chronic illnesses such as diabetes and rheumatoid arthritis can affect the body’s ability to support healthy hair growth. Treatment of the underlying Hairstyles and Treatments Sometimes, our quest for beauty can be detrimental to our hair. Frequent use of heat styling tools, chemical treatments, and tight hairstyles can damage hair folli- cles and lead to hair fall. Traction alopecia is a condition caused by persistent pulling on the hair, which can result from tight 14 Why Do You Have Hair Loss?

17. ponytails, braids, or extensions. To prevent hair fall due to styling practices, it’s essen- tial to give your hair a break from harsh treatments and opt for gentle, hair-friendly alternatives. Conclusion In conclusion, hair fall is a multifaceted issue with numerous potential causes. Genetics, hormonal imbalances, nutritional deficiencies, stress, medical conditions, medications, hairstyles, environmen- tal factors, and aging all play a role in determining the health of our hair. Under- standing the underlying cause of hair fall is crucial in addressing the issue and find- ing appropriate solutions. By maintaining a healthy lifestyle, managing stress, and adopting gentle hair care practices, you can help preserve your hair’s health and reduce hair fall. Environmental Factors Environmental factors such as pollution, hard water, and exposure to the sun’s UV rays can also contribute to hair fall. Pollutants and chemicals in the air can accumulate on the scalp, clogging hair follicles and causing inflammation. Hard water, which contains high levels of min- erals like calcium and magnesium, can make hair dry, brittle, and more prone to breakage. Prolonged exposure to UV rays can weaken the hair shaft and lead to hair fall. Protecting your hair from these envi- ronmental stressors can help maintain its health and reduce hair fall. Taking care of your hair is not just about vanity; it’s about overall well-being. After all, your hair is often a reflection of your inner health. So, treat it with the care and attention it deserves. Aging As we age, our hair naturally undergoes changes. Hair follicles shrink, and the hair growth cycle shortens, resulting in thinner, weaker hair. Additionally, the production of melanin, the pigment responsible for hair color, decreases, leading to graying hair. While aging is inevitable, maintaining a healthy lifestyle and proper hair care can help slow down the process and reduce hair fall. While aging is inevi- table, maintaining a healthy lifestyle and proper hair care can help slow down the process and reduce hair fall. Why Do You Have Hair Loss? 15

18. BEYOND THE SCALP : Hair is a natural part of our look and an expression of our personality. Hair can also offer protection: It protects from sun’s rays reaching our scalp. Eyelashes and eyebrows protect our eyes from dust and dirt. The hair in our nose and ears serves as a natural barrier, preventing germs and foreign particles from entering the body. Similarly, body hair plays a role in regulat- ing temperature by retaining heat in cold conditions and aiding sweat evaporation to keep us cool in warmer climates. 16

19. UNCOVER THE HIDDEN CULPRITS BY DR. LIJI ISSAC BEHIND HAIR LOSS! Beyond The Scalp 17

20. Hair Structure Each hair consists of a hair shaft and a hair root. The hair shaft is the visible part, while the hair root extends into the deeper layers of the skin. The hair follicle surrounds the root and is linked to the arrector pili mus- cle, which causes the hair to stand upright. Additionally, nerve endings at the hair fol- licle detect hair movement. Hair loss is a common concern and a sig- nificant challenge for dermatologists. Also known as alopecia, it can stem from var- ious causes. Nutrition Nutrition plays a major role in the main- tenance of hair. Keratin which is a protein is the major component of hair. Kwashior- kor, which is a disease due to inadequate protein intake and anorexia nervosa has been associated with hair loss. There will be a loss of elasticity of hair, and hair tex- ture will be dry. Treatment comprises of an adequate protein intake via natural food sources to a minimum of 60–80 grams per day. Symptoms of deficiency of essential fatty acids such as linoleic acid, alpha lin- oleic acid include depigmentation and loss of hair on scalp and eyebrows. Dietary Supplements Dietary supplements like protein drinks, protein bars have been found to have unsafe levels of heavy metals like arse- nic, lead, mercury and their long-term use could lead to toxicity and subsequent hair loss. Other chemical adulterants found in protein drinks include acrylamides, ethyl carbamate, melamine, and radionu- clides. Other pharmaceutical ingredients in supplements include phenolphthalein, aromatase inhibitor, sildenafil, fluoxetine, and various anabolic steroids. Endocrine diseases Endocrine imbalances like hyperan- drogenism seen in PCOD and pituitary malignancies is associated with male pat- tern baldness. In some women elevated levels of androgen is associated with hair loss. Both Elevated levels of thyroid hormones Excess Vit A due to supplementation or due to chronic kidney disease also causes hair loss. Metallic cofactors are also a cat- egory of nutrition needed for hair growth. Zinc and iron deficiencies are associated with hair loss. 18 Beyond The Scalp

21. “ infections or anemia. Iron studies include serum iron and total iron-binding capacity (TIBC) and Ferritin levels. Metabolic panel may find metabolic imbalances that could suggest underlying hepatic or renal pathol- ogy. Thyroid function test can be done for complete assessment of hyperthyroidism and hypothyroidism. Further laboratory studies include antinuclear antibodies test , erythrocyte sedimentation rate to rule out any autoimmune disorders. Individual tests to explore specific nutritional deficien- cies and excesses, such as zinc, selenium, and vitamins are also useful to evaluate causes of hair loss. Prolactin and sex hor- mone-binding globulin should be ordered if a clinician wants to evaluate a patient’s androgen level. (hyperthyroidism) and lower levels of thyroid hormones (hypothyroidism) are associated with hair loss. Hair loss is a common concern and a significant challenge for dermatol- ogists. Also known as alopecia, it can stem from various causes. Medications Some group of drugs like anti-hyper- tensives (for high blood pressure like propranolol, metoprolol, enalapril), anti- arrhythmics (for abnormal heart rhythm), statins (for high cholesterol levels), anti- metabolites, psychotropic agents (mood stabilisers like lithium, valproic acid, SSRI s like fluoxetine), anti-convulsants (for sei- zures), anti-coagulants (blood thinners), anti-retrovirals, and H2 blockers are associ- ated with hair loss. Some cytotoxic agents like methotrexate, acitretin, 5-FU, Colchi- cine are also associated with hair loss. Telogen effluvium(TE) TE is associated with an acute insult or sudden change in the body routine fewer than 3 months prior. Some common causes include fever, postpartum period, oral contraceptive use, crash dieting, and anes- thesia exposure with surgery. Infectious diseases Hair loss has been found to be associated with bacterial infections like syphilis which manifests as patchy or diffuse alopecia. Viral infections associated with hair loss include varicella zoster virus, hepatitis C, HIV, cytomegalovirus, and Epstein–Barr virus. Laboratory evaluation Tests that are routinely ordered for hair loss are - complete blood count with hemato- crit and hemoglobin could reveal acute Other diseases Metabolic imbalance in patients with hepatic and renal failure can cause hair loss. Rheumatologic disorders can also mani- fest in hair loss. Scarring alopecia occurs in discoid lupus erythematosus, while non- scarring alopecia is found in acute lupus. Other diseases include connective tissue disorders like dermatomyositis, amyloi- dosis (due to amyloid protein deposition), cutaneous sarcoidosis are also associated with hair loss. Both cutaneous and systemic malignancies like leukemia, lymphoma are associated with hair fall. Beyond The Scalp 19

22. BEHIND THE FLAKES: A DEEPER LOOK AT SCALP HEALTH DR. BERDY JOSE 20 Behind the Flakes: A Deeper Look At The Scalp Health

23. Scaly scalp can be a sign of various conditions, including dandruff, seborrheic derma- titis, psoriasis, fungal infections or even dry scalp itself. Besides the discomfort, this disorder is also socially embarrassing and affects the self-esteem of the patient. Understanding the underlying cause is crucial for effective treatment, which can range from over the counter shampoos to prescription medications. Here's a breakdown of common causes and treatments for a scaly scalp:

24. Dandruff and Seborrheic Dermatitis: 1.Seborrheic Dermatitis: Seborrheic Dermatitis and dandruff are a continuous spectrum of the same disease. Dandruff is restricted to the scalp, while seborrheic dermatitis is a more severe form of dandruff that can cause redness, inflam- mation, itching and scaly patches on the scalp, as well as other areas like the face, eyebrows, ears, upper-chest, axillae, and inguinal folds. Incidence is 1–3% of the general adult population and men are affected more frequently than women in all age groups, suggesting an association with male sex hormones. Dandruff Dandruff is a common condition charac- terized by itchy, flaky skin on the scalp, often caused by the yeast Malassezia. The prevalence of dandruff in population varies between 30-95 per cent. Malasse- zia species play a role in pathogenesis of this condition along with stress, fatigue, weather extremes, oily nature of skin, use of shampoos, immunosuppressed status, and neurological disorders.  Malassezia exists on everyone’s scalp. Around 50% of people have a negative reaction to the presence of this fungus, causing dandruff. It feeds on scalp’s natural oil known as sebum. Dandruff-causing microbe Malas- sezia feeds off these oils, breaking it down into by products such as oleic acid.50% of people in the world are sensitive to oleic acid and if you are you’ll probably expe- rience dandruff. The body reacts to the presence of oleic acid by increasing the speed at which your skin cells renew in an attempt to “shed” the irritant and this is the mechanism that causes flaking. Dead skin cells accumulate on the scalp and become visible in your hair and fall off onto your shoulders. Treatment: Treatment depends on the severity of the condition. It usually includes topical and or oral antifungals and in some cases short term topical steroids. 2. Scalp Psoriasis: A chronic inflammatory condition that causes thick, scaly patches on the scalp and other areas of the body. Psoriasis of scalp causes thicker white silvery scales on the scalp that spreads towards the fore- head and back of scalp beyond the hair line. Psoriatic patients will experience bleeding points on traumatizing the scales. Treatment: Topical medications: Corticosteroids, Vita- min D analogues, salicylic acid and coal tar preparations can help reduce inflammation and scaling. Systemic medications: In severe cases, oral medications or phototherapy may be necessary. There’s more to the body’s response to Malasseiza than just flaking like itching, redness and dryness. These are all symp- toms caused by the body’s response to irritation caused by Malassezia. 22 Behind the Flakes: A Deeper Look At The Scalp Health

25. 3. Dry Scalp: A dry scalp can cause flaking and itching and is often mistaken for dandruff. Itching, and a feeling of tightness or irritation on the scalp, leading to brittle and dull-look- ing hair.  Cradle Cap: A common condition in babies character- ized by yellow, scaly patches on the scalp. When to Seek Medical Advice? If you’re experiencing scaly scalp with itching, pain, pustules over scalp and/or hair loss. If you suspect a fungal infection or other underlying conditions. If you have any concerns about your scalp health. Causes: • Lack of Moisture. • Environmental Factors: Dry or cold weather, low humidity, and excessive sun exposure can contribute to a dry scalp.  • Harsh Products: Using harsh shampoos or hair products that strip the scalp of its natural oils can lead to dryness.  • Over-Washing: Washing your hair too frequently can also remove the scalp's natural oils, leading to dryness.  • Poor diet and Hydration. To sum up, the root cause for your scaly scalp can be any of the aforementioned etiologies. Treatment should be based on the diagnosis done by your dermatolo- gist. Self treatment and unscientific salon treatments are seen to be more damaging. Hence, solution for your scaly scalp is to consult, get a proper diagnosis and then follow the treatment protocol given by your dermatologist. Treatment: Oils and moisturizing scalp creams Fungal Infections: In some cases, tinea capitis, a fungal infec- tion of the scalp, can present with a scaly, non-inflamed appearance resembling seb- orrheic dermatitis, but tinea capitis also causes hair loss, which is not a character- istic of seborrheic dermatitis. Treatment: Antifungal medications (topical or oral).  Treatment should be based on the diagnosis done by your derma- tologist. Self treatment and unscientific salon treatments are seen to be more damaging. Contact Dermatitis: Irritation from certain shampoos, condi- tioners, or hair products can lead to a scaly scalp. Behind the Flakes: A Deeper Look At The Scalp Health 23

26. 24

27. AM I GOING BALD? BY DR. SAMEEHA HAMZA CHENGANASSERI 25

28. Hair loss is something many people worry about, especially when it starts gradu- ally and doesn’t seem to stop. One of the most common causes of hair thinning and baldness is androgenetic alopecia (AGA). In men, this is often called male-pattern baldness, while in women, it’s known as fe- male-pattern hair loss. In individuals with AGA, the hair follicles are genetically sensitive to DHT.DHT binds to androgen receptors in hair follicles, trig- gering a process called follicular miniatur- ization Miniaturization Process: DHT shortens the anagen (growth) phase of the hair cycle, leading to: This condition is mainly caused by family history (genes) and hormones. The good news is that with the right treatment, hair loss can be slowed down, controlled, and even reversed in many cases. Let’s break it down in simple terms so you can under- stand what’s happening and what you can do about it. • Thinner, shorter, weaker hair strands • Fewer actively growing hairs • Hair follicles shrinking over time • Increased hair shedding (telogen effluvi- um) • Follicle Dormancy:If left untreated, hair follicles shrink to the point where they no longer produce visible hair What Causes Androgenetic Alopecia? Why Some People Are More Sensitive to DHT: 1. Family History (Genetics) If your parents or grandparents had hair loss, you might experience it too. This condition runs in families, meaning you could inherit the tendency for your hair to become thin or fall out over time.primarily polygenic, meaning multiple genes inherit- ed from both maternal(mainly) and pater- nal sides contribute to it. The key player is the AR (Androgen Receptor) gene, located on the X chromosome, which influences the sensitivity of hair follicles to dihydrotestos- terone (DHT) • Not everyone with high DHT levels expe- riences baldness. It’s the sensitivity of the hair follicles to DHT(determined by genet- ics) that makes the difference. • Studies have shown that men with AGA have higher DHT levels in the scalp but normal levels in the blood, proving that local sensitivity is the key factor. How Does Androgenetic Alopecia Look? 1. In Men (Male-Pattern Baldness): Men typically experience hair loss in a pre- dictable pattern : 2. Hormones (DHT – The Hair Thinning Hor- mone) Your body naturally produces a hormone called testosterone. Some of it gets con- verted into another hormone called dihy- drotestosterone (DHT). Androgens (male hormones) are essential for hair growth, but in AGA, an overactive response to DHT (dihydrotestosterone) leads to hair loss • Hair starts receding from the forehead (forming an “M” shape). • Thinning begins at the crown (top of the head). • Over time, these areas merge, leading to partial or full baldness. • Norwood-Hamilton Scale is used to clas- 26 Am I Going Bald?

29. sify MPB. It ranges from Stage 1 (minimal recession) to Stage 7 (extensive baldness) • Increases blood flow to hair follicles, making them stronger. • Prolongs the anagen (growth) phase of the hair cycle. • Reduces follicular miniaturization, helping to thicken existing hair • Suitable for both men and women. 2. In Women (Female-Pattern Hair Loss) • Hair becomes thin all over the scalp, but the hairline remains intact. • The parting becomes wider over time. • Complete baldness is rare, but hair volume reduces significantly. • Ludwig Scale is used to classify FPHL, ranging from mild thinning to severe hair loss on the crown, while maintaining the frontal hairline. Finasteride (Oral & Topical): • A tablet that blocks DHT, stopping further hair loss. • A topical version is available for those who don’t want to take it orally. Oral Minoxidil (Low Dose, for Men & Women): • A pill that improves hair growth from within. • Usually prescribed in low doses by derma- tologists. How is Androgenetic Alopecia Diagnosed? If you notice gradual hair thinning, visit a dermatologist as soon as possible. They will check your scalp and may do the following tests: Spironolactone (For Women): • Helps reduce hormonal hair loss in women. • Often combined with oral contraceptives. 1. Scalp Examination: To see if the hair fol- licles are shrinking. 2. Pull Test: Gently pulling a few hairs to check for excessive shedding. 3. Trichoscopy (Scalp Camera Test): A close-up look at your hair follicles. 4. Blood Tests (if needed): To rule out other causes like iron deficiency or hormone problems. 2. Advanced Treatments (For Better and Faster Results) Microneedling: • Tiny needles create small injuries in the scalp to stimulate hair growth. Treatment Options for Androgenetic Alopecia Hair loss due to AGA can be treated with the right approach. Early treatment gives the best results. These micro-injuries stimulate wound heal- ing, triggering the release of growth factors and increasing blood supply to hair follicles • Helps medications like minoxidil work better. 1. Medications (To Stop Hair Loss and Promote Growth) Platelet-Rich Plasma (PRP) Therapy: • Your own blood is processed to extract growth factors. • These are injected into the scalp to boost hair regrowth. Minoxidil (Topical Solution/Foam): • Available as a liquid or foam applied to the scalp daily. Am I Going Bald? 27

30. The good news is that with the right treatment, hair loss can be slowed down, controlled & even reversed in many cases. 28 Am I Going Bald?

31. Growth Factor Concentrate (GFC) Therapy: • Similar to PRP but with purer growth fac- tors, giving faster and stronger results. Low-Level Laser Therapy (LLLT): • Uses red light therapy to stimulate hair growth. • Available as laser caps or helmets for home use. Hair Transplant: • Hair follicles from the back of the scalp are moved to bald areas. • A permanent solution for advanced bald- ness. Why You Should See a Dermatologist Early Many people ignore hair loss until it’s too late, making treatment less effective. If you start early: • You can slow down hair loss before it gets worse. • Treatments work better on active hair follicles. • You’ll avoid wasting money on ineffec- tive home remedies. • Your dermatologist can recommend the best plan for your hair type. Conclusion Androgenetic alopecia is a common but treatable condition. If you notice grad- ual thinning or a receding hairline, don’t wait—seek help early. With the right treat- ment, you can control hair loss and even regrow your hair. A dermatologist can guide you with med- ications, advanced treatments, and life- style changes to keep your hair healthy. So, take action today and protect your hair for the future. Am I Going Bald? 29

32. 30 From Thin To Thick

33. FROM THIN TO THICK: PRP & GFC bring your hair dreams to life! dreams to life! PRP & GFC bring your hair BY DR. NEETHU SUNNY. Hair loss is a common problem that requires actions to stop or reduce it. Androgenic alopecia (AGA) is described as progressive hair loss, having a specific distribution pat- tern. It is a primary cause of hair loss. This condition affects males and females, affecting their self-es- teem and confidence and impairing their quality of life. From Thin To Thick 31

34. AGA is due to hormonal and genetic fac- tors characterized by a distributed pattern of hair loss. It is a condition that presents with elevated levels of 5-alpha reductase around the hair follicle. This enzyme con- verts testosterone to dihydrotestosterone, which turns stable hair follicles into un- stable hair follicles, weakening them and ultimately leading to hair fall. Fortunately, hair loss can be reversed using the individ- ual’s own platelets without the need for any specialized surgery. Hair replenishment is attained using the innovative approach of growth factor concentrate (GFC) therapy. GFC, meticulously formulated and concen- trated from the individual's own blood, pro- duces remarkable results in addressing hair loss and facial rejuvenation. PRP(Platelet rich plasma) for hairloss PRP is prepared by concentrating platelets into a small volume of plasma. 01 02 BLOOD COLLECTION SEPARATIONS OF PLATELETS How does PRP/GFC work? Platelets, a type of blood cell, naturally con- tain numerous growth factors like, 03 04 BLOOD PRP COMPOSITIONS INJECTION 1. Platelet-Derived Growth Factor (PDGF), which enhances cellular growth and repairs damaged hair follicles. 2. Epidermal Growth Factor (EGF), which stimulates the scalp’s natural ability to pro- duce healthy skin cells, improving follicular health. 3. Vascular Endothelial Growth Factor (VEGF) promotes blood vessel formation, ensuring follicles receive adequate nutri- ents. 4. Insulin-like Growth Factor-1 (IGF-1) pro- longs the growth phase of the hair cycle, supporting thicker and longer hair strands. PRP and GFC treatments are nonsurgical treatment that uses blood platelets to stim- ulate hair growth. These treatments have shown promising results in stimulating hair regrowth and improving hair density. Procedure for preparing PRP After the proper consent and with all asep- tic precautions venous blood is withdrawn in a tube containing an anticoagulant ci- trate dextrose solution or sodium citrate. This is followed by soft spin centrifugation to seperate PRP from whole blood and then via heavy spin centrifugation platelets are concentrated by removal of supernatant plasma. 32 From Thin To Thick

35. GFC (Growth factor concentrate) for hairloss GFC(Growth factor concentrate) treatment, a modern approach to hairloss, involves in- jecting a concentrated mix of growth fac- tors from the patient's own blood into scalp to stimulate hair growth and improve hair quality. This superior follicular regeneration using GFC therapy is attributed to the modi- fied PRP technique, which degranulates the intracellular alpha-granules of the platelets to release a relatively high concentration of the above mentioned growth factors. These growth factors are believed to act on the stem cells in the bulge area of the follicles, stimulating the growth of new follicles, and promoting neovascularization. 5. General hair thinning For those experiencing diffuse thinning, GFC enhances overall scalp health, improv- ing density and texture. Suitable Candidates Ideal candidates include individuals who are in the early stages of hair loss, have healthy scalp conditions. Most importantly, the skin sensitivity is normal; that person can undergo such treatment. Who Should Avoid GFC Treatment? People with active infections, certain auto- immune diseases, or severe scalp damage should not undergo GFC treatment. Differences Between GFC and PRP While both treatments use blood platelets, GFC is a purified form with a higher con- centration of growth factors. Unlike PRP, GFC eliminates unnecessary components, making it more effective and less inflam- matory. Platelet-rich plasma (PRP) is also found to have various other applications as in treatment of ulcers, also used in or- thopaedics, sports medicine and plastic surgery. Types of hair loss treated by GFC 1. Alopecia Areata Alopecia areata, an autoimmune condition that causes patchy hair loss, responds well to GFC due to its regenerative properties, which repair damaged follicles. 2. Telogen Effluvium Often triggered by stress or hormonal changes, telogen effluvium involves exces- sive shedding. GFC helps stabilize the hair cycle, reducing hair fall. How GFC Hair Treatment Works Preparation for the Session The process begins with a blood draw, fol- lowed by centrifugation to extract and con- centrate growth factors from platelets. 3. Tractional Alopecia Caused by prolonged tension on hair fol- licles, tractional alopecia benefits from GFC’s ability to rejuvenate and strengthen weakened roots. During the GFC Procedure Injecting the concentrate into the scalp targets areas of thinning or hair loss. This minimally invasive process stimulates folli- cles directly. 4. Androgenetic Alopecia Commonly known as male or female pattern baldness, androgenetic alopecia is charac- terized by follicular miniaturization. GFC re- vitalizes follicles and slows progression. From Thin To Thick 33

36. Fortunately, hair loss can be reversed using the individual’s own platelets without the need for any specialized surgery. 34 From Thin To Thick

37. Aftercare and Recovery Post-treatment, patients should avoid harsh chemicals, excessive sun exposure, and vigorous scalp massages for optimal results. Avoid applying any soap, sham- poo, or conditioner that contains synthetic products or harmful chemicals immediately after the treatment. GFC results permanent? The longevity of hair treatment is anywhere from 6 months to 2 years, or more in some cases. If the patient properly follows af- tercare instruction and practices a regular haircare routine the results can last longer. Benefits of GFC Treatment for Hair Advantages Over Other Treatments GFC is a non-surgical, biotechnologically advanced solution offering fewer side ef- fects and quicker recovery compared to alternatives like hair transplants or medi- cations. Expected Results and Timeline Typically, 3–6 months show visible improve- ments in hair density and quality, with ben- efits continuing over subsequent sessions. How many sessions of GFC needed GFC treatment will need around 3-4 ses- sions with each session in 1month inter- val. To maintain full effects usually require booster session every 2-3 months Exact number of session is decided based on age, health status and extent of hairloss. Conclusions The use of GFC and platelet-rich plasma has shown promising results and may be considered a treatment option for AGA. Studies have demonstrated the potential efficacy of these treatments in stimulating hair growth and improving hair density in AGA patients. GFC helps in the reduction of hair loss, improves hair thickness, and en- hances hair volume. It is crucial for patients to consult with a qualified healthcare pro- fessional before pursuing these treatments to ensure they are appropriate and safe for their situation. GFC with Miconeedling benefits Growth factor concentrate and derma roll- ing together are an efficient treatment for hair regrowth, especially in individuals with androgenetic alopecia.   Micro-needling improves the growth factors' transport as well as penetration and absorption into the scalp’s deeper layers, thereby increasing GFC’ effectiveness in reaching hair follicles. From Thin To Thick 35

38. BALD TODAY, BOLD TOMORROW: The Science Behind Hair Transplantation! BY DR. ANISHA K JANARDHANAN Hair transplantation is a sur- gical procedure by which we can transfer hair from a hairy area to a bald patch. 36 Bald Today, Bold Tomorrow

39. 37

40. What is hair transplantation? Hair transplantation is a surgical proce- dure by which we can transfer hair from a hairy area to a bald patch. The area from where we take the hair is known as the do- nor area, and the bald area into which we implant the hair is called the recipient area. Even in people with advanced levels of balding, we can see that there will be a 4 to 5 cm broad band of hair left at the back of the head. This area is called the permanent zone of hair, and it is from this area that we harvest hair to implant into the bald areas, usually at the front. Who are the ideal candidates for hair transplantation? Any person with androgenetic alopecia, with miniaturisation of hair follicles, where we are sure that hair will not regrow with any medical management, can be a candi- date for hair transplantation. It is not nec- essary that there should be completely bald areas. In fact, cosmetic results are much better when we transplant into areas with some native hair. We can also do hair trans- plantation for traumatic scars on scalp or hairy areas of face. In selected cases, hair transplantation can also be done for thin beards or moustaches. As such, there is no age limit for undergoing transplantation. But there is a general dic- tum that, for younger individuals, especially for those less than 20 or 25, we can try by all possible medical and adjuvant therapies to strengthen exist hair before consider- ing a hair transplantation. For the elderly, as long as there are no coexisting diseases like heart or kidney or liver problems, and the person is generally healthy, there is no issue in undergoing a hair transplantation procedure. What is the procedure of hair trans- plantation? The procedure has majorly 4 steps and can take anywhere from 6 to 10 hours or more depending on the number of grafts. Step 1: Local anaesthesia The entire surgery is done under local an- aesthesia, which is a kind of anaesthesia where injections are given into the surgical site to numb the area. The patient remains conscious and aware and able to move and talk, throughout the procedure. Step 2: Making of slits Slits are holes made in the skin of the re- cipient area into which the follicular units are implanted. These slits are made using specialised slit makers or needles. Step 3: Extraction of hair Hair is extracted from the donor area, not as individual hairs, but as follicular units which contain 1, 2, 3 or 4 hairs along with the tissue surrounding the hair. These extracted follicular units are commonly referred to as the grafts. Extraction is done using special motorised punches of varying sizes, accord- ing to the size of the follicular units. 38 Bald Today, Bold Tomorrow

41. After extraction these follicular units are stored in specialised fluids under strict tem- perature control to maintain their viability, till implantation Step 4: Implantation Each follicular unit is carefully implanted into the premade slits using special implan- tation forceps. deferred for at least a month post proce- dure. A large part of the implanted hair can fall out in the first 3 months after the surgery. Regrowth will start spontaneously after that. By around 6 months post procedure, you can expect to see around 50% of the fi- nal growth. By 10-11 months you can expect full regrowth. Points to note: 1) You will not immediately have a full head of hair after a hair transplantation surgery. So if you plan to have a hair transplantation before an important life event like a wed- ding or a graduation, make sure to plan it well ahead, like a year or so before the event. What to expect post procedure? In the first 3 days after procedure, there will be a dressing at the donor area. The re- cipient area will be left open, and has to be kept moist. The donor area dressing will be removed after 3 days. The first hair wash will be after 1 week, and is ideally to be done from the hair trans- plant centre. The donor area will heal completely in 1 to 2 weeks. Minoxidil , finasteride etc will be started 2 weeks after the procedure. ( For persons already on minoxidil, it will be stopped ide- ally 2 weeks before the procedure). Other supportive treatments like PRP, GFC etc will also be started in the next few months. Rest is advised for the first 1 week. Minor exercises like walking can be restarted af- ter 2 weeks. Heavy gym exercises have to 2) Donor area hair will not regrow. After the wounds heal, you will be able to see tiny round scars from where the grafts have been extracted. But in the hands of a good surgeon, the extraction will be done so aes- thetically that the remaining hair will cover the scars in such a way that it will not be easily noticeable, unless you have a buzz cut or you shave your hair. 3) It is not a one stop solution to all your hair problems: even though the transplant- ed hair will remain stable for 10 to 15 years or more, the preexisting native hair will con- tinue to thin out and get lost unless you take all the necessary treatments to preserve it. Without some amount of natural hair, transplanted hair will look quite unnatural and aesthetically unappealing. Bald Today, Bold Tomorrow 39

42. EXCESSIVE HAIR GROWTH – BY DR. GEETHU F ALAPPATT BOTHERING YOU? It is a common endocrine disorder that af- fects millions of women worldwide, causing excessive growth of dark or coarse hair over the upper lip, chin, chest abdomen or back instead of the fine hair sometimes referred to as the “peach fizz” that commonly grows in those areas. It is not a disease in itself but a symptom of an underlying medical condition. Despite its prevalence, hirsutism remains a poorly understood condition, of- ten shrouded in stigma and misconception. Causes of Hirsutism Hirsutism is often caused by an imbalance of hormones, particularly androgens (male hormones). The most common causes of hirsutism include: 1. Polycystic Ovary Syndrome (PCOS) This condition often begins with onset of puberty and causes an imbalance of hor- mones. Over the years it may slowly result in excess hair growth, acne, hair loss, irreg- ular periods, obesity, diabetes, infertility, and multiple cysts on the ovaries 3. Congenital Adrenal Hyperplasia This inherited condition is characterized by abnormal production of steroid hormones including cortisol and androgen by your adrenal glands. 2. Cushing Syndrome This occurs when your body is exposed to high levels of the hormone cortisol. This can happen when your adrenal glands produce too much cortisol or from taking medica- tions such as prednisone for a long period. 4. Thyroid Disorders Hypothyroidism or hyperthyroidism can sometimes cause hirsutism 5. Tumors Rarely an androgen secreting tumor in the 40 Excessive Hair Growth Bothering You?

43. ovary or adrenal glands can cause hirsutism. 6. Medication Some medications can cause hirsutism including minoxidil, danazol, anabolic ste- roids, cyclosporine, phenytoin, testosterone. How common is Hirsutism? It affects over 40 percent of women. How does Hirsutism affect my body? Hirsutism does not affect your physical health however it may affect you psy- chologically. It may cause depression and anxiety. 7. Post Menopause The hormonal changes that take place in the body after menopause may lead to increase in hair growth including a mous- tache or whiskers Does Hirsutism always mean PCOS? Pcos is not the only cause of hirsutism. However, 70 to 80 percent of people with pcos develop hirsutism. 8. Obesity Being obese causes increased androgen production which can worsen hirsutism Is Hirsutism contagious? No, it is not contagious 9. Idiopathic Often hirsutism occurs with no identifiable cause. 41

44. Diagnosis If you are concerned about excessive hair growth, a visit to your doctor is the first step. Diagnosis typically involves a phys- ical exam, an assessment of your medical history and potentially blood tests to mea- sure hormone levels. In some cases, an ultrasound or other imaging tests may be ordered, especially if there is a suspicion of a condition like PCOS. help improve hormone balance. Weight loss is often the first step in treating hirsutism. Losing even 5 percent of your body weight can lower your androgen levels and stop excessive hair growth. 2. Medications Birth control pills, androgen suppressing medications, insulin lowering medications etc can help regulate hormone imbalances. Complications Hirsutism can be emotionally distressing. Some women feel self-conscious about having unwanted hair. Some woman devel- op depression. Although hirsutism does not cause physical complications the underly- ing cause of a hormonal imbalance can. 3. Eflornithine skin cream This product can be applied to the affected area. It does not remove hair but it slows down how fast your hair grows. It may take 6-8 weeks for visible results. Once you stop using the cream your hair starts to grow at the same rate as before you started using the cream Prevention Hirsutism is not generally preventable but losing weight if you are overweight can help particularly if you have PCOS. 4. Electrolysis This technique uses a tiny needle and a mild electrical zap to destroy your hair follicle one by one. Each hair follicle requires treat- ment so it may not be practical to use this technique over a large area of your body. Side effects are rare but they may include slight discoloration, temporary dark spots, and a slight tingling sensation. 5. Laser hair removal In this technique, heat from a laser de- stroys cells that have a lot of pigment. Dark hair has a lot of pigment so it absorbs the most heat. Hair transfers heat to the hair follicles and destroys them so hair cannot grow. Side effects may include blisters, burns, scars, dark area of skin and tingling sensation during the procedure. A hair fol- licle must be in its anagen or growth stage for the procedure to work. Follicles are in different stages at different times, so most people need multiple laser sessions. Treatment While there is no cure for hirsutism, various treatment options can help manage symp- toms and improve quality of life: 1. Lifestyle Changes Maintaining a healthy weight, following a balanced diet, and exercising regularly can 42 Excessive Hair Growth Bothering You?

45. It usually takes about 6-8 sessions for re- sults and treatment sessions will be 4-6 weeks apart. Home Remedies 1. Shaving This is the most common method of hair re- moval. It is simple and safe but you must shave regularly to prevent stubble. Side ef- fects may include cuts and ingrown hair. 2. Bleaching Bleaching products lighten unwanted hair but it can cause irritation of the skin. 3. Waxing and plucking Waxing or using a tweezer to remove hair from the root is effective but painful. Side effects may include skin irritation and in- grown hair. Living With Hirsutism Hirsutism can have a significant impact on a women’s self-esteem and quality of life. Seeking support from healthcare profes- sionals, support groups and loved ones can help women with hirsutism cope with the emotional and psychological aspects of the condition. By understanding the causes, symptoms and treatments options of hirsutism, wom- en can take the first step towards managing their symptoms and regaining control over their lives. If you suspect you may have hir- sutism. consult with your healthcare provid- er to discuss their diagnosis and treatment options. Whether through medical interven- tion, lifestyle changes, or hair removal tech- niques, there is no one-size-fits-all solution. But options exist to help women feel more comfortable in their own skin. Excessive Hair Growth Bothering You? 43

46. 44 10 Rules To Revive Your Strands

47. The Haircare Commandments: 10 RULES TO REVIVE YOUR STRANDS! BY DR. SAHIBA RAFI 10 Rules To Revive Your Strands 45

48. Are you finding that your hair is feeling brittle? Are your ends starting to split? Maybe you're noticing that you're finding extra hair in the shower drain or hairbrush. Thinning, damaged hair does not happen overnight, and in many cases, it can be entirely preventable. Remem- ber, prevention is much more effective than correction when it comes to healthy hair. So, it's important to develop great habits as soon as possible to avoid any future haircare woes. If you're trying to get on the path to luscious tresses but don't know where to begin, don't worry! Here are some of the best dermatologist-approved tips for healthier, stronger hair! 1. Cut down on the shampooing. Excessive shampooing can strip the scalp of sebum which is naturally produced by the hair for protection. Minimal shampoo- ing can lead to collection of sweat and dirt which can cause much damage. It is important to use the right amount of hair products with the right frequency to en- sure the optimal results When it is a hair wash day, focus on sham- pooing primarily the scalp rather than the entire length of the hair. When you wash your roots, the shaft and ends of the hair will also get cleaned as the soap rinses out, so there's no need to concentrate on anything but the scalp. In fact, shampoo- ing of mid-length and ends of the hair can contributes to dullness and frizziness. Al- ways use conditioner on the lower half of the strands on shampoo days. It's best not to shampoo wash your hair every day, as shampoo can strip the hair and scalp of natural oils and cause it to become dry, brittle, and dull. If you've got an oily scalp or have worked up a sweat, try rinsing your hair without using sham- poo! 2. Be gentle with wet hair. Wet hair absorbs water and hair tempo- rarily losses its bond which make them more susceptible to breakage. Never ag- gressively rub hair dry. This leads to frizz, tangles, and damaged hair. Instead, use a microfiber towel and gently scrunch and dab out the excess moisture. Never brush hair when it is wet; instead, use a wide-tooth comb to detangle gently. Use nutrient-rich and protective products on damp hair, such as leave-in conditioners, lightweight gels and protective sprays 3. Eat a balanced diet While there is no magic food or ingredient that alone can lead to Rapunzel-esqe hair, a daily balanced diet is the most import- ant thing for overall hair health. Lustrous hair results from a protein-rich diet filled 46 10 Rules To Revive Your Strands

49. with lean meats, beans, lentils, and fish. Since trace minerals like iron, zinc, mag- nesium, biotin, and other B vitamins also affect hair, it may be a good idea to in- vest in a high-quality multivitamin to help fill any potential nutritional gaps. Eating a well-balanced diet also contributes to hair growth, reduces hair fall, and improves the overall appearance of hair. hair up when it is wet! Twisting, pulling, stretching, and tugging on wet strands is just asking for it to snap off and lead to frizzy, unruly locks. 5. Ditch the heat-styling tools. Frequent heat styling (including, straight- ening, curling, and crimping) can change the hair's inner molecular structure. The thermal heat from the tool opens up the hair's outer cuticle layer and penetrates the strand, breaking the hair's bonds - this is how split ends occur. It can also dry out the hair, making it dull and unmanage- able. If you must use heat products, try to limit it to once per week and use it on the lowest heat setting possible. And, of course, ALWAYS use a heat-protecting hair product before applying heat to your strands! 4. Stay mindful when styling your hair. Experimenting with different hairstyles can be a fun and exciting way to mix up your look! And while we all love a slick po- nytail and tight braid styles, could these chic looks be harming your hair? The short answer is yes. Here are some ways your hairstyle might be causing damage: • Wearing the same ponytail every day. When you wear your ponytail at the same spot every day, you're adding stress to the same area over and over, which can eventually cause the hair strands to break off at the base of the pony. Changing the hair styles every other day maybe helpful. If a daily ponytail or bun is necessary, ditch your rubber hair elastics for a thick- er, fabric-coated hair tie that's more gen- tle on the hair. • Regularly doing tight braids and buns. Braids and other hairstyles that are too tight can cause tensile stress, which causes hair to break away from its roots, ending in splitting, follicle damage, hair weakness, and even hair loss. Over time, tensile stress can lead to more severe con- ditions like traction alopecia, resulting in permanent hair loss. • Wet updos. As previously mentioned, wet/damp hair is more delicate than dry hair, making it more prone to breakage. Because of this, you should never tie your 6. Sleep on silk or satin pillowcases Sleeping on silk pillowcases has fantas- tic benefits to both the skin and hair. For one thing, silk pillowcases are wondrous at preventing frizzy hair. Thanks to its smooth texture, hair can glide over it without any friction, meaning you'll be less likely to wake up with a head of frizz- filled, tangled bedhead. This is especial- ly true for those with textured and curly hair. Traditional cotton pillowcases are also significantly more porous than silk, 10 Rules To Revive Your Strands 47

50. so they tend to absorb moisture from the hair, which contributes to strand brittle- ness and a dry, flaky scalp. Pay attention to how your own hair reacts to products, practices and haircare rou- tines. Then, adjust accordingly. 7. Incorporate scalp massages 10. Beyond beauty Giving yourself a quick daily massage re- duces stress and tension and encourages blood flow that brings nutrients and oxy- gen to hair cells. Regular scalp massages can also exfoliate and open up clogged pores to help clear scalp conditions like eczema and dandruff. According to some research, it can also increase hair thick- ness by stretching the cells of the hair fol- licles and dilating blood vessels beneath the skin, stimulating the follicles to pro- duce thicker hair. The condition of one’s hair can be a help- ful indicator of overall health. Factors such as nutritional deficiencies, hormonal imbalance, general well-being and a nat- ural drop in collagen levels, which occurs with age, can also significantly impact the quality of hair, leading to thinning or a lack of luster. 8. Get a trim When you get a trim, what comes off is ends, the weakest part of the strands. If left, they could break or split. So you can get a trim in every 3 months or so. 9. Listen to your hair An important thing to remember is that everyone’s hair and scalp are different. 48 10 Rules To Revive Your Strands