Hair Loss in Systemic Disease

In the 1987 document, the authors outlined how systemic diseases can lead to hair loss, particularly diffuse nonscarring alopecia. They highlighted that hair loss can be caused by severe stress, hormonal or vascular changes, and deficiencies in essential nutrients like protein, fatty acids, biotin, and zinc. The scalp typically has about 100,000 hairs, and losing up to 100 hairs daily is normal. Hair loss can occur due to telogen effluvium, where stress causes hair follicles to prematurely enter the resting phase, or anagen effluvium, where growing hairs are lost due to metabolic insults like chemotherapy. The document also discussed hair loss in the context of systemic diseases such as vitamin D resistance, thyroid disorders, collagen vascular diseases, and syphilis, noting that hair changes are often reversible with appropriate treatment. The authors emphasized the importance of a thorough history and examination to diagnose the cause of hair loss, which is often preceded by systemic stress or involves damage to the hair follicle. They concluded that while telogen hair shedding indicates new growth and should resolve within six months, some conditions may lead to incomplete regrowth due to follicle damage.