What is Trichology (And When You Should See a Trichologist)

http://scene-chicago.com/scene/index.php/alopecia-totalis-awareness-by-dr-linda-amerson/ Trichologist Dr. Linda Amerson, founder of hairandscalpessentials.com performs a microscopic assessment.

Trichology is the science of the hair and scalp, their structures, diseases and functions. Every stylist should have a decent foundation in trichology, even if you’re the stylist working on your own hair.  And if you’re aspiring to be a hair genius, there’s no way around trichology!

For example, if you’re trying out a new style you’ve seen on YouTube, it’s important to know your hair type as compared to the hair type of the vlogger, right? If you have Type 3 hair, it isn’t going to do what Type 4 hair can do, and vice versa. Well, hair typing is only a very, very small part of trichology, as it deals with hair structure.

Hair structure also has to do with the components of the hair, such as the hair cuticle and hair cortex. With regard to the scalp, there is the hair root, the hair follicle and the surrounding supportive structures.

Why is this important? Knowledge of the structure of the hair and scalp lays the foundation for understanding their function. The healthy structures and proper functioning of the hair and scalp, in turn, help trichologists recognize the disease state, when it occurs.

Hair conditions usually start with the scalp. If the scalp isn’t doing its job correctly, there may be some obstructions to the hair growing out properly, and hair loss or hair breakage could be the end result. Alopecia fall into this category. 

However, there are scalp ailments that affect the hair only as secondary symptoms when left untreated, like dandruff.

So the scalp is very important. We’ll talk more about the scalp and its disease states a little later.

History of Trichology

If you thought a trichologist was a hair specialist, you’re right, literally. The “trich” part of trichology started off as “trikhos” in Greek, which means hair.

It looks like the British of the early 1900s thought “trich” sounded way better than “capillum,” which is Latin for hair. Capillum-ology is definitely a mouthful for “the science of hair.” And of course it had to sound scientific, not like hair-ology…

Speculation aside, para-medical (non-physician) hair science practitioners have been called trichologists since 1902. This is the year when the landmark College for Diseases of the Hair was founded in Britain. It would later be known as The Institute of Trichologists, as it is still called today.

And why did they go through all the trouble of founding such an institute? It’s simple: to beat hair loss.

Why Do People See a Trichologist?

Primarily, folks go to a trichologist because their hair is falling out. Ideally, a person with the symptoms of hair loss will go to a trichologist right away. Unfortunately, not many people know what the symptoms are. (The symptoms of hair loss are listed below, under Conditions That Affect the Hair.)

On the other hand, a person might go to a trichologist if they have itchy, burning scalp or  dandruff that’s way out of control.

In other words, if the problem isn’t super obvious, like hair that’s already falling out, or scalp that needs a brillo pad to scratch, we don’t usually look up a specialist.

It’s better to visit a trichologist when you first notice continued symptoms, than to wait until the issue develops into something that affects your social life and tampers with your self esteem – hair loss.

What Does a Trichologist Treat?

A trichologist treats the hair and scalp conditions mentioned above, and many others. Here are the main categories.

Conditions That Affect the Hair

With regards to the hair, a trichologist looks into the causes behind hair breakage, hair miniaturization (thinning in diameter) and hair thinning in density. All of these can be precursors to hair loss. A trichologist should be able to tell you which of these are:

• Leading to hair loss
• Standalone conditions not leading to hair loss
• Due to genetics, and leading to hair loss
• Symptoms of an internal medical issue, such as a hormonal imbalance, which may or may not lead to hair loss, depending on the condition.

So yes, it’s complicated. That’s why a trichologist is a specialist.

If the trichologist determines the hair symptoms you are experiencing i.e., breakage, miniaturization or thinning, are due to a form of alopecia/hair loss, or not, she will treat you accordingly.

Below are the different types of alopecias. Each alopecia originates in the hair follicles of the scalp.

Included are notes on the alopecias that greatly affect African American women.

1. Cicatricial, or scarring, alopecias. Unfortunately, scarring alopecias are synonymous with  permanent hair loss.Note: Out of the different kinds of cicatricial alopecias, one form, central centrifugal cicatricial alopecia (CCCA), affects 30-40% of black women. It begins at the top or crown of the head. Like other forms of cicatricial alopecias, once the hair is shed, the loss is permanent.Note: Frontal fibrosing alopecia is another cicatricial alopecia that affects black women. With this, the hairline recedes and leaves scarring.Hair chemicals and tension are possible causes for both of these scarring alopecias.
2. Noncicatricial – non-scarring alopecias. This can be genetic, female pattern hair loss, which is characterized by hair loss in the crown for women. If the cause isn’t genetic, non-scarring alopecias usually have an underlying medical reason.
3. Diffuse alopecias. These instances of heavy breakage or shedding can be caused by underlying health issues or chemotherapy.
4. Trauma alopecias. This signifies some type of physical harm done to the hair or scalp.Note: Traction alopecia, breakage and hair loss around the scalp margin due to tension and inflammation of the hair follicles, falls into this category. Approximately 1/3 of African American women have traction alopecia due to chemical and style-related trauma like relaxers and tight braids. Traction alopecia does not usually signify permanent hair loss, but if the traction continues, it can lead to it.

While the word alopecia means hair loss, normally the hair doesn’t fall out right away. Instead it passes through different stages of breaking, miniaturization and thinning until it eventually falls out. If your hair is already falling out by the time you visit a trichologist, you may have already reached the latter stages of the condition that’s causing it.

Conditions That Primarily Affect the Scalp

Scalp conditions are different from alopecias, but conditions like dry scalp can cause hair loss or slowed hair growth as secondary symptoms, if left untreated. If allowed, some scalp conditions can cause hair loss.

Notes are again added to indicate issues that pertain to African American women, specifically.

1. Seborrheic dermatitis. Also known as seborrheic eczema, seborrheic dermatitis is the most common form of dandruff and is caused by a genetic sensitivity to malassezia yeast.Note: This dandruff, characterized by greasy scales, affects people of different races equally. However, there are differentiated treatments for people of African descent, owing to the dry nature of our hair that isn’t shampooed as frequently as the hair of other ethnicities.
2. Irritant or contact dermatitis. Skin-irritating chemicals found in relaxers and some shampoos, conditioners and other hair treatments can cause itchy, dry scalp and flakes. Depending on the severity, inflammation and pustules may also develop. Irritation can also be caused by excessive heat used near the scalp, or cold and dryness in the environment.Note: Dry scalp, which is so rampant in the black community, is sometimes a manifestation of irritant dermatitis. This may be due to a single cause, or a combination of irritating product chemicals, excessive heat used during styling and living in cold and dry climates.
3. Psoriasis. This is an autoimmune condition that is characterized, in the scalp, by small, dry, silvery flakes attached to the skin. It is believed to be primarily a genetic condition that has environmental triggers, like stress.
4. Pityriasis amiantacea. These are layers of scales that adhere to the hairs. This is usually accompanied by the presence of staphylococcus bacteria. In other words, it is a staph infection.
5. Folliculitis. This is the infection and inflammation of hair follicles.Note: The form known as folliculitis keloidalis primarily affects black men, and at times black women, in the occipital area at the back of the scalp. This is believed to be caused by the sensitive nature of the occipital area of the scalp combined with the use of hair clippers.
6. Acne miliaris necrotica is a sparse form of acne of the hair follicles.
7. Ringworm of the scalp, or tinea capitis, is a circular fungal infection that can cause hair breakage and loss in the area.Note: Scalp ringworm likes dark, damp conditions. So if you’re protective styling, don’t leave the style in past the recommended time period, and make sure your scalp dries thoroughly when you cleanse it.

As mentioned above, it’s important to note that untreated scalp conditions can trigger others. For example, when scratched, the itchy flakes of seborrheic dermatitis, irritant dermatitis and psoriasis can develop into a bacterial infection of the scalp – pityriasis amiantacea. Irritant/contact dermatitis can develop into hair loss.

Time for Trichology Q&A!

Q. Can’t hair loss just be treated with natural remedies? When there are oils around that can help stop hair loss and encourage hair growth, like castor oil, why is a trichologist even needed?

A. If you choose to use natural remedies, remember that there is often more power in a formula that contains multiple hair growth and scalp health ingredients.

Another reason to see a trichologist is that if you have alopecia, there might be an underlying health condition behind it. Hair loss can be battled with natural formulas. But any underlying medical condition should be identified, also, to ensure the war is won.

A trichologist will team up with a medical doctor, or refer you to another specialist, if he or she suspects there to be an underlying medical condition.

Q. What happens at a trichologist visit?

A. Of course, a trichologist will examine your hair and scalp. A trichologist also looks at hair and scalp conditions holistically, so you can expect questions that will help the trichologist determine whether your personal environment and genetics are affecting your hair and scalp.

After the trichologist completes the evaluation, treatment may be suggested or dietary and lifestyle advice offered that will improve the state of your hair and scalp.

Q. What is the difference between a trichologist and a dermatologist?

A. A trichologist is a licensed specialist, but not a medical doctor. A dermatologist is a medical doctor that can practice  trichology, when necessary, but may not have the same level of experience dealing with hair and scalp issues as a trichologist would.

A trichologist can only recommend over the counter medication. A dermatologist can prescribe medication or perform biopsies or other medical procedures.

Do Natural Trichologists Exist?

Yes! Many sell their own anti-hair loss/healthy scalp product regimens online. Others even focus on black hair.

Trichologist Dr. Linda Amerson and HaircareEssentials.com, Arlington, Texas

Dr. Linda Amerson specializes in black hair. Visits can be scheduled through her website and Dr. Amerson’s products are also available for sale there.

Patou Salon And Spa, Washington, DC

French owner of Patou Salon and Spa, trichologist Patou Castay, gives free trichology examinations with every salon appointment. She also crafts relaxers and other products with botanicals and lower percentages of hair straightening chemicals.

Trichologist Lisa Akbari of Lisa Akbari Salon, Memphis TN

Lisa Akbari sells natural products and regimen kits, does hair consultations and offers natural hair licensing. Check out her radio show Ask the Hair Doctor!

The Trichology Clinic at TrichOOrganics, Westmeath, Ireland

TrichOOrganics owns the Davines brand of organic hair products, including the NaturalTech line that complements their trichology practice. Luckily Naturaltech is also sold in the U.S.

Trichologist David Satchell at the Eucaderm Hair Loss Clinic, Eastbourne, UK

David Satchell treats patients using his all natural, hand-crafted products and vitamin supplements for the hair and scalp. His products are sold internationally. There’s a marvellous selection of testimonials on his site. Having practiced trichology for some 40 years, Mr. Satchell is convinced that natural regimens work better than medicinal prescriptions.

Are you are experiencing unusual hair breakage, hair loss or hair miniaturization? Does your scalp itch, burn or flake? See a trichologist as soon as possible!

If you’ve already been to one, share with our readers what recommendations you received in the comments. You can help us spread the word about trichology and give hope to others suffering from hair loss by sharing this article on social media.