BusinessDay 24 Aug 2018

Introduction
One of the ‘gifts’ that being a doctor
has bestowed on me is the
ability to spot health disorders in
people I meet everywhere outside the
hospital. Alopecia commonly known as
hair loss, has become one of the commonest
medical disorders in the society
today that is easily recognizable even to
the untrained eye.
What is alopecia?
It is the sudden or chronic abnormal loss
of hair and can be precipitated by several
hundred disease states or events.
Loss of scalp hair is considered abnormal
in many societies including Nigeria.
Hair is perceived to be important for
many reasons. It serves as a means for
wealth display, beauty, desirability,
social status, and youthfulness.
With that perception comes the reality
that millions of naira are spent annually
for hair care and its perceived abnormalities.
To help us better understand hair loss,
I will classify it simply.
Classification of hair loss
Clinically, hair loss is classified into:
1. Scarring: The hair follicle is destroyed
leading to permanent hair loss
and there is associated inflammation,
shrinkage, and scarring of the scalp.
2. Non-scarring: There is loss of hair
without destruction of the hair follicle,
no sign of tissue inflammation, scarring,
or shrinkage of the skin of the scalp.
Examples include Traction alopecia and
Androgenetic alopecia.
The hair loss could be generalised
or localised, complete (affecting the
whole scalp) or partial, patterned (like
in Female pattern hair loss) or nonpatterned.
CAUSES OF HAIR LOSS
Non-scarring hair Loss
Friday 17 August 2018
Understanding hair loss
Dr Agility U. Obi-Ihesie
Ravishe Medical Skin & Haircare
This is the commonest type of hair loss. Traction alopecia
is caused primarily by unhealthy hair care practices.
It results from cosmetic stress due to poor knowledge
of hair type, poor styling (untrained stylist, tight styles
[braids, weaves, ponytails, rollers], repetition of styles,
etc).
Prolonged traction alopecia can lead to scarring of the
scalp and irreversible hair loss.
Other causes of non-scarring hair loss include chemical
damage from relaxers and dyes, pressure-induced
traction (from repetitive use of tight-fitting wigs,
scarves/ turbans, and Trichotillomania (neuromechanical
alopecia).
Telogen Effluvium is the rapid shedding of a large
number of hairs throughout the scalp due to a variety
of physical or mental stressors such as: Hormonal
imbalances after childbirth, around menopause or
hypo/ hyperthyroidism, physical stress from anaemia,
surgery, systemic illness, and psychological stress. The
precipitating event precedes the telogen effluvium by
6 to 16 weeks and removal of inciting cause leads to
resolution over the next few months as the number
of hairs in telogen return to normal.
Some anti-hypertensive drugs, anticoagulants, anticancer
agents, Anti-epilepsy drugs, Beta blockers,
Cholesterol-lowering drugs, and so on have been
connected to hair loss.
Systemic diseases like Systemic Lupus erythematosus,
secondary syphilis, polycystic ovarian syndrome, and
adrenal diseases can cause hair loss.
Nutrient Deficiencies including Protein, Iron, Biotin,
Zinc, Copper, Selenium, Iodine, Calcium, Essential
Fatty Acids (Omega 3 & 6) and Vitamins (A, Bs, C, D, )
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BUSINESS DAY
can trigger hair loss.
Abnormal and imbalanced diets
like Crash Diets, FAD Diets and Eating
disorders (Anorexia nervosa,
Bulimia) are also causes of hair loss.
Androgenetic (female-pattern)
alopecia is common in postmenopausal
women who may develop
a receding hairline. Acne, excess
facial or body hair, male-pattern
escutcheon, irregular menses may
be present in younger women.
Scarring Hair Loss
CENTRAL CENTRIFUGAL CICATRI-
CIAL ALOPECIA
This is commoner in blacks than
whites and presents as an area of
slowly expanding scarring alopecia
on the vertex or crown. It may
be asymptomatic or accompanied
by itching, tenderness, redness or
pustules. Chemical or mechanical
processing of the hair may play a
role. It is a common cause of permanent
hair loss.
Management
Healthy hair practices are advocated
to prevent hair loss; incorporating
the appropriate products, techniques
and styling are beneficial.
A healthy lifestyle including appropriate
nutrition, regular health
checks and stress management are
encouraged.
Hair loss may be a pointer to systemic
illnesses and most cases of
hair loss can be successfully managed
with EARLY and AccURATE
diagnosis.
If within the first 2 weeks to 3
months of hair loss, there is no
regrowth after commencing selftreatment,
seek professional help
from a doctor or Trichologist to
avoid permanent hair loss.
It happened to me! I married a
monster and I thought he was a man
Eseosa PRincess
It was NE who summarized my thoughts in a few words. I didn’t even know
that it was what I’d been thinking, but the minute he said it, it hit straight
home. “In 2016, I don’t know what is going on, if it’s more publicity or more
women speaking out but our men are cowardly and weak and they are seriously
misbehaving”. I agreed. But it was while lying down and watching TV with Jaden
Lee sitting on my head (he loves to sit on my head; he probably thinks it’s his
personal stool. Lol) did it occur to me that this was a man stating the obvious. Not
making excuses, not justifying what cannot be justified and standing with them
in confused solidarity. Men like these are not many, I tell you. I should know, it’s
the first topic of discussion with male folks these days.
When my marriage collapsed, that was when I realized that most women were
suffering in silence. It was amazing how confident women became to share marital
issues with me. It was strange. Now they can tell you the shocking truths about
their marriage. Previously, when I complained, they’d tell me that all men were
the same. I strongly disagreed; still do. Mind you, I did not say men were perfect
but they were not all the same. There are good men and they are bad men. Wrong
is wrong and right is right, simple! Then they would utter some vague words and
unsolicited advice, majoring bordering on ‘bearing it’ and praying about it and
telling you to work on yourself. I have little patience for that these days. I usually
just shut it down firmly. I don’t have time for nonsense. No more. I took it for 2
years. But no more. Hug me instead if you have nothing useful to say.
The last time I took such utterances lightly was at Iponri Police station where I
had gone to lay a complaint and ask for the arrest of Imoh. I remember the woman.
Leaning lazily over the counter, she had this air of ‘I don’t care’ and threw condescending
sideway looks at me while I complained to another officer behind the
counter. I punctuated each complaint with tears. Imoh would have been shocked
to see me cry. I never let him see me cry; I never gave him that satisfaction. I remained
stoic through it all, defiant. I would break down and weep in the bathroom
when he was done hitting me but never in front of him. It was not deliberate or a
conscious action, I guess the essence of who I was refused to bow down to him
or allow him break me. How he had hated that stoicism and dry eyes. Maybe I
should have cried. Maybe that was my offence but I digress.
After a particularly lengthy pause in which I sobbed while my friend held
my uncharacteristically quiet baby, she suddenly said, “My dear, better go back
and beg your husband. Tell him to forgive you and forget. You are too young for
divorce o. You don’t know what you are saying. Go back and beg my friend. All
you young girls sef!” I looked at Omos and she looked at me. I asked “Am I also
not too young to die?” “Na you know that one. Go and beg him. You will not die”.
I was shocked. I was stunned. I was speechless. Me, a hyper, talkative person just
could not remember any sound. “Ehn? What? This is the reason men beat their
wives! Is that what you’re telling me? You, a Police officer? How can you tell me
that? For what?” I walked out of the station, shaking with anger and called the DPO.
Hmmmmm! Imoh had been right. He had said “if you like, go to the Police. I
will deny everything. Is it not money? Is it not money that the Police want? Bring
them. Go and call the police. All my friends beat their wives; it’s not a big deal. The
wives know not to do stuff that will get them a beating. It is not a new thing. Stupid
woman”. If the Police ask you to go beg an abusive man, then what help is there
really? A police woman for that matter! Even as I write, I am still surprised. What was I expecting though? Compassion
or sympathy? Did I expect them to swoop to the house and arrest him? Did I expect them to hug me and ask if I was
okay? Should they have asked to see my bruises and injuries; old and new? What exactly did I expect them to do? In
all honesty, I don’t know. I have never been beaten before now so I don’t know what I should have expected. I don’t
know what I expected them to do but I sure did not expect them to ask me to go beg a man who had just beaten me
till I passed out and continued hitting me as I laid on the floor, still and unmoving. A man who after I was revived by
a friend brought a wire and wanted to flog me? The police asked me to go and beg him.
So yes! There’s a lot more publicity, thank God. There are a lot more women speaking out. A lot more people are
involving themselves in issues like this, helping the woman and giving her a voice. In some cases, helping her find
justice. For these, I am truly grateful. I am aware that a lot of women have died. I could have died actually. He told
me he wanted to kill me; repeatedly and at different times! He’s squeezed my neck so hard I couldn’t breathe and
had bruises round my neck. I thought I would when he shattered the glass window upstairs with my head and blood
poured all over me and Jaden Lee whom I was carrying. He was just 4 months old then. He’d gotten angry that he’d
been punching my head and that ‘it refused to break’. This my head! My head happily blocked and covered my precious
infant son when it realised that some punches were falling on him too. Remembering Jaden’s screams and the
blood all over him still brings tears to my eyes, even as I write this. Oh, my golden, precious boy, I am so sorry! But die,
I did not. God knew the suffering that a motherless child passes through; I know because I am one. He loves Jaden
Lee and I too much for that to happen.
I am aware that a lot of women are suffering same, not exactly sure who to contact or what to do. I didn’t either.
You are not supposed to talk about these things. You are expected to stay silent; don’t let people know your business
or what goes on in your home. You are expected to pray. A lot. A lot of women who chose to exit these bondages
and have found life to be hard and unyielding. Some being asked, “na me say make your husband dey beat you?’ A
lot, begging for sustenance for themselves and their children (in cases where the children were not taken away from
them). Too many! Sadly, too many!
It happened to me! I married a monster and I thought he was a man.