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Every individual loses a small amount of hair each day. The degree of hair loss varies from person to person. Upto 100 hairs a day is considered normal for any given person.

STRESS in any form, physical or mental can lead to increased hair fall. 'Telogen effluvium', i.e., all the hairs in the resting stage are shed. Once the stress period is over, all the lost hairs are regained. This is the commonest reason for hair fall and the more the person is worried about the hair loss, the worry itself acts as a stress factor, which in turn causes more hair fall - a vicious cycle.

The other common reason for hair fall is the normal baldness which men and women will develop as they grow older. Some may begin to lose their hairs earlier than the others. There are surgical and medical methods of treating baldness, but any non surgical method will have to be continued for a very very long period of time and will have to be used continuously, (like minoxidil for local application).

Other causes to be ruled out are :

  • Hormonal: menses / thyroid /others.
  • Recent illness / medical problems / anaemia.
  • Drugs / medications.
  • Itching /dandruff.
  • Pregnancy / surgeries / childbirth.
  • water source / combing / shampoos / hair-dye / oil.
  • diet / food habits.

Pityriasis simplex or furfuracea, popularly known as 'dandruff" is a simple cosmetic problem of adolescence and adult life and is relatively rare and mild in children. Severity reaches a peak at the age of around 20 and becomes less frequent after 50. This age incidence suggests that hormonal variations play a role and the level of sebaceous activity may also be a factor.

Although there is no specific organism related to dandruff, an increase in the normal microbial flora is a factor.

Small white or grey scales collect on the scalp surface in localised, more or less segmental patches, or more diffusely. After removal with an effective shampoo, the scales form again within 4 - 7 days. The condition first becomes a cosmetic problem during the II and IIIrd decades, but there are long and short term variations in the severity without any obvious cause. There are variations in the ease with which the scales become detached and drift unaesthetically along the hair shafts or fall on the collar and shoulders. Although it usually clears spontaneously during the fifth and sixth decade, it may persist in old age.


In those people whose scalps become greasy at or after puberty, the seborrhoea binds the scale in a greasy paste and it's no longer shed, but accumulates in small adherent mounds - 'pityriasis steatoides'. The development of clinically evident inflammatory changes in such individuals leads to seborrheic dermatitis ITCHING IS NOT A FEATURE OF SIMPLE DANDRUFF. It's more common when inflammatory changes develop in seborrheic scalp and such recurrent episodes may be clearly related to stress.

Pityriasis in its milder form is a physiological process. THE OBJECT OF TREATMENT IS TO CONTROL IT AT THE LOWEST POSSIBLE COST AND INCONVINIENCE TO THE PATIENT, ESPECIALLY THAT ANY PROCEDURE FOUND EFFECTIVE WILL NEED TO BE REPEATED AT REGULAR INTERVALS. One cannot expect a permanent cure for dandruff. Medicated antidandruff shampoos will have to be used regularly to keep it under good control.




  • use a hair dryer, especially very hot air.
  • crash diet for weight loss.
  • use very hot water for scalp.
  • use strong chemicals and hair dyes.
  • share combs and brushes.
  • comb wet hair soon after a bath.
  • use rollers or curlers.
  • over-use shampoos or shikakai.

Info added on Jan/Feb, 2013.
See these slide shows on causes & prevention of hair loss

Dr.Anuradha Rao,

Consultant Dermtologist.

Update in Feb. 2011
Slide show on Hair Loss and Treatment options –


Updated on 01.02.2013.

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