Introduction

• As people age, most people experience changes of their body functions and organs in some way due to changes in individual cells and in body organs

• These changes may result in changes in appearance and thus the experience of aging

• Similarly, hair colour starts to change and by age of 50 years old, 50% of the hair in 50% of people will have turn grey. This is mainly due to the loss of melanocytes (pigment-producing cells)

• The degree of hair graying often runs in families, however, the responsible genes are unknown

Symptoms and signs of hair problem among elderly

As a person ages, the hair quality and distribution can change considerably and hair may become thinner, more brittle and loses its natural colour.

The common aging changes in hair include:

1. Hair color change

   • This is one of the obvious signs of aging

   • Hair graying usually starts as early as the 30s. With aging, less melanin are formed by the hair follicles.

   • Hair on the scalp usually starts to turn grey at the temples region and extend upwards toward the roof of the scalp.

   • Hair color becomes lighter and eventually turning white

   • Hair on the body and face will also turn grey. This occur much later compare to the scalp hair.

   • The speed of hair graying may be determined by genetic factors

2. Hair loss

   • With aging almost everyone has some hair loss due to the slowing down of hair growth

   • Many hair follicles stop producing new hairs

   • Eventually, the hair becomes thin, fine and light-colored

   • Baldness may occur in both sexes but with differing distribution

   • Men may start showing signs of baldness by the time they are 30 years old and many men are nearly bald by age 60. In male-pattern baldness, hair may be lost at the vertex (top of head) and front temporal (front and side) region

   • In women, they can have loss of hair after menopause and this is called female-pattern baldness i.e. hair becomes less dense and the scalp may become more visible

   • As a person ages, body and facial hair are also lost

3. Excessive hair growth

   • In women, excessive or unwanted hair growth becomes common after menopause. Facial hair may become coarser, especially on the chin and around the lips

   • Men may  notice  that hair grow longer and coarser in eyebrow, ear and nose regions

Factors affecting / aggravating hair problem in elderly

Hair problem in elderly may be affected or aggravated by many other factors, such as:

1. Medical conditions

   • Iron deficiency: Studies showed that iron deficiency due to medical conditions or a poor diet may cause significant hair loss in elderly. So, by improving iron deficiency in both men and women, hair re-growth rates may be improved.

   • Hypothyroidism:Thisis a hormonal condition in which the thyroid hormone is inadequate. Hair loss happens rapidly and hair growth is slow due to slow metabolism rate. However, when hypothyroidism is corrected with medication, the hair loss usually improves .

   • Diabetes: In some elderly, diabetes can cause hair loss. The stress of this illness causes hair to stop growing or grow at a slower rate leading to hair loss. Effective management and control of diabetes may improve hair condition.

2. Poor nutrition

   • Many elderly individuals do not maintain a healthy diet due to chewing problem or poor dietary habit

   • Poor diet may contribute to hair problem in elderly. A diet which is imbalance and deficient in nutrients can cause hair shafts to weaken. This causes hair to break easily and to grow back slower

   • A diet rich in lean proteins (chicken and fish), vegetables and fruits often supplies enough nutrients to avoid hair problem

3. Medications

   • As individuals age, they may become more susceptible to medical illnesses and some medicines used to treat these illnesses can cause hair problem.

     • Blood thinners medications: Drugs used to treat various heart conditions e.g. anticoagulants can lead to hair loss

     • Gout medications: Drugs used to treat gout such as Allopurinol can cause hair loss

     • Chemotherapy medications: These medications are used to for cancers. It specifically target hair cell production and drastically destroy hair cells and lead to rapid hair loss

     • Hair loss due to medications are usually transient. Hair growth may resume after the removal of insulting medications.

Treatment of hair problem in elderly

Hair problem in elderly men and women may occur because of a combination of multiple conditions. Moreover, hair problem may be a symptom of a more serious underlying health condition . Therefore, elderly persons should consult their doctors if they have sudden and significant hair problem.

Common facts about treatment of hair problem in elderly:

• Natural hair loss products e.g. a long list of tonics, creams, and oral supplements are costly and have little to no benefit

• Treatment of hair problem depends on the underlying causes. If a medical condition e.g. vitamin deficiencies, thyroid problems is causing the hair problem, the medical condition  needs to be treated and corrected

General measures to prevent hair problem in elderly:

1. Balance nutrition

   • Protein is an important component to strengthen and promote hair growth. It is recommended to take about two to three servings of meat or a combination of four to five servings of dairy and beans daily. Try to include nuts and seeds, eggs and fish in their diets

   • To eat a variety of foods that include six to 10 servings of various vegetables , two to four serving of fruits daily

   • Some nutrients that may be helpful for hair growth: e.g. iron supplements are only recommended if the elderly are tested positive for iron-deficiency anemia

2. Appropriate hair styling

   • Be gentle with the hair and do not overdo with brushing or washing. A void items and procedures that damages the hair like rubber bands, perms, straightening irons, dyes, , and hair curling

   • Hanging hair makes the hair appear thinner. Therefore, keep the hair short

   • As hair thinning often occurs over the crown, try parting the hair on the side. This takes away the focus off the region of thinnest hair.

3. Manage Stress

   • Facing problem of hair loss can be stressful

   • Physical and emotional stress can sometimes increase the problem of hair loss

   • Some extra hair loss is normal for women especially during menopause

   • Appropriate stress management can reduce the worsening of hair problem

References

1. Habif TP et al. Hair diseases. Clinical Dermatology 5th ed. St. Louis, Mo: Mosby Elsevier 2009.

2. Tosti A. Diseases of hair and nails. In: Goldman L, Schafer AI eds. Goldman’s Cecil Medicine 24th ed. Philadelphia, PA: Elsevier Saunders 2011.

3. National Library of Medicine. Aging changes in hair and nails. www.nlm.nih.gov/medlineplus/ency/article/004005.htm. Accessed June 18, 2014