Canities-Greying of Hair & An Unknown Fact about Queen of France

Definition:

Any change in colour of hair pigment named melanin of follicular melanocytes due to gradual age dependent dilution is called Greying of Hair or Canities.

                                                           Fig-Greying of Hair

Description:
It generally occurs after 30 years of age due to normal physiological process called Senile Canities.
But when it occurs before 30 years of age it is called Pre-Mature Greying(PMG). Regarding the PMG we will discuss it in detail in upcoming blog. We are here to discuss and explain the Greying of Hair but before that we should make a clear idea how the pigmentation of hair happens in our hair so we have to first look into that and before that we have to know physiology and nomenclatures of melanocytes and melanin with the help of followings-:

1)Epidermal & Follicular melanin unit: One unit of melanocyte and 36 unit of keratinocytes are responsible for transporting, metabolising and degrading the granules of melanin obtained from melanocytes.
Presence of epidermal and follicular melanocyte is same like co-existence of white hairs and black skin in Asians. And this can be clinically verified by targeting the epidermal melanocytes in most of the cases of Vitiligo while follicular melanocytes in active case of  Alopecia Areata  due to immune mediated pathology. 

                                                Fig-Epidermal & Follicular Melanocytes.

2)Melanin:
  Word Meaning:- The name melanin generally comes from a Greek word "melas" which means       "dark-black"

                                                             Fig-Melanin in hair


  Definition:-Melanin is a high molecular weight biological complex polymer pigment found in
  skin, hair, feather, some internal membranes formed as an end product of amino-acid tyrosine in melanosome.

  Classification:- There are 2 kinds of melanin found, which are as follows.
   A) Eumelanin- Dark Brown in colour
                          -Insoluble nitrogenous pigment
                          -Derived from 5,6 dihydroxyindoles

B)Pheomelanin- Yellow-red in colour
                         - Alkaline soluble sulphurous pigment
                         - Derived from cysteinyldopa
C) Nueromelanin- This is another type also found in brain but much detail is not needed here.


3)Melanoblast: 
  These are the precursor cells.

4)Melanogenesis: 
   Its a complex process of bio-synthesis of melanin in living cells by matured melanocytes through multiple steps including different substances, enzymes, co-factors that start process by phenilealnin/tyrosine and completes with a complex polymer deposited in melanosome on a protein matrix.

5)Melanophage: Dermal macrophage internalised with melanin along with follicular papilla and dermal connective tissue can take up melanin during Catagen Phase of Hair Cycle.

6) Melanosome: Within it matured melanocytes synthesise melanin

7) Mechanism of Hair Pigmentation: Hair colour in humans is a very unique appearance in regards to cosmetic & social life.
Melanins are highly efficient and fast for ion transport.During Anagen Phase( Growth phase) proper pigmentation of hair occurs within cytoplasmic organelle named melanosome.
In hair follicle there is keratinocyte that accepts melanin and form pigmented hair shaft(Body part of Hair). In this way detoxification of scalp tissue occurs by trapping of toxins including heavy metals also within highly vascularised scalp fibre. Melanocytes migrate out of the neural crest to enter dermis of skin.

                                                                Fig-Hair Pigmentation

Melanogenesis occurs as early as 7 weeks of gestation with pigment synthesis. Some melanoblasts proliferate and differentiate into melanocyte while residing into epidermis some melanocytes leave epidermis to distribute into developing hair follicle as dopa-positive and dopa-negative cells in hair follicle and its associate sebaceous glands.
When formation of hair fibre started, melanocytes concentrate at basal lamina around the top of the follicular dermal papilla and melanocytic melanocyte enter into outer root sheath of a fully developed  hair follicle.
In a matured hair follicle positive melanocytes for 3,4 dihydroxy phenylalanin as seen at basal layer of infundibulam and upper dermal papilla while few are seen in basal layer of sebaceous glands.Hair bulb is the only site for pigment production for hair shaft and has both highly melanocytic melanocytes and poorly differentiated melanocytic melanocytes.

Location:
Greying first appears in temporal region of the scalp and then slowly reaches to vertex and then other region and finally covers the occiput.
Beard and body hairs also affected much later .

                                             
                                                         Fig-Whitening in Beard

                                       
Histopathology:
Due to marked reduction in active melanocytes in hair bulb there is loss of melanin pigment in greying hair follicles.Grey hair bulb then showing less dopa reaction(tyrosinase activity) while hair bulb does not show any activity.

                                                        Fig-Melanin Pathology

Also there is specific defect of melanosome transfer in greying hair bulb because keratinocytes fail to have melanin granules inspite of very close to melanocytes with moderate number of melanosome. This is obvious presence of melanin debris in greying hair bulb and surrounding dermis too.
Melanosomes are packaged with lysosome suggesting these melanoskmes defective.Then degradation of lysosome of melanosomes is followed by death of melanocytes leading to white hair bulb vacuolated.

An Unknown Fact about Canities:
This is very special case of Canities that we called Canitis subita. 
Word meaning:- This is Latin word which means "sudden grey". The name itself suggests this condition & you may also tell that greying most of case occurs suddenly or may we notice it suddenly then we make a concern and consult the Trichologist ops! sorry then we consult with Dermatologist not the Trichologist because this is not in our known knowledge that we should consult Trichologist in the case of hair & scalp related problems.
Anyhow here is not such case we will be astonished to know that whole hairs of scalp become white over a period of night, can you imagine this. And I think this is really a unknown fact about canities or may be people who work in hair related industry know about it.

                                                 Fig-Marie Antoinette syndrome

This is also called Marie Antoinette syndrome and there is a small story about it but before that we should know some facts about the Last Queen of France Marie Antoinette, Yes, she was the Queen.
She was the 2nd last child of her family. When her husband ascended to throne, she became the Queen of France & there only till 1791 because after that French Revolution started in 18th century so basically she was the last Queen of France.
There are several "not to feel good" events happened to her life. Like a great number people in France population did not like her.A False accusation came on her due to a Diamond Necklace and it damaged her reputation in public too.Then after people used to call her "Madam Deficit" .
like this several other events happened to her during the Revolution. After that Royal Family were placed under house arrest in 1989. Then after she was sentenced to death in 1791 by guillotine.
So, before she was executed by guillotine her whole hairs become white completely.
This was seen as a myth but not completely because some of report cases came into its support and even cases of some physician's own cases came. Here one question may come to mind that why the name Marie Antoinette syndrome was given because she was the first patient of such kind of problem and before that nobody else reported such type of cases so named Marie Antoinette was given.
Till now no biological cause had been found but it believed that stress is the key role factor & yes we can also believe in that due to several unhappy events in Queens's life.


Etiology:
1) Alopecia Areata:-
Pigmented hair is preferably targeted in  Alopecia Areata while white is relatively spared. In acute Alopecia Areata pigmented bulbar melanocytes undergoes a degenerative change and patient with acute Alopecia Areata due to immunology produces anti-bodies to cytoplasmic antigen and T-cells induced to proliferate in response to pigment cell antigen. As immune response usually slows down the re-growth of white hairs as seen it recovers it original colour . This slowing of re-pigmentation is due to slow recovery from severe damage in hair pigment unit that may reduce total number of available melanocytes in hair follicle.

2) Vitiligo:
In de-pigmented skin simply called Leukoderma Vitiligo sometime can lead to Leukotrichia.

3) Albinism:
It consists of auto-somal recessive diseases that exhibit congenital reduction or absence of melanin in skin, hair and eyes.

4)Plica polonica:
Sometime loss of pigmentation is seen in a circumcised patch which can be genetic or acquired.

5)Radiation & Chemotherapy: It may also affect the greying of hairs .

6) Smoking: Smokers are more likely to face greying of hair at very young age.

7)Illnesses: Sometime greying of hair may be an indication for some underlying health issues. Following underlying we should think about them-
a) Werner's Syndrome-
can be the underlying cause for greying and showing symptoms but in younger people only.
b) Pernicious Anaemia-
It is due to vit-B12 deficiency, may be associated with decreased production of melanin.
c) Thyroid Disease also may come in this to some extend.

8) Drugs & Medicines:Drugs like lithium and methotrexate used in arthritis and cancer, can also cause greying of hair .
9) UV Rays: Exposure to UV rays and pesticide leads to canities in some cases.
Treatment:
As I always say, there are many modes of treatment in our great county India for any kind of disease.
But mostly people prefer to take treatment from Old School of Medicine(Allopathy) as their first choice of treatment & when some percentage of them do not get benefit or cure, they do take a move towards  the other option available in medical field.
Yes, here we are talking about the about the world's 2nd largest practising medicine called Homoeopathy but it does not mean that you should not take Allopathy as your first choice of medicine for treating your concern diseases.
Homoeopathy has a great scale of for treating every kind of diseases for last 200 years.

Old School of Medicine:-
Treatment of Canities is a complicated process and majorly focus on the deficiencies factors like Iron & Vitamin supplements in such deficiency.
Camouflage techniques are also in some group of individuals.
There are so many  options are available in medical field to treat the Canities but here I would like to add that treating any kind disease from any of the school , you should know about the fact of that diseases. There are so many videos are also available to treat this condition so you should think practically then take a step because one wrong step towards anything can make a permanent damage to you life.

Homoeoopathy:
As I told you, Homoeopathy has a great scale of treating any kind of diseases but it does not mean that it can turn your grey/white hair in black.
Like in Canities there is no any medicine or treatment procedure via which we can turn Grey/white hair into black . Actually why I am saying like this because most of patients when go for the consultation about Greying of hairs, they have a healthy thought that their hairs will become black after a period of time.
Homoeopathy does not have a specific drug or medicine for any kind of disease so if you have any kind such hair problem consult a Trichologist first. For the same you can also reach us in HairTalk Clinic.For appointment give your comments in comment box.

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