eMedicine Specialties > Otolaryngology and Facial Plastic Surgery > Cosmetic Surgery

Hair Growth

Author: Samer Alaiti, MD, Clinical Assistant Professor, Departments of Dermatology and Internal Medicine, University of California at Los Angeles
Contributor Information and Disclosures

Updated: Aug 15, 2007

Hair Embryology

During the third month of gestation, the epithelial primary hair germs develop in the eyebrow region and scalp. Subsequently, hair development continues in a cephalocaudal direction.

The primary hair germ begins as an epithelial bud that protrudes into the dermis and seems to be directed by a collection of mesenchymal cells that eventually form the dermal (follicular) papilla.

The germ continues to grow deeper in the dermis under the guidance of the dermal papilla. It then acquires multiple epithelial buds that grow transversely and differentiate into the many components of the primary hair follicle (ie, sebaceous gland and duct, apocrine gland and duct, attachment point of the erector pili muscle [bulge region]).

Sebaceous glands are absent in the palms and soles; apocrine glands develop only in certain body regions. The hair grows at a slant angle.

Melanocytes are scattered haphazardly in the primary epithelial bud.

Classification Of Hair

Human hair varies with respect to texture, color, and length. Lanugo hairs cover most of the fetal skin and shed perinatally. These lightly pigmented hairs are fine in texture.

Thicker and darker than lanugo hairs, vellus hairs cover most of the glabrous skin surface except palms, soles, palmar and plantar surfaces of fingers and toes, inner aspect of the prepuce, and the glans penis.

Darkly pigmented terminal hairs are long and thick and are most commonly located on the scalp and the facial areas of men. These hairs can reach a preprogrammed length based on length of the anagen phase. Ultimately, terminal hairs undergo involution and convert to catagen and then to the telogen phase. The mechanism and factors that induce the hair to terminate growth and involute are largely unknown.

Some hair follicles have the ability to produce different types of hair at various times. For example, hair follicles on an adult scalp that normally produce terminal hairs can, in individuals with androgenetic alopecia, undergo miniaturization and produce short, fine, and lightly pigmented hairs. Similarly, hair follicles on the male beard, which until puberty produce only vellus hairs, are capable of producing terminal hair thereafter.

Hair Growth Cycles

Histological features of the human hair follicle vary greatly during the growth cycle. All hair, terminal and vellus, goes through a growth phase (anagen), a regression or transitional phase (catagen), and a resting phase (telogen).

Anagen hair bulbs are located in the subcutaneous fat, catagen bulbs are in the dermis, and telogen bulbs are in the mid-to-upper dermis. The anagen phase for vellus hairs is much shorter than that for terminal hairs.

The hair growth cycle in different regions of the body varies, and the duration of anagen, catagen, and telogen phases differs according to body site. While the entire cycle duration for the eyelashes is 4 months, the scalp cycle requires about 3-4 years to complete.

In the normal human scalp, the anagen phase duration averages 2-3 years (occasionally much longer); the catagen phase, 2-3 weeks; and the telogen phase, approximately 3 months.

Hair located on other body sites (eg, eyebrows, trunk, extremities) is characterized by longer telogen phases (up to 9 months) and shorter anagen periods (4-7 months). The catagen phase remains constant at 3-4 weeks.

Absent a disease state, 85-90% of all scalp hair follicles are in the anagen phase, 10-14% are in the telogen, and only 1-2% are in the catagen. Estimates place daily scalp hair shedding at about 100 hairs per day.

Scalp hair grows at an average rate of 0.4 mm/day (approximately 0.5 in/month). At any particular time, not all human hair follicles in any given anatomical location are in identical growth stages; some are in the anagen, while others are in the telogen or catagen. This phenomenon is referred to as the mosaic pattern and is in contrast to some animals whose follicular units all are synchronized. This explains some animals' ability to shed winter coats when the ambient temperature becomes warm, while humans do not go bald during the follicular rest period.

Keywords

hair growth, follicular growth, hair germ, follicular papilla, hair follicles, anagen phase, catagen phase, telogen phase, lanugo hairs, vellus hairs, terminal hairs, hair growth cycles, body hair, scalp hair

 


More on Hair Growth

References
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References

  1. Hashimoto K. The structure of human hair. Clin Dermatol. Oct-Dec 1988;6(4):7-21. [Medline].

  2. Kligman AM. The human hair cycle. J Invest Dermatol. Dec 1959;33:307-16. [Medline].

  3. Kollar EJ. The induction of hair follicles by embryonic dermal papillae. J Invest Dermatol. Dec 1970;55(6):374-8. [Medline].

  4. Murphy GF. Histology of the skin. In: Lever's Histopathology of the Skin. 1997:5-50.

  5. Sperling LC. Hair anatomy for the clinician. J Am Acad Dermatol. Jul 1991;25(1 Pt 1):1-17. [Medline].

  6. Tiede S, Kloepper JE, Bodò E, Tiwari S, Kruse C, Paus R. Hair follicle stem cells: walking the maze. Eur J Cell Biol. Jul 2007;86(7):355-76. [Medline].

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Further Reading

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Keywords

hair growth, follicular growth, hair germ, follicular papilla, hair follicles, anagen phase, catagen phase, telogen phase, lanugo hairs, vellus hairs, terminal hairs, hair growth cycles, body hair, scalp hair

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Contributor Information and Disclosures

Author

Samer Alaiti, MD, Clinical Assistant Professor, Departments of Dermatology and Internal Medicine, University of California at Los Angeles
Samer Alaiti, MD is a member of the following medical societies: American Academy of Cosmetic Surgery, American Academy of Dermatology, American College of Phlebology, American College of Physicians-American Society of Internal Medicine, American Society for Dermatologic Surgery, American Society for Laser Medicine and Surgery, and American Society of Lipo-Suction Surgery
Disclosure: Nothing to disclose.

Medical Editor

Paul S Nassif, MD, Clinical Assistant Professor, Department of Otolaryngology-Head and Neck Surgery, University of Southern California at Los Angeles, University of California at Los Angeles School of Medicine
Paul S Nassif, MD is a member of the following medical societies: American Academy of Facial Plastic and Reconstructive Surgery, American Academy of Otolaryngology-Head and Neck Surgery, and American College of Surgeons
Disclosure: Nothing to disclose.

Pharmacy Editor

Francisco Talavera, PharmD, PhD, Senior Pharmacy Editor, eMedicine
Disclosure: Nothing to disclose.

Managing Editor

Keith A LaFerriere, MD, Fellowship Director, Clinical Professor, Department of Surgery, Division of Otolaryngology, University of Missouri at Columbia
Keith A LaFerriere, MD is a member of the following medical societies: American Academy of Facial Plastic and Reconstructive Surgery, American Academy of Otolaryngology-Head and Neck Surgery, American College of Surgeons, American Medical Association, and Missouri State Medical Association
Disclosure: Nothing to disclose.

CME Editor

Christopher L Slack, MD, Otolaryngology-Facial Plastic Surgery, Private Practice, Associated Coastal ENT; Medical Director, Treasure Coast Sleep Disorders
Christopher L Slack, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Facial Plastic and Reconstructive Surgery, American Academy of Otolaryngology-Head and Neck Surgery, and American Medical Association
Disclosure: Nothing to disclose.

Chief Editor

Arlen D Meyers, MD, MBA, Professor, Department of Otolaryngology-Head and Neck Surgery, University of Colorado School of Medicine
Arlen D Meyers, MD, MBA is a member of the following medical societies: American Academy of Facial Plastic and Reconstructive Surgery, American Academy of Otolaryngology-Head and Neck Surgery, and American Head and Neck Society
Disclosure: UST Grant/research funds Consulting

 
 
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