When hair turns grey in your youth: The dos and don’ts

Dear doctor,

I am 27 and I already have some white hair. Is there anything I can do to stop the process? I’m afraid of pulling them out since I was told that each strand will be replaced by two.

Hally

Dear Hally,

Hair gets its colour from melanin, which is a pigment that is produced by melanocytes. Hair turns grey due to progressive reduction in these melanocytes and reduced production of melanin. It is normal for hair to turn grey as one ages, though the onset of the grey hairs is different for different individuals and across the races. Caucasians approximately start getting grey hair in their 30s; Asians in the late 30s and Africans in the mid-40s. If greying of the hair happens 10 years or more before the expected time, this is known as premature ageing. 

For most people, premature greying occurs due to genetics. It can also be due to build-up of hydrogen peroxide, which is naturally occurring in the air, which then bleaches the hair. In a few people, it may be due to vitamin B12 deficiency, or problems with the thyroid or pituitary gland, in which case this may be reversible once the underlying problem is treated. It may also be a consequence of an auto-immune disease (a disease where the body’s immune system fights against its own cells or tissues) like vitiligo and alopecia. Smoking can also contribute to premature greying.

You can visit a doctor to check your Vitamin B12 levels, thyroid hormones and other hormones.  If these are abnormal, once they are corrected, the hair colour may go back to normal.

Premature greying cannot be prevented, especially if it is due to genetics. Avoiding smoking and limiting exposure of the hair to sunlight may be protective to some extent. For the existing grey hair, you can choose to embrace it and let it be, or you can hide it using hair dye or highlights. Avoid harsh hair products since grey hair is more brittle than other hair. Plucking off the grey hair does not make it grow faster.  It will still grow back grey.

Dear Doc,

What is leukaemia? Can it be treated?

Lucy

Dear Lucy,

Leukaemia is a cancer of the blood cells, where the bone marrow makes too many white blood cells. The specific type of leukaemia depends on the type of white blood cells affected, and whether it grows fast or slowly.

Most of those affected by leukaemia are those over 55 years old. However, leukaemia is the most common cancer affecting children below 15. There is no known cause of leukaemia, though there may be a higher risk if there is a family history of leukaemia, or if there is a genetic disorder like Down’s syndrome, or there is exposure to radiation or chemotherapy, or exposure to chemicals like benzene, or if you smoke.

In leukaemia, the many white blood cells that are made are not normal in structure and/or do not work properly. This means that the body is not able to fight off infection as it should. In addition, the excess white blood cells can affect how other organs work, and they also crowd out the other blood cells – the red blood cells and platelets – which in turn leads to poor blood supply to the tissues and poor clotting function. 

There may be no symptoms early on in the disease. The symptoms may be fatigue, dizziness, weakness, fever, night sweats, easy bruising or bleeding easily, headache, recurrent infections, swollen lymph nodes, weight loss, bone and joint pains, visual problems, ringing in the ears, and seizures. 

Diagnosis of leukaemia may involve tests like blood tests, bone marrow biopsy, scans, and examination of spinal fluid to check for spread of the cancer. 

With treatment, some patients get completely cured. The treatment chosen depends on the type of cancer and how far it has spread. Treatment options include chemotherapy, radiotherapy, immunotherapy, stem cell transplants, and surgery to remove the spleen.

Dear Doc,

I am concerned that my five-year-old daughter is not able to speak well like her age-mates, even though she interacts well with them. Even her teacher is concerned. What could be the problem?

Dear reader, 

Speech builds up over the first few years. By the age of four, a child should have more than a thousand words in their vocabulary. The child should also be able to identify colours and shapes, name body parts, narrate a story, and make sentences that have four to five words.

While children do not develop the same way, there are several possible causes of delay in development of speech, including:

- Structural problems in the mouth like cleft lip and palate, or tongue-tie, which would cause challenges with formation of words

- Problems with hearing

- Problems with the brain and the nerves due to cerebral palsy, brain injury, etc. 

- Developmental disorders like autism spectrum disorder and mental retardation 

- Auditory processing disorder, which is a problem with understanding speech sounds

- Speech apraxia, which is difficulty in carrying out speech movements

- Severe environmental deprivation. This happens when the child is neglected or is being abused, or if no one talks to them for long periods of time

It is advisable for your daughter to be evaluated by a developmental specialist, or a paediatrician, and an ENT specialist. The best course of action will be determined by what the underlying problem is. It would also be beneficial for her to work with a speech therapist or a speech-language pathologist.

In all settings, actively engage the child and spend a lot of time communicating with her: talking, playing games, singing, and reading with her. Have active speech. That is, use gestures together with words. Also, describe activities, processes, feelings, items, and animals.  

Maintain eye contact when talking to her and when she is communicating back; ask her questions and allow her a lot of time to respond. Encourage her to give narratives, like describing what she has eaten or a journey or an experience. 

Also, interaction with other children her age will encourage speech.

You also have to work closely with the teacher in school so that she is able to get individualised attention as much as possible.

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