Hair loss refers to an imbalance where one loses more hair strands than are newly formed.
Hair loss can be attributed to various factors, with some of the most common ones being:
Heredity:
Heredity is the primary cause of male pattern baldness.
Stress:
Prolonged periods of high pressure and stress, or sudden life crises, can trigger this type of hair loss. It often occurs abruptly, but the hair usually regrows once the stress subsides.
Aging:
As we age, the number of healthy, active hair follicles decreases, resulting in thinner hair over time.
Nutritional deficiencies:
Insufficient nutrients can prevent the hair follicle from receiving all the necessary vitamins and minerals for proper functioning.
Infections:
Infections can cause sudden hair loss, and it often occurs a couple of months after the infection.
Inflammation:
Various inflammatory conditions can lead to hair loss, and in rare cases, they can cause scarring where hair cannot regrow.
Medications:
Drug interactions can sometimes result in hair loss, with cancer treatment being one of the most well-known examples. Hair usually regrows once the medication is discontinued.
Each strand of hair grows out of a small hole (cavity) in the skin called a follicle. Over time, the follicle shrinks, resulting in thinner and shorter hair strands. Eventually, it shrinks so much that it stops producing any hair strands at all.
Depending on the type of hair loss, the follicles may still be functional to some extent and can be reactivated to a certain degree. In other types of hair loss, the follicles have been destroyed, making reactivation no longer possible.
Hair loss can occur due to various causes and in many different ways. It can happen suddenly or gradually, affecting only the scalp, specific body parts, or the entire body. Signs and symptoms of hair loss may include:
Gradual thinning on the top of the head:
This is the most common type of hair loss, which becomes more noticeable with age. In men, hair often starts receding at the hairline on the forehead. Women, on the other hand, typically experience widespread thinning across the entire head. An increasingly common pattern among women is receding hairline on the forehead, also known as frontal fibrosing alopecia.
Circular or patchy bald spots:
Some people lose hair in a way that leaves circular or patchy bald spots on the scalp, beard, or eyebrows. The affected skin may itch or be painful before the hair falls out.
Sudden hair loss:
Physical or emotional shocks can cause hair to loosen and fall out. It is often noticed when combing or showering, with large amounts of hair strands coming off the scalp. This type of hair loss usually results in general hair thinning but is temporary.
Hair loss all over the body:
Certain conditions and medical treatments, such as chemotherapy for cancer, can result in hair loss throughout the entire body. If the cause is a medication or infection, hair usually grows back once the treatment or illness is over.
Circular patches with scaling that spread across the scalp:
Suspicion of ringworm, which is a contagious fungal infection. It may be accompanied by broken hair, redness, and swelling.
If you find that you are losing more hair than usual or that your hair is thinning in a way that is unexpected, it may be beneficial for you to seek professional help from your healthcare provider.
The investigation of hair loss varies depending on the type of hair loss you are experiencing. The first step when visiting a doctor is to answer a series of questions focusing on:
Your hair loss
When did you start losing hair?
Did it happen suddenly or gradually over time?
How much hair has fallen out?
Where on your body have you lost hair?
Your well-being and habits
Have you been under stress lately?
What are your sleep patterns like?
What are your dietary habits?
Any other symptoms of conditions that could cause hair loss?
Your medical history
Do you have diabetes?
Thyroid disease?
Gluten intolerance?
Lupus?
Anemia?
Have you recently had an infection?
Have you recently experienced unusual rashes or itching?
Have you had a fever in the past three months?
Medications you are taking
What medications are you currently taking?
Have you recently completed a treatment?
Did the hair loss begin in relation to a new medication?
Hereditary factors
Is there a family history of hair loss?
Do any of your parents or grandparents have thinning hair or are bald?
Based on how these questions, along with a few others, are answered, the doctor will have a better understanding of the risk factors you may have for different types of hair loss. Depending on this assessment, you will receive recommendations and, in some cases, further investigation or treatment.
In men, the most common cause is hereditary factors.
There are several types of medications that can cause hair loss. Common examples include:
Antidepressant medications
Blood thinners
Birth control pills
Lithium
Chemotherapy drugs
The treatment for hair loss depends on its underlying cause. Just as certain treatments are only applicable to specific causes, there may also be cases where no treatment is available for certain types of hair loss. Hair loss can be classified into two the two categories temporary and permanent hairloss.
A common characteristic of temporary hair loss is that it can be transient, and the hair can regrow without permanent interventions.
Examples of causes behind temporary hair loss include:
Stress
Hair loss caused by stress is treated by reducing the level of stress in your daily life. Once stress levels decrease, hair begins to recover, and within a few months, hair usually regrows.
Medication
If hair loss begins in conjunction with starting a new treatment or changing medications, it is important to consult your doctor and inform them of this. If the doctor suspects that the medication is causing the hair loss, it may be necessary to switch to a different medication or discontinue the treatment. Hair often grows back when the medication causing the hair loss is removed or replaced.
Infections
Hair loss resulting from a previous fever infection typically occurs after a couple of months to three months.Infections of the scalp, such as various fungal infections, may require specific treatment. As this hair loss is a byproduct of the infection, the hair will gradually recover without any additional treatment.
Nutritional deficiency
Hair loss due to nutritional deficiencies diminishes when the deficiency is addressed. The treatment involves supplementing the lacking nutrients. By rectifying the nutritional deficiency, over time, the hair will start to grow back. Some nutritional deficiencies that can cause hair loss include:
- Iron deficiency
- Zinc deficiency
- Riboflavin deficiency (B2)
- Biotin deficiency (B7)
- Folic acid deficiency (B9)
- Vitamin B12 deficiency
- Vitamin D deficiency
In the case of permanent hair loss, treatments are not available in the same way as with temporary hair loss. As the name suggests, permanent hair loss is irreversible and therefore does not come back, even with attempts at treatment. However, this does not mean that there are no measures that can slow down the process or even replace lost hair.
Examples of causes behind permanent hair loss are hereditary (androgenetic), age-related (senile), alopecia areata and scar-forming conditions.
Hereditary hair loss is not dangerous and does not require treatment. There are different types of interventions for hereditary hair loss, which can be categorized into slowing down measures, partially treating measures and hair replacement.
Slowing down measures refer to actions that can be taken to reduce hair wear and minimize the friction experienced by hair follicles. Friction and wear are common causes of hair loss becoming more noticeable than it would need to be.
Examples of slowing down measures include:
- Washing the hair less frequently
- Avoiding tight hairstyles
- Refraining from using headgear such as caps or hats
Partial treatment measures are those that can partially restore lost hair. It is important to note that these measures do not address the underlying cause. Instead, their purpose is to reduce the effects of hair loss. While they also have a slowing effect, they are distinguished from purely inhibitory measures because they aim to regenerate hair follicles.
There are two main medications primarily used for hereditary hair loss in men. These are:
Minoxidil (also known as Rogaine)
Minoxidil is an over-the-counter medication available in the form of foam or liquid, which can be directly applied to the scalp. Minoxidil extends the hair growth phase and stimulates more hair follicles to produce hair. The effects of minoxidil usually become noticeable after 4-6 months. During the first two months, you may experience increased hair loss, but it does not mean the treatment is ineffective. Hair growth typically begins after 4-8 months, and the effects of the treatment usually stabilize after 12-18 months. Minoxidil must be used regularly to maintain its effectiveness. If treatment is discontinued, the benefits of the treatment will diminish.
Finasteride (also known as Propecia)
Finasteride is a prescription medication available in tablet form. Its primary function is to prevent the conversion of testosterone into the more potent dihydrotestosterone (DHT). In individuals experiencing hereditary androgenetic hair loss, the hair follicles are particularly sensitive to DHT. By reducing DHT levels, this medication counteracts the process that shrinks hair follicles, thus preventing hair loss. It is important to consult your doctor before considering the use of Finasteride.
There are a few products on the market that emit low-level laser light, which has been observed to be effective for some individuals with hereditary hair loss. These products are used a few times a week, with each session lasting several minutes.
This procedure involves extracting plasma from your own blood and injecting it into the scalp. The idea behind this approach is that the platelets, which are involved in wound healing, can stimulate hair growth.
Note: Studies have shown that this procedure has an effect on hair loss, but the scientific community has yet to reach a consensus on the optimal use of this method and its long-term effects. Further research is required.
Hair replacement refers to the measures taken to replace lost hair. The two most common methods of hair replacement are:
Hair Transplantation
This procedure involves transplanting hair follicles from one area of the scalp to another, typically where hair loss has occurred. It is a surgical technique that aims to restore hair growth in areas of thinning or baldness.
Products that camouflage hair loss
There are various products available that can help conceal hair loss. These include:
Wigs: Wearing a wig can provide a natural-looking solution to hair loss. Wigs are available in different styles, colors, and materials to suit individual preferences.
Scalp-coloring spray: This type of spray is used to color the scalp in a shade that matches the individual's hair color, creating the illusion of fuller hair.
Hair color: Changing the hair color can help mask the appearance of thinning hair by creating more contrast between the hair and the scalp.
Thickening shampoos: Certain shampoos are formulated to add volume and thickness to the hair, giving the appearance of fuller, denser hair.
With age-related hair loss, the function of hair follicles diminishes due to the natural aging process. While it is not possible to reverse or completely prevent this type of hair loss, there are treatments available that may help slow down the progression. One common treatment option for this type of hair loss is a stronger cortisone medication, known as a Group III steroid. However, it is important to note that the effectiveness of the treatment will vary for each individual, and improvement cannot be guaranteed. If treated with cortisone, your doctor will evaluate the progress of the treatment regularly to determine its efficacy.
Alopecia areata (AA) is an autoimmune condition that results in the destruction of hair follicles. AA can be temporary for some individuals and permanent for others. It is often triggered by significant emotional stress or an infection. Currently, there is no effective treatment for AA, and self-healing attempts are preferred. In some cases, potent steroids (corticosteroids) may be attempted in consultation with your doctor.
Scarring conditions as a cause of permanent hair loss involve skin damage that prevents hair from growing in that area. There are no treatments available for scarring hair loss, but preventive measures can be implemented to prevent the spread of scarring. Skin scarring can occur due to various reasons, and some common conditions associated with hair loss (and lack of hair regrowth) include:
Severe acne
Intense inflammations such as deep folliculitis
Deep scalp infections
Radiation damage to the scalp
Burn injuries
Less common conditions that can cause this are:
Discoid lupus erythematosus
Secondary syphilis
Since hair naturally sheds and regrows, it is impossible to completely avoid hair strands falling out. However, you can reduce the risk of increased hair loss by maintaining good hair hygiene. Here are a few things to keep in mind:
Avoid hairstyles that pull on the hair, such as braids, knots, and man buns.
Steer clear of products that heat up the hair to prevent drying out the hair follicles, such as hairdryers, straighteners, and curling irons.
Avoid chemical hair treatments like bleaching, as they can damage the keratin.
Hereditary hair loss is primarily influenced by genetic predisposition. Therefore, there are limitations to what can be done to prevent it. However, there are behaviors that can reduce the rate of hair loss. These include:
Washing your hair less frequently: When you wash your hair, you pull on the hair strands, leading to more shedding compared to if you wash it less often and minimize the frequency of hair pulling.
Avoiding the use of hats or caps: Wearing headgear causes friction and strain on the hair every time you put it on or take it off. This friction increases the risk of pulling out more hair strands compared to completely avoiding headgear altogether.
Avoid tight hairstyles: When styling your hair in a man bun, a tightly pulled braid, or a ponytail, the initial pulling of the hair to achieve the desired look can have a persistent effect. Scientific evidence has shown that this can cause hair thinning, even in individuals without genetic predisposition. Therefore, it is advisable to avoid such hairstyles in order to reduce the risk of further hair loss.
Maintain a balanced and varied diet: Nutritional deficiencies are a clear cause of hair loss, so it is important to keep this in mind. Neglecting your diet can increase the risk of additional hair loss, but being more mindful about your nutrition can help eliminate this risk.
Consider medication: There are various medications available, including creams and tablets, that can indirectly slow down hereditary hair loss. They work by attempting to reduce the hair follicles' sensitivity to androgens. By taking medication that decreases this sensitivity, the impact of androgens on the hair follicles is also diminished. As with any medication, there are potential side effects. It is always advisable to consult your doctor before starting any medication.
There are numerous risk factors associated with hair loss, some of the most common being:
- Genetic predisposition from either the mother's or father's side
- Advanced age
- Significant weight loss
- Certain medical conditions such as diabetes, lupus, and thyroid disorders
- Stress
- Nutritional deficiencies
Currently, it is not possible to definitively predict whether or not you will experience hair loss in the future. However, the likelihood is considerably higher if there is a history of hair loss or thinning hair on your mother's or father's side of the family.
There are a few situations related to hair loss that may require professional assistance. These situations include:
- Concurrent itching, pain, or rashes on the scalp
- The appearance of bald spots that were not present before
- Experiencing an unusually large amount of hair loss
- Noticing a rapid increase in thinning hair
- Observing hair thinning or loss in areas other than the head