Hair Loss: Causes, Symptoms, Solutions | Everything you need to know

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Guide, Hair loss | HairMD | June 1, 2021

What is hair loss?

The medical term for hair loss is alopecia. It occurs due to hormonal changes, heredity, medical conditions, or as a part of the normal aging process. Alopecia may affect only the scalp or the hair growth on the entire body and may be permanent or occur as a temporary phase. Although hair loss can be a problem for anyone including children, it is more common in men.

Hair growth happens in four cycles: Anagen, Catagen, Telegen, and Exogen. Anagen is the growth phase, the longest among all, in which the growth of hair begins. Catagen is the transition phase when hair follicles shrink and hair growth slows. Telogen is the resting phase when hairs don’t grow at all, but they also don’t fall out. The last stage Exogen is the shedding phase when hairs fall out and new hairs start growing in the follicles. This cycle repeats.

Generally, we lose about 50 to 100 strands of hair every day, but that is completely normal. Besides, this small hair loss isn’t noticeable considering the 100,000 hairs that the average human head has. The problem arises when you start losing more hair than usual or if you notice clumps of hair falling out every time you brush or wash your hair. You might also notice thinning hair or bald patches on the head. In this case, it is recommended to consult a doctor to determine the underlying cause of your hair loss problem and start the appropriate hair loss treatment plan.

Hair Loss Symptoms

Hair loss symptoms can appear differently in individuals depending on the underlying reasons behind it. Some of the signs and symptoms of hair loss include:

The hair on top of the head starts thinning gradually:

 This type of hair loss is quite common and affects people as they age. In men, the hair typically starts to recede at the temples; thinning of hair and hair-loss in the crown are also quite prevalent. Women see broadening of their hair parting; in addition, they experience hair-thinning, as well as loss of hair throughout the scalp. 

Bald spots start appearing in circles or patches:

In some people, hair loss can occur as circular or patchy bald spots on the scalp. They may experience itchiness or pain on the skin before the hair on the area falls out.

Sudden loosening of hair:

Sometimes, the hair roots may loosen from the scalp due to a physical or emotional shock, and they will fall off when brushing or washing the hair. This leads to hair thinning but that is temporary.

Hair loss from the body:

Loss of hair from all over the body may occur as a consequence of certain medical conditions and treatments, for example, chemotherapy for cancer. The hair usually regrows within three to six months after the treatment.

Scaly patches over the scalp:

If the hair loss is due to scaly patches over the scalp, it is a sign of ringworm infection. The scaly patches may also appear due to psoriasis, which is an autoimmune disorder causing the skin cells to grow too quickly.

Types of Hair Loss

Hair loss can be categorized in several different ways. Typically, the doctor will examine the scalp first to identify whether the hair loss is caused due to physical destruction or loss of hair follicles, also called scarring or cicatricial alopecia. If there is no scarring and the scalp appears normal with sufficient empty hair follicles, it is called non-cicatricial alopecia. Non-scarring alopecia can also result due to physical or chemical damage to the hair shaft.
Other types of hair loss include –

Patchy hair loss

The hair loss may occur over small or large areas of the scalp depending on the underlying condition. Some of the causes of patchy hair loss are:

Alopecia areata:

Alopecia areata is a common skin condition that starts as a coin-sized bald patch and regrows over time without treatment. It can also affect the hair on other body parts, such as the beard and eyebrows. In its most extensive form called alopecia totalis, the entire scalp goes bald.

Traction alopecia:

Repetitive or persistent pulling or traction on hair roots due to tight braids and ponytails can lead to localized hair loss called traction alopecia. It is therefore recommended to choose hairstyles that don’t put a lot of tension on the hair.

Trichotillomania:

This is a mental disorder characterized by habitual pulling or twisting of one’s hair. The treatment for trichotillomania involves stress counselling with a therapist. Antidepressants or anti-anxiety medications may also be prescribed.

Tinea capitis:

It is a fungal infection of the scalp mostly affecting school-age children. Tinea capitis causes bald spots or broken-off hairs accompanied by dermatitis.

Diffuse hair loss

In diffuse alopecia, hair density reduces all over the scalp. Common causes of diffuse alopecia are –

Pattern alopecia:

Here, the top and front of the scalp are affected. In men, pattern hair loss is characterized by loss of hair on the crown and a receding hairline. Women tend to experience thinning hair, as well as hair-loss on top of the scalp (mainly in the parting line), from female-pattern hair loss.

Drug-induced alopecia:

Certain medications such as the ones used for chemotherapy can lead to loss of actively growing hair. Antihypertensive medications like beta-blockers and ACE inhibitors can rarely lead to hair loss in some individuals.

Protein malnutrition:

Occasionally, lack of protein in the diet or abnormal eating habits may cause people to develop protein malnutrition which can lead to hair loss.

Alopecia induced due to systemic disease:

Systemic disease, such as endocrine disease (like thyroid disorder and PCOS) can lead to hair loss.

Telogen effluvium 

This is a type of hair loss that happens after a stressful experience. If you’re under a lot of stress or have gone through a traumatic event, you may experience this type of hair loss. Good thing is it’s temporary and reversible. The hair grows back and gets in shape after you’re back to your “normal” emotional and mental-self; after the stress or shock of any event has receded. In that, the treatment usually involves reducing your stress and calming yourself down. Meditation and exercise may help with this.

Nutritional deficiency

Nutrition intake plays a key role in our overall health of the hair. Any deficiency, especially in iron, vitamins, minerals and trace elements, can cause hair loss.

How Is Hair Loss Diagnosed?

Hair loss diagnosis starts through a  physical examination and investigation. The doctor or dermatologist will also ask about your diet and medical and family history. Some of the tests that may be ordered are-

  • Blood test is necessary to determine whether there are any medical conditions that may be the reason behind hair loss.
  • The doctor will perform a pull test to determine which stage of the shedding process are your hair at.
  • Dermoscopy of scalp skin. It involves examining the hair and scalp skin using either a manual dermoscope or a video-dermoscope. It’s a quick and simple method that helps in the diagnosis of a range of hair-related problems, including alopecia and telogen effluvium.
  • A scalp biopsy will be conducted which involves taking samples from the skin and hair from the scalp to check the condition of the roots under a microscope. A scalp biopsy, which is uncommon, can help to determine if the hair loss is the result of an infection or an autoimmune underlying skin disease.
  • A special technique called light microscopy is used where the doctor examines the hair trimmed at their bases to identify any disorders affecting the hair shaft.

Treatment Options for Hair Loss

If you are experiencing hair loss due to an underlying disease, getting treatment for the disease usually solves the problem. Thereon, maintenance of the treatment may not necessarily be required. That said, it’s important to note:

  • Cicatricial hair loss, also called scarring alopecia, is difficult to treat. The hair follicles are permanently destroyed and get replaced with scar tissue. This usually starts with small patches and the initial-days symptoms may go unnoticed. Early diagnosis (through biopsies) can help establish the problem. The should be followed by aggressive measures, which can include medications and topical creams, to prevent the progression of scarring alopecia.
  • Pattern baldness, following treatments, does demand consistent care and maintenance. This is to ensure the problems don’t return and that the outcome of the treatment lasts longer.

Some types of hair loss can be effectively treated. Here are some of the common hair loss treatment options available.

Topical,oral, and procedural intervention

Topical treatment

  • Minoxidil:Minoxidil for hair loss is available in the form of lotion, foam and gel. It can be applied to the scalp once or twice a day or as directed by the doctor. It needs to be used at least for six months to slow down the rate of hair loss and start hair regrowth. If the medication works well, you need to continue using it in pattern baldness to maintain the benefits. Possible side effects of using minoxidil include scalp irritation, dryness, flaking, itching, redness, as well as hair growth on the forehead or face.

Oral treatment

  •  Finasteride:Finasteride is prescribed as an oral medication for hair loss. It is an effective hair loss treatment for men and has to be taken daily to slow down the progression of hair loss and hair thinning. You have to take it for a few months before it can produce any marked results. 
    Certain rare side effects that may result from the use of finasteride are a decline in sex drive and sexual functions, which is reversible. Some small studies have also shown a link between finasteride use and prostate cancer. (Source)
  • Other medications: For individuals with alopecia areata, doctors may prescribe corticosteroids like prednisone to suppress the immune system and reduce inflammation. Spironolactone  and dutasteride are other hair loss solutions that may be prescribed in treating female and male pattern baldness respectively.

Procedural treatments

There are a range of procedural treatments that are employed to treat hair loss. The likes of Regenera Activa (Dermal Micrografts), Stromal vascular Fraction – Nanofat treatment, and micropigmentation are common. While Regenera Activa helps by activating dormant hair follicles, nanofat helps hair follicles become larger and healthier. Micropigmentation provides a fuller looking hair by applying pigment to the scalp.

Hair transplant surgery

In a hair transplant surgery, the cosmetic surgeon extracts small plugs of skin containing a few hairs (FUE) and transplants them to the bald spots on the scalp. To ease the pain from the surgery or reduce any discomfort, the patient is put under local anesthesia. The hair loss that people with inherited baldness experience is progressive, therefore, more than one surgery may be necessary to get the desired result. Post-surgery, proper maintenance must be done with minoxidil solution and oral finasteride.

Low Level Laser Therapy

For the treatment of hereditary hair loss in individuals, low level laser therapy has shown results in improving hair density as per some studies. More studies have to be conducted to determine its long-term effects.

Hair Loss Remedies

There are a variety of hair care methods for you to try and find the one that suits you better. Let’s say, for example, you can use safe hair styling products that add volume to your thinning hair or even try out a new hairstyle that makes your widening hair part less noticeable. Many people rock the bald look as well. You can talk to a hairstylist to help you with ideas and also use wigs or hair extensions.

Here are some natural hair loss remedies and approaches that you can use to address temporary or permanent hair loss and maintain healthy hair.

Regular care:

  Caring for your hair regularly is an essential step for hair loss prevention and to keep your hair healthy and strong. Avoid using hair products with harsh chemicals. It is better to go as natural as possible for your hair care regime. Besides, it is also important to keep your hair clean and gently massage it with a hair oil of your choice; hair oil acts as a conditioner that makes hair soft, smooth and easy-to-manage. Massaging will also improve blood flow to the scalp and to the hair follicles and strengthen the hair roots.

Fenugreek:

Apart from being a good source of protein and nicotinic acid, fenugreek works wonders to strengthen the hair shaft, fenugreek seeds also contain hormone antecedents that can help to restore damaged follicles and boost hair growth.

One of the best home remedies for hair loss is to apply a paste of fenugreek seeds that have been soaked in water overnight on the hair and let it rest for half an hour. You can then wash it off.

Onion Juice:

Due to the high concentration of sulfur in onion juice, it is beneficial for several conditions of hair that cause it to fall out. Applying onion juice to the scalp can revitalize the hair follicles as well as minimize inflammation. You can wash it off with shampoo after half an hour.

Jojoba oil:

Jojoba oil can be highly beneficial for people who have dry scalp, dandruff problems, and dull hair. It moisturizes the scalp and the hair follicles and helps in promoting faster hair growth.

Flax seeds:

Flax seeds are a good source of fatty acids that help in encouraging hair growth and preventing hair fall. It is recommended to consume one tablespoon of freshly grounded flax seeds with a glass of water in the morning. You can also add whole flax seeds to salads and soups.

Aloe Vera:

Massaging aloe vera gel along the scalp can soothe the scalp, clean up the sebum that clogs hair follicles, and also offer nourishment to the hair cells.

Licorice root:

Licorice roots are known to open up the clogged pores on the scalp and strengthen the hair follicles. It can be applied on the scalp as well as can be consumed in the form of licorice tea.

Egg mask:

An egg hair mask is an effective natural hair loss treatment. To prepare your egg mask, you can mix one tablespoon of olive oil and one egg in a bowl and apply the mixture on your scalp after washing your hair with shampoo. Let the mask sit on your damp hair for about ten to fifteen minutes and then wash it off.

It’s worth noting that these home remedies do not guarantee any results. Home remedies for hair loss may work for some and may not for others. Moreover, some of these remedies may leave side-effects depending on your individual case. So, if you’re indeed struggling with hair loss, it’s usually recommended to consult an expert and take any measures under their supervision.

Diet for Hair Loss: Foods for Healthy Hair

p>Unlike genetics and age, one can have control over the diet. The deficiency of nutrients is one of the causes of hair loss. To avoid hair loss problems due to deficiency, you can follow a balanced diet plan consisting of the right nutrients. Foods that are rich in vitamins, minerals, trace elements, and protein are the primary need here.

Here are some of the best foods that can help in promoting hair growth

Spinach:

Spinach is one of the best foods for hair growth. It is loaded with nutrients, such as iron, vitamins A and C, folate, etc.

Eggs:

Protein is one of the most important nutrients whose deficiency can lead to hair loss; eggs are a great source of protein that should be included in your everyday meals.

Fatty fish:

Fatty fishes are rich in omega-3 fatty acids, which can effectively promote hair growth and improve density. A few examples of these fishes are herring, mackerel, and salmon.

Meats:

Meats are a good source of protein and are helpful to make hair strong and healthy. Besides, red meat is also rich in iron, which can promote hair growth.

Sweet potatoes:

Sweet potatoes are a great source of vitamin A. Vitamin A helps increase sebum production, which subsequently boosts hair growth rate.

Hair Loss: Myths & Facts

Myth:

Pattern hair loss is common only in men

Fact:

Pattern hair loss is common in women too. While fifty percent of men will have male pattern hair loss by the time they are 50, forty percent of women will experience female pattern hair loss by the time they reach menopause.

Myth:

People with hair loss have inherited it from their father, mother, or grandparents.

Fact:

There isn’t any single gene that determines hair loss in individuals. Although genes from both parents are a contributing factor, researchers have found out that hair loss is probably caused due to the interaction between several genes from both parents. No specific person in the family is to be blamed.

Myth:

Wearing hats suffocates the scalp and leads to hair loss.

Fact:

The oxygen and nutrients that hair follicles need for their growth and nourishment comes from the blood flow to the scalp, and not from the air. So, wearing hats can’t possibly lead to hair loss.

Myth:

Shaving off the hair leads to thicker and faster hair growth.

Fact:

Everybody has a different hair cycle that determines the length and growth of their hair. It depends on their genetics and nutrition as well. If they have a long growth phase, they can grow longer hair. So, in reality, shaving off hair doesn’t lead to thicker and faster hair growth.

When To Consult A Doctor?

If your hair loss is persistent and causing distress in you or your child, it is time to consult a doctor and seek treatment. Women who are experiencing a receding hairline need to seek early treatment to avoid significant hair loss or permanent baldness.

If you are noticing sudden hair loss that is more than the usual or patchy, it could be due to an underlying medical condition. In that case, prompt medical attention is necessary.  Make sure to talk to your doctor as soon as possible.

Why Choose HairMD ?

Over the years, HairMD has helped thousands of people recover from their hair and skin problems and regain their self-confidence. We have developed personalized hair regrowth, restoration, or replacement procedures for everyone looking to get back the hair they love or always wanted. As true trichologists, our dermatologists focus extensively on clinical examination and thorough investigations to find the root cause of hair loss, which subsequently helps in defining a fitting hair loss management plan that delivers lasting results.

We understand that every individual is different and so are their problems and requirements. Therefore, the tested and proven solutions that we use for their treatment are tailored and are unique to them.

Our panel of doctors, dermatologists, and surgeons have a lot of experience and expertise in the field and can help you accurately determine the stage of your hair loss as well as offer the right solutions and professional advice. At ClearSkin, we aim to offer the best possible guidance and support to our patients throughout all the phases of their hair restoration journey.

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