Hair Loss Treatments

Causes and Solutions for Hair Loss

Hair loss, medically known as alopecia, is a condition where there is a partial or complete loss of hair from the scalp or other body parts. It can manifest in various forms, from minor thinning to complete baldness, and can affect both men and women at any age. While it is natural to lose up to 100 hairs per day as part of the normal hair growth cycle, excessive hair loss may indicate an underlying condition that requires attention.

Hair loss is a common concern, with millions of people affected worldwide. It is estimated that up to 50% of men experience some degree of male pattern baldness by the age of 50.

Hair Loss Causes and Risk Factors

Hair loss can arise from a variety of causes, ranging from genetic predisposition to environmental factors and underlying medical conditions. Male and female pattern hair loss, known as androgenetic alopecia, is primarily driven by genetic factors and hormonal changes. In men, it is linked to dihydrotestosterone (DHT), a derivative of testosterone that affects hair follicles. Women may experience this type of hair loss due to hormonal imbalances, particularly during menopause.

• Alopecia areata is an autoimmune condition where the body’s immune system mistakenly attacks hair follicles, leading to patchy hair loss.
• Telogen effluvium is often a response to physical or emotional stress, such as surgery, illness, or childbirth, which pushes a large number of hair follicles into the resting phase, causing diffuse hair shedding.
• Scarring alopecia, also known as cicatricial alopecia, results from inflammatory conditions that destroy hair follicles and replace them with scar tissue, leading to permanent hair loss.

Risk Factors for Hair Loss

Several groups are at higher risk of experiencing hair loss. Age is a primary risk factor, with the likelihood of hair loss increasing as you grow older. Genetic predisposition is another significant factor, especially in androgenetic alopecia, where a family history of hair loss increases your risk. Men are generally more prone to pattern hair loss due to the influence of male hormones, although women are not immune.

Lifestyle choices, such as a poor diet, smoking, and lack of proper hair care, can also increase the risk of hair loss. Additionally, individuals with autoimmune diseases or those undergoing treatments like chemotherapy are at a heightened risk of developing hair loss.

Hair Loss – Symptoms and Diagnosis

Hair loss can manifest in several ways, depending on the underlying cause. Androgenetic alopecia typically presents as a receding hairline and thinning crown in men, while women may notice a widening part or overall thinning on the top of the scalp.

Alopecia areata is characterised by sudden, round patches of hair loss on the scalp or other body parts. In severe cases, it can lead to complete baldness, known as alopecia totalis.

Telogen effluvium causes diffuse thinning across the entire scalp rather than bald patches. The hair shedding may be sudden and noticeable, particularly after washing or brushing your hair. Scarring alopecia, on the other hand, may present with symptoms such as redness, itching, and pain in the affected areas, along with permanent hair loss in patches where the follicles have been destroyed.

Symptom severity can vary widely. Some people may experience only mild thinning, while others might face extensive hair loss.

Hair Loss Consultation and Diagnostic Process

Diagnosing hair loss begins with a thorough clinical examination by a dermatologist like Dr Dalia. Your medical history, including any recent illnesses, stressors, or medication use, will be reviewed. The pattern and severity of hair loss will be assessed, often using trichoscopy—a non-invasive, detailed examination of the scalp and hair follicles under magnification. Trichoscopy can provide valuable insights into the type of hair loss and help distinguish between different forms of alopecia.

In some cases, additional tests may be needed to confirm the diagnosis. Blood tests can identify underlying conditions like thyroid disorders or nutritional deficiencies that may contribute to hair loss. A scalp biopsy might be performed if scarring alopecia is suspected, allowing for microscopic examination of the hair follicles.

Early and accurate diagnosis is vital for effective treatment. Identifying the specific type of hair loss ensures that the appropriate therapeutic approach is taken, potentially reversing or halting the progression of the condition.

Different Types of Hair Loss

Hair loss is not a one-size-fits-all condition; it comes in various forms, each with distinct characteristics.

• Androgenetic alopecia, or pattern hair loss, is the most common form. In men, it typically starts with a receding hairline and progresses to balding at the crown. Women, however, usually experience diffuse thinning on the top of the scalp while maintaining their frontal hairline.
• Alopecia areata is another significant form of hair loss, characterised by sudden, round patches of hair loss on the scalp or other body areas. It can progress to alopecia totalis (complete scalp hair loss) or alopecia universalis (total body hair loss). The exact cause is unknown, but it is believed to be an autoimmune disorder.
• Telogen effluvium is a temporary form of hair loss that occurs after a shock to the system, such as surgery, childbirth, or significant stress. It causes diffuse thinning of hair across the scalp, which usually resolves once the underlying trigger is addressed.
• Scarring alopecia, or cicatricial alopecia, is a rarer form where inflammation destroys hair follicles, leading to irreversible hair loss in the affected areas.

Treatment Options for Hair Loss

Medical Treatments

Treating hair loss effectively often hinges on the underlying cause, and medical treatments are typically the first line of defence. For androgenetic alopecia, the most common form of hair loss, there are two main medications that are frequently prescribed. One of them (minoxidil) is a topical treatment available over-the-counter in various strengths. It works by prolonging the anagen (growth) phase of the hair cycle, thereby promoting hair regrowth and slowing down hair loss. Consistent use is essential, as discontinuation often leads to a return of hair loss.

The other one (finasteride) is an oral medication primarily used in men. It works by inhibiting the conversion of testosterone to dihydrotestosterone (DHT), the hormone responsible for shrinking hair follicles in androgenetic alopecia. This medication can effectively halt hair loss and promote regrowth in some men, but it must be taken continuously to maintain results. Women of childbearing age are typically not prescribed finasteride due to the risk of birth defects.

For alopecia areata, treatments focus on modulating the immune system. Corticosteroids, particularly intralesional injections, are commonly used to reduce inflammation and suppress the immune response targeting hair follicles. Topical corticosteroids can also be applied, although they are generally less effective. Other immunosuppressive treatments, such as topical immunotherapy with diphencyprone (DPCP) or systemic treatments like methotrexate, may be used in more severe cases.

Telogen effluvium often resolves on its own once the underlying trigger is addressed, but supportive treatments can be beneficial. Nutritional supplements, particularly those containing iron, zinc, and biotin, may help restore hair health. In cases where telogen effluvium is caused by hormonal imbalances, such as thyroid dysfunction, treating the underlying condition is key to resolving the hair loss.

Scarring alopecia requires a more aggressive approach, as the goal is to halt the inflammatory process before permanent scarring occurs. Oral antibiotics, such as doxycycline, are often prescribed for their anti-inflammatory properties. Hydroxychloroquine, an antimalarial drug, is another option used to reduce inflammation in these cases. In more severe instances, systemic corticosteroids or immunosuppressants like cyclosporine may be necessary to control the condition.

Alternative and Complementary Treatments for Hair Loss

In addition to conventional treatments, you might explore alternative and complementary therapies to manage hair loss.

• Herbal remedies, such as saw palmetto and ginseng, are often touted for their potential to promote hair growth. Saw palmetto, in particular, is believed to work similarly to finasteride by inhibiting DHT production, although more research is needed to confirm its efficacy.
• Aromatherapy with essential oils like rosemary, lavender, and peppermint is also popular for promoting hair health. These oils are believed to improve scalp circulation and stimulate hair follicles when massaged into the scalp. While the evidence is mostly anecdotal, these treatments are generally safe when used as directed and can be a pleasant addition to a comprehensive hair care routine.

Tips for Hair Loss Prevention

Preventing hair loss involves a combination of proactive measures aimed at maintaining the health of your hair and scalp. While it may not be possible to prevent all types of hair loss, particularly those with a genetic or autoimmune component, certain strategies can reduce the risk and slow the progression of hair thinning.

One of the most effective preventative measures is maintaining a healthy diet. Nutrient deficiencies, particularly in iron, zinc, vitamin D, and biotin, are linked to hair loss. Ensuring that your diet includes a variety of nutrient-rich foods, such as leafy greens, nuts, seeds, fish, and eggs, can support hair health. If you suspect a deficiency, consider speaking with your dermatologist about the need for supplements.

Avoiding harsh hair treatments is another important step in preventing hair loss. Frequent use of heat-styling tools, chemical relaxers, and colouring agents can weaken the hair shaft, leading to breakage and thinning. Opting for gentler styling methods, using heat protectants, and allowing your hair to air-dry whenever possible can minimise damage.

Stress management plays a vital role in preventing stress-related hair loss, such as telogen effluvium. Chronic stress can disrupt the hair growth cycle, pushing more hairs into the resting phase and leading to increased shedding. Incorporating stress-reducing activities into your routine, such as yoga, meditation, or regular physical exercise, can help maintain a healthy hair growth cycle.

Protecting your scalp from environmental damage is another important preventative measure. Excessive sun exposure can damage the scalp and weaken hair follicles, leading to hair loss. Wearing a hat or using hair products with UV protection can shield your scalp from harmful rays. Additionally, avoiding harsh environmental conditions, such as extreme cold or wind, can prevent scalp irritation and hair breakage.

FAQs for Hair Loss Causes and Solutions

Can hair loss be reversed?

• The possibility of reversing hair loss depends on the underlying cause. In cases of temporary hair loss, such as telogen effluvium, hair often regrows once the trigger is removed. For conditions like androgenetic alopecia, treatments like minoxidil and finasteride can help slow down hair loss and promote regrowth in some patients, but these treatments must be continued to maintain results. Alopecia areata can sometimes resolve on its own, but other cases may require ongoing treatment.

Is hair loss hereditary?

• Yes, hair loss can be hereditary. Androgenetic alopecia, the most common type of hair loss, is strongly linked to genetics and can be inherited from either parent. If you have a family history of hair loss, particularly if it started at an early age, you may be at a higher risk of developing similar patterns of hair thinning or baldness.

How long does it take to see results from hair loss treatments?

• The timeline for seeing results from hair loss treatments varies depending on the treatment and the patient. For example, minoxidil typically requires at least 3 to 6 months of consistent use before noticeable results appear. Hair transplantation results can take several months to become fully apparent as the transplanted hair follicles go through their growth cycle. It’s important to have realistic expectations and be patient when undergoing hair loss treatments.

Can hair loss be a sign of an underlying health condition?

• Yes, hair loss can sometimes indicate an underlying health condition. For example, thyroid disorders, iron deficiency anaemia, and polycystic ovary syndrome (PCOS) are all conditions that can cause hair loss. If you are experiencing unexplained hair loss, it’s important to seek medical advice to rule out any underlying health issues.

When to See a Dermatologist for Hair Loss

You should consider seeing a dermatologist if you notice sudden or severe hair loss, if your hair loss is accompanied by itching or scalp discomfort, or if you are distressed by the changes in your hair. Early intervention can help identify the cause of your hair loss and allow for more effective treatment options.

If you’re concerned about hair loss and want to explore your treatment options, don’t wait—early intervention can make a significant difference. Schedule a consultation with Dr Dalia today to receive a personalised assessment and start your journey towards healthier, fuller hair.

Medical References for Hair Loss

• Telogen Effluvium
• Female pattern hair loss: A comprehensive review
• New Treatments for Hair Loss
• Common causes of hair loss – clinical manifestations, trichoscopy and therapy
• Role of vitamin D in hair loss: A short review

Further Reading on Skin Conditions & Concerns

• Read more about Eczema and Psoriasis
• Read more about Pigmentary Disorders
• Read more about Rashes
• Read more about Acne and Rosacea
• Read more about Mole Removal