Hair Loss: Everything You Need to Know

Losing 50-100 strands of hair daily is normal. Anything more than that can be worrying. Read all you need to know about hair loss and its treatments below. 

 

Author Nuffield Aesthetics 15 July 2021 | 12 mins read

Hair loss is a common phenomenon experienced by people of all ages, sizes and genders, and finding a treatment that works for you can be frustrating. In this article, you will learn about the different types, causes, symptoms and treatments for hair loss.

What is Hair Loss?

Hair loss, also known as alopecia, refers to a loss of hair from the body or head. The amount, severity and cause of hair loss differ from person to person. There are many different types of hair loss and hair loss is a condition faced by both men and women.

Types of Hair Loss

 

Androgenetic Alopecia

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Androgenetic alopecia, more commonly known as male pattern hair loss or female pattern hair loss, is the most common type of hair loss and is hereditary. It affects more than 50 million men and 30 million women in the United States alone. The treatment for this type of hair loss is usually through medication or surgery.

 

Traction Alopecia

Traction Alopecia is often a result of tight hairstyles that pull on the hair to the extent that it eventually damages and falls out of the hair shafts. Traction Alopecia can result in hair thinning and bald spots if it is consistently pulled on. The best way to cure this type of hair loss is by altering the hairstyles to loose up-dos that do not pull on the hair follicles. By doing so, it can encourage hair growth again. 

 

Telogen Effluvium

Telogen Effluvium occurs when big numbers of hair follicles on the scalp are in the “resting” phase of the hair growth cycle without triggering the next phase of hair growth. This causes hair all over the scalp to fall without forming new hair.

Telogen effluvium is commonly a temporary condition that can be resolved as long as you can determine the cause. Some possible causes include intense stress, childbirth, rapid weight loss, thyroid disease and taking certain medications.

 

Anagen Effluvium

Anagen effluvium is when significant amounts of hair are shed in the anagen (growth) phase of the hair cycle. This is the opposite of telogen effluvium where hair fall is experienced during the resting stage of the hair cycle. 

Anagen effluvium affects the scalp as well as all over the body. The causes of anagen effluvium include radiation therapy, fungal infections and chemotherapy.

 

Alopecia Areata

This is a condition where the body’s immune system attacks the hair follicles. This causes a loss of hair on any part of the body from the scalp to inside the ears to the hairs on the toes. 

Alopecia Areata is a polygenic disease which means it requires a pool of genes to be inherited from both parents to bring about the disease, as well as some contribution from the environment.

 

Tinea Capitis

Tinea Capitis, also known as ringworm, is where fungal infections affect the scalp and hair shafts. Someone experiencing this condition would have an itchy scalp coupled with scaly and bald patches on their head. Sometimes, sores and blisters with pus can develop on the scalp as well. 

tinea-capitis

 

Tinea Capitis is more common in toddlers and children and is highly contagious. Treatment is often antifungal medications that can be consumed orally and have a prescribed shampoo for the period.

 

Cicatricial Alopecia

cicatricial-alopecia

Cicatricial alopecia, also known as scarring alopecia, is a rare type of hair loss in which inflammation destroys hair follicles on the scalp and forms scar tissues in their place. Once the scar tissue forms, hair does not regrow in that area. There are many variations of Cicatricial Alopecia such as:  

 

Lichen Planopilaris

Lichen planopilaris happens when lichen planus affects the scalp. Lichen planopilaris causes dry, flaky rashes on the scalp which causes hair to drop off in handfuls. You can expect the scalp to be red, inflamed, and covered in small white or red itchy, painful bumps.

Lichen planopilaris is not a common condition and usually affects women more than men.

Discoid Lupus Erythematosus

Discoid lupus erythematosus is a variation of cutaneous lupus, which is an autoimmune disease affecting the skin. With this condition, inflamed sores and scarring form on the ears, face, and scalp and hair loss is also one symptom. When the scar tissue forms on the scalp, hair can no longer grow on that area.

 

Folliculitis Decalvans

Folliculitis decalvans is an inflammatory disorder where hair follicles are destroyed. It is common to have redness, swelling, and pus-filled, itchy sores on the scalp. When the hair follicles are destroyed, it inevitably leads to hair loss. This type of hair loss is not reversible, but there are medications to aid with the damage control and sometimes, stop the hair loss.

 

Dissecting Cellulitis of the Scalp

Dissecting cellulitis of the scalp, also known as Hoffman disease, is a rare, chronic condition, where bumps, pustules and painful nodes develop on the scalp. You can also expect scar tissue to develop, destroying hair follicles, causing hair loss. The condition, if untreated, could evolve into scarring alopecia. You may be prescribed medications to help control the symptoms.

 

Frontal Fibrosing Alopecia

Frontal fibrosing alopecia is a patterned form of scarring hair loss that happens on the frontal scalp hair region. They typically result in receding hairline and may also cause hair loss in the eyebrows and underarms. Frontal fibrosing alopecia usually affects postmenopausal women. You may be prescribed medications to manage the symptoms of the disease.

 

Central Centrifugal Cicatricial Alopecia

Central centrifugal cicatricial alopecia is a variation of scarring alopecia on the scalp. More often than not, it is a result of using excessive hair products or styling techniques that damage hair follicles. As the hair follicles are destroyed, permanent hair loss is the main effect.

The condition can also be a result of the frequent use of oils, pomades or gel. Hair loss can be reversible if you stop using these hair products or styling techniques. You may be recommended to take medication to aid the hair to grow again.

 

Symptoms of hair loss

 

According to The American Academy of Dermatology, it is normal to lose 50 to 100 hairs a day. This just means the hair is at the “resting stage” or telogen and they drop off to promote a new hair growth cycle. However, if you notice an abnormally high amount of hair fall, it is a cause for concern. Below are some symptoms of hair loss you may be experiencing. 

 

Gradual thinning of hair

This is the most common type of hair loss which affects people as they age. With age, men may notice their hairline starting to recede, exposing a larger forehead. Meanwhile, women typically experience having a broader hair part or a thinner ponytail.

 

Sudden loose hair

Physical shock can also cause hair to drop. With gentle tugging, combing or washing your hair or even after, you may notice multiple strands of hair stuck on your hand or comb. This type of hair loss causes overall hair thinning but is usually temporary and can be cured.

 

Patchy bald spots

You may also lose hair in circular or patchy spots on the scalp. This also happens to the beard and eyebrows. With this type of hair loss, the skin of your scalp often becomes itchy and painful before the hair falls out.

 

Scalp Psoriasis

Scalp psoriasis is a common skin disorder involving inflamed, raised, scaly patches on the head. It can appear as a single patch or several on part of the scalp or even your entire scalp. The condition itself does not cause hair loss. However, constantly picking and scratching at affected areas and doing harsh treatments can lead to hair loss. Fortunately, the hair loss is temporary and your hair can grow back when the skin clears up.

scalp-psoriasis

 

Causes / reasons for hair loss

 

There is a myriad of reasons and risk factors your hair may be falling from environmental factors, diet, heredity and even treatments. Some common causes include diet, family history, pregnancy, stress, age, rapid changes in hormones, medication, sexually transmitted infection, scalp infection, radiation therapy, drastic weight loss, and certain medical conditions.

 

1.Hereditary Hair Loss

The most common cause of hair fall is genetics. Due to the genes, hair fall is common in both men and women and is prevalent in any age group. It cannot really be cured but it can be controlled with diet, certain hair products and changes in hairstyles. In this type of hair loss, you normally experience hair falling from your scalp but could also fall from other parts of your body. You can normally identify genetic hair loss with male pattern baldness or female pattern baldness.

 

2. Diet

Diet has a huge impact on the external features of the body. Collagen, which is a degenerated version of the protein, is known to make your skin, hair and nails stronger. This is because your hair is mostly made up of protein. Hence, if your diet doesn’t include much or enough protein, you can expect hair loss. 

Unhealthy diets with excess consumption of sugar, fats and lifestyle choices such as binge drinking and smoking affect the quality of your hair as well. Sugar produces insulin and androgen, which shrinks hair follicles and forces the hair to fall out. Eating too many fried foods can cause testosterone levels to surge leading to a higher chance of developing male pattern baldness.

Vitamin and nutrient imbalances such as toxicity of vitamin A, B, E and an iron deficiency can affect hair loss as well. 

Another phenomenon is known as crash diet also contributes to the cause. This is when you dramatically restrict your calorie intake. This means you likely are not consuming adequate essential nutrients such as proteins, zinc and fatty acids. These deficiencies, especially if maintained over time, can lead to a type of hair loss called telogen effluvium.

 

unhealthy-vs-healthy-food 

The good news is that the hair fall is irreversible. Once you are able to pinpoint what foods are causing excessive hair loss, you will see stronger hair and less hair fall once you regulate the consumption. 

Some foods that are known to help reduce hair fall and promote hair growth include eggs, chicken, carrot, lentils, oats, walnuts,  fish, tofu, broccoli, all kinds of greens. and yoghurt.

 

3. Pregnancy

Pregnancy causes a change in hormones in women. After giving birth, women experience a decrease in the hormone, estrogen, in their body. This causes the hair follicles to go into the resting phase of the hair cycle, also known as telogen. With that, they start to experience hair fall more rapidly than they had before. The hair loss is not enough to create bald spots and it gradually improves 3 to 4 months post-delivery.

 

4. Stress

Stress is one of the most prevalent reasons for hair loss and is known as telogen effluvium. If you feel an extreme amount of stress, the hair follicles force themselves to go into the resting stage of the hair cycle where the hair falls without instigating more hair growth. If the stress persists, you can expect patchy bald spots on the scalp. There is no measurement of how much stress could cause hair loss as it is subjective to each individual. However, if your stress is managed and reduced, the good news is that hair grows back and restarts the anagen of the hair cycle once again.

 

5. Age

A side effect of age is gradual hair loss which is almost always hereditary. By the time you turn 30, you have lost about 20% of the hair on your head from a healthy head. Men can expect to lose 50% of their hair by the time they reach the age of 50 and be well into noticing they have male pattern baldness. Women, on the other hand, would have noticed female pattern baldness by the time they turn 70 where they will start to see a wider hair parting. This is very normal and they shouldn't need to worry about it.

 

6. Menopause

Similar to pregnancy, women experience hair fall due to the rapid changes in hormones. With menopause, the levels of estrogen fall drastically which then cause hair to become finer (thinner) since hair follicles shrink. Hair grows more slowly and falls out more easily in these cases.

 

7. Medication

medication-causing-hair-loss

As ironic as it sounds, medication can sometimes lead to other adverse side effects. Most of the time, medications contribute to two types of hair loss: telogen effluvium and anagen effluvium. Some common medications include birth control pills, acne medications containing retinoids, antibiotics and antifungal drugs, antidepressants, steroids and mood stabilizers. They usually cause temporary hair loss, or at least while you are on these pills.

 

8. Sexually Transmitted Infection (STIs) or Sexually Transmitted Diseases (STDs)

With STI and STDs such as chlamydia, the side effects may include temporary alopecia. If they are treated, the hair is able to grow back again. If left untreated, a sexually transmitted infection (STI) can lead to further, more serious hair loss. For instance, syphilis, if left untreated, can cause patchy hair loss on the scalp, eyebrows, beard, and elsewhere. Therefore, it is important to get yourself tested for sexual infections and diseases before the matter escalates.

 

9. Scalp Infection

There are few types of scalp infections that could lead to hair fall like ringworm (also known as Tinea Capitis), Folliculitis and Piedra. Most of these infections are caused by fungus taking over the scalp and hair follicles, disrupting the normal hair growth cycle and therefore leading to hair loss. 

 

10. Radiation Therapy

Radiation therapy is a treatment for cancer patients that uses high-beam rays like X-rays and protons to kill off cancer cells in the affected area.. Due to the exposure to radiation, hair is induced to fall. The process of hair fall usually starts 2-3 weeks after therapy has begun and typically leads to hair falling in chunks. Hair grows back after the treatment.

 

11. Drastic Weight Loss

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Drastic weight loss can cause hair fall. This is due to nutrient deficiencies or strict diets that limit receiving all the nutrients for the body to function well. Fluctuations in the bodyweight cause physical stress and signal the hair follicles to move into the telogen stage. Hair loss after weight loss is usually associated with Telogen Effluvium.

 

12. Certain Medical Conditions

Certain medical conditions such as thyroid, diabetes and lupus can cause hair loss. With thyroid, due to hormonal changes, the hair growth cycle is affected, causing it to move into the telogen stage which leads to hair fall. Hence, it is crucial to get the right medications to put a pause to the condition without elevating it.

 

Treatments for hair loss 

 

Once you are experiencing hair loss, it is important to investigate the causes and treat accordingly to prevent further hair loss. As you have read, hair loss has many different causes and therefore, needs different treatments. Some hair treatments include medication, specific hair products and if all else fails, professional intervention. 

Early stages of hair loss can be treated with oral and topical medication and do not require surgical intervention. With some of the types of hair loss, the effect may even be reversible if certain hair products, styling tools or hairstyles are either changed or completely not used on the scalp anymore. Therefore, it is important to diagnose your hair loss properly and early via consultation with standard blood tests, pull tests, scalp biopsy and light microscopy.

 

1. Medication

There are oral and topical medications that specifically aim to reduce hair fall. Below are some instances:

 

  • Finasteride (Propecia) is an oral prescription for men experiencing hair loss. It encourages the hair to move into the anagen stage of the hair cycle by blocking the conversion of testosterone to DHT (dihydrotestosterone), which decreases the amount of DHT in the body. DHT is the hormone that causes hair loss.

    You are required to take it daily and it may take a few months to see noticeable results. If your scalp does not show adverse reactions, you will need to continue using the medication to ensure the benefits can be sought to their full potential. Finasteride may not work as well for men over 60.

    Some side effects of finasteride, although rare, include lower sex drive and sexual function. Women who are or may be pregnant need to avoid touching crushed or broken tablets as there is a possibility of absorption which subsequently leads to the potential risk to the fetus.

 

  • Minoxidil (Rogaine) is an over-the-counter product that comes in liquid, foam and shampoo forms. You are directed to apply the product to the scalp twice a day for men and once a day for women. Depending on the condition of your hair loss and scalp, the product takes at least six months to show noticeable results, preventing further hair loss and starting a new cycle of hair regrowth. If your scalp does not show adverse reactions, you will need to continue using the medication to ensure the benefits can be sought to their full potential. Some possible side effects of Minoxidil include scalp irritation and unwanted hair growth on the face and hands. If you are experiencing these symptoms, stop use immediately and visit a doctor.

  • Dutasteride (Avodart) is prescribed for male pattern baldness though it is more commonly used to treat prostatic enlargement. It works similar to finasteride, just more effectively. This drug only works if taken daily and has a possibility of becoming less effective over time. Using them at an earlier stage of hair loss will show more desirable and noticeable results.

  • Spironolactone (Aldactone) is a medication commonly used to treat conditions such as high blood pressure, heart failure and liver disease. However, it has been prescribed for female pattern hair loss as well. It works by slowing down the production of androgens (male sex hormones) including testosterone. To that effect, it slows down the progression of hair loss caused by androgenic alopecia. It can also encourage hair to regrow. The medication is usually only prescribed when other treatments, such as minoxidil, don’t work.

 

2. Hair Transplantation

hair-transplantation-surgery

If medications do not work for you, a more surgical method to recover the hair loss you have been experiencing is through hair transplantation. The dermatologist will start by taking hair from areas that have a dense amount of hair and planting it at balding spots to encourage hair growth. This is useful for those experiencing male and female pattern baldness and receding hairline. Although this is a surgical procedure, not everyone is suitable for surgical intervention. You will have to seek medical advice and have a thorough assessment from a dermatologist to find out if you are eligible. Although the condition of your hair differs from individual to individual, generally, you need to have:

 

  • Enough healthy hair on your head to be replanted on balding spots
  • The ability to grow hair on the balding spots

If you do not meet these requirements, you won’t be suitable for a hair transplant. At Nuffield Aesthetics, we offer hair transplantation services with 2 different types of technology - Regenena or FUE. Read all about these technologies here

As you may have read above, there are many types of hair loss, with various symptoms, causes and treatments. Therefore, before proceeding with hair surgery, it is important to seek professional advice. 

 

Home remedies

 

There are many types of home remedies you may be familiar with that aid with hair loss. While they may be effective for some, it depends on each individual’s condition. Some of the more common home remedies include:

home-remedies-for-hair-loss

  • Coconut oil mask: apply coconut oil onto scalp and hair for minimally 30 minutes and wash off with shampoo.

  • Egg mask: mix one part egg white with a teaspoon of olive oil and honey into a paste and apply it all over the scalp and hair for 20 minutes. 

  • Aloe vera: Apply the aloe vera pulp to your scalp and hair and leave it on for about 45 minutes. Rinse with normal water. Repeat this process three to four times a week to see results.

  • Aromatherapy: Rub any of these essential oils (sandalwood, lavender, rosemary and thyme oils) into the scalp and leave it overnight wrapped in a towel.

  • Green tea: Pour cooled green tea over the scalp and massage into the hair, leaving it on for 1 hour and wash off with shampoo.

 

Review

 

As you can see, the causes, reasons and symptoms behind hair loss differ which mean the treatment for each type vary as well. To get a comprehensive assessment of your hair, scalp and hair loss, it is important to go to an experienced clinic that can advise you accordingly. At Nuffield Aesthetics, we believe in being honest and helpful to our patients to give them the best aesthetic advice for their wellbeing. A hair transplant is not suitable for everyone. However, if you wish to find out more, read here or book an appointment to speak to our aestheticians to find the best option for a healthy head of hair. 

 

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Frequently Asked Questions

What are some “do’s” and “don’ts” when you have milia?
How to prevent hair loss?
As you may already know at this stage of the article, hair loss may be associated with many causes like diet, genes and other medical conditions. Before trying remedies, look into your lifestyle. Do you use a lot of hair styling products? Do you have a medical condition that may cause hair loss as a side effect? If you have pinpointed the reason, then great! Alter accordingly to reduce hair loss. If you find that you do not engage in the above causes, you could try some of the following habits that may reduce hair loss

  • Use a microfibre towel or a shirt to dry your hair
  • Do not over-shampoo your hair, once in 2-3 days is good enough. Over shampooing causes you to lose the natural oils on your scalp. 
  • Use hair protection products if you plan to use hair styling tools.
How much do hair loss treatments cost?

Depending on the technology you decide to go for (FUE or Regenera Activa) the hair transplants procedures can cost anywhere from $10,000-20,000 when using the FUE technology. The specific costs depend on your specific hair condition, including the areas being treated and the number of follicles being transplanted, while Regenera Activa costs between $3000-5000.

Do vitamins work for hair loss?

In the recent decade, there have been many vitamins (in the form of gummies or pills) that claim to aid with strengthening the hair, reducing hair loss and promoting hair growth. However, there have been no scientific studies that prove that these supplements indeed help with hair loss. We suggest sticking to a healthy diet and lifestyle to see a more sustainable and noticeable difference in your hair. 

When to see a doctor?

It is normal to lose anywhere from 50-100 strands of hair per day. Anything more than that can be a little worrying. If you are noticing a lot of hair fall at one go, or seeing a growing bald spot, you may want to visit the doctor for professional advice.

Can itchy scalp cause hair loss?

Having an itchy scalp could be any of the following: seborrheic dermatitis (dandruff) and psoriasis. More often than not, you will notice hair fall if you have either of these conditions. So, yes, itchy scalp can cause hair loss.

What are the myths about hair loss?
  • “Only older people experience baldness”. Balding can start early, especially if it is hereditary.
  • “Taking hair supplements to help with hair loss”. So far, there hasn’t been substantial studies to prove this claim. 
  • “Wearing too many hats causes hair loss”. Hair loss has nothing to do with how often you wear hats!

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