Hair loss can be a confidence killer as everyone knows that hair plays an important part in our overall appearance.
Although the hair isn’t an organ, it is an important accessory to the skin that helps in the transmission of sensory information.
In order to understand why hair loss happens, we must first understand how it grows.
The First hair growth
A fetus first develops all its hair follicles at 22 weeks and it is at this stage that there are over 1 million hair follicles on the head with 100,000 of those follicles residing on the scalp.
This is actually the most number of hair follicles available in our lifetime and there are many people that notice the reduction in hair density as they grow from childhood to adulthood.
The reason isn’t that our hair is falling out, but it is because our scalps expand as we enter into adulthood.
To understand why hair begins falling, it is important to understand what follicles are and their growth cycle.
What are hair follicles?
Hair can be separated into two main structures:-
1) The follicle – this resides inside the skin and contains the sebaceous gland that is crucial in producing sebum to condition the hair.
2) The shaft – the hair that we see above the scalp that is made of a hard protein called keratin.
Hair Growth Cycle
The hair on the scalp grows about 1 centimetre per month depending on hair type. (curlier hair grows slower than straighter hair)
Unlike other mammals, human hair grows and sheds at random, and at any given time, a random number of hairs will be in one of the three stages of growth and shedding.
These stages are called the anagen, catagen, and telogen stages.
Anagen – Active stage
Anagen is the active phase of the hair where a new hair is formed and pushes the club hair (a hair that has stopped growing or is no longer in the anagen phase) up the follicle and eventually out past the scalp.
This is the time when hair grows and stays in this active phase of growth for two to six years.
Some people have difficulty growing their hair beyond a certain length because they have a short active phase of growth.
Catagen – Transition stage
This is the transitional stage of an active growing hair entering the club hair stage or better known as hair that has stopped growing.
About 3% of all hairs enter this phase at any given time and last for about two to three weeks.
Telogen – Resting stage
Telogen is known as the resting phase and usually accounts for 6% to 8% of all hairs.
This phase lasts for about 100 days when the hair follicle is completely at rest and the club hair is completely formed.
Pulling out a hair in this phase will reveal a solid, hard, dry, white material at the root.
About 25 to 100 telogen hairs are shed normally each day.
Why does hair fall more than usual?
Hair loss or hair fall occurs when the hair growth cycle is disturbed or it can be caused by your genetics.
Another common cause of sudden hair loss is known as telogen effluvium and this is a condition that occurs when more of your hair enters the resting stage and proceeds to fall out.
Telogen effluvium can be caused by:
- high-stress levels
- side effects of medication
- other underlying health conditions
Other causes of hair loss include:
- alopecia areata
- androgenetic alopecia / androgenic alopecia – female pattern hair loss
- traction alopecia areata
- polycystic ovary syndrome
- scalp infections
- thyroid disease
- nutritional deficiencies
- Excessive amounts of perms or bleaching
In order to understand what is causing your hair to fall more than usual, it is important to consult a dermatologist or a doctor who will ask you about your health, medical conditions as well as medications you consume, and your family history.
You can also keep track of any unusual events that may have driven this sudden increased hair loss to determine the triggers.
A good doctor will also look at your eyebrows, lashes, and hair growth in other areas of your body to determine if it is something serious that requires medical attention.
Hair loss after pregnancy
It is common that most women suffer from severe hair loss or even female pattern baldness after pregnancy which is mainly caused by dehydration, fatigue, stress, and hormonal changes as their bodies adjust to life after pregnancy.
This condition is usually temporary and should be resolved within a year after the pregnancy has ended.
In order to treat hair loss, continuing your prenatal vitamins if you are breastfeeding can be an option for you. Eating a healthy diet rich in protein and vegetables can help strengthen hair and promote healthy hair growth as well.
What is Female Pattern Hair Loss?
The excessive amount of hair loss is known as alopecia and this usually happens as a symptom to tell you that something is wrong with your body.
Androgenetic or also known as androgenic alopecia refers to a diffuse thinning on all areas of the scalp. This happens when there are male hormones present in small amounts are can be caused by a myriad of actions due to hormonal changes such as the presence of ovarian cysts, birth control pills, pregnancy, and menopause.
The hormone called DHT appears to be somewhat the culprit in the miniaturization of hair follicles but genetics is the main factor.
What is Anagen Effluvium?
Anagen effluvium is a type of hair loss that occurs after the hair follicle is impaired in its cellular-level mitotic or metabolic activity. This is common in chemotherapy.
As chemotherapy targets rapidly dividing cancer cells, any other dividing cells are also greatly affected during the treatment.
The hair fall happens when there is a tapered fracture in the shaft. This causes the hair to narrow as it is damaged and causes severe hair loss.
However, as soon as chemotherapy ends, a healthy diet with the essential nutrients will help hair regrow again.
How to prevent hair loss?
Most of the time, it is our lifestyle that acts as the main contributor to our hair loss. Therefore, we can make changes to our lifestyle to stimulate hair growth again.
1) Avoid tight hairstyles that pull too much at the hair roots.
Hairstyles inducing stretching forces like high ponytails that give you an instant facelift, tight french braids, or any hairstyle that just tends to pull tightly will cause hair to become permanently damaged.
This is because your hair can only be stretched so much and the frequency of wearing these hairstyles will cause traction alopecia areata.
Try wearing looser hairstyles to prevent further hair thinning or let your hair down once in a while as it promotes hair growth.
2) Avoid excessive heat styling tools
It is important to apply heat protectant spray before using any heat styling tools. The excessive amount of use can promote excessive hair loss as the hair shaft becomes dehydrated and vulnerable to damage.
3) Avoid excessive colouring or bleaching
Whenever hair is coloured or bleached, chemicals are used to split the protein molecules in our hair shaft to allow the colour to enter. This causes fragile hair and if you noticed your hair falling more than usual or it stopped growing, maybe you should consider taking a break from wearing chemically treated hair and opt to wear your natural colour instead to stop further hair loss.
4) Choose a mild shampoo or one that suits your scalp
There are plenty of shampoos on the market and it is important to understand that the main use of a shampoo is to clean your scalp, not just your hair.
When the scalp is healthy, it will end up producing healthy hair, and choosing the right shampoo can help in promoting hair growth which may increase hair thickness in the long run.
There is no set rule to the number of times you need to wash your hair either.
The general understanding is if you have a drier scalp, you can go longer without washing your hair. If you have an oiler one then it is best to wash your hair every day.
5) Avoid excessive use of dry shampoos
There’s been a surge in the number of dry shampoos offered in the market. Although they have their uses, it is important to understand that excessive use of them is one of the causes of hair loss.
Dry shampoos act as a refresher to the scalp after the gym or when you are skipping a shampoo for the day.
However, prolonged use can cause the scalp to get congested as the product will block the follicles and cause your scalp to get irritated which will lead to losing hair.
6) Choose the right comb
Depending on your hair type and length, there are plenty of combs to choose from such as the paddle brush, mixed bristle brush, natural bristle brush (this is good for vegans), and hair detangler brush, and many others.
Generally, it is important to brush your hair daily as brushing can promote hair growth as it moves the oils secreted from the sebum in your scalp to the ends of the hair. Brushing also promotes blood circulation that increases blood flow to the hair and scalp which stimulate hair growth.
A wide-toothed comb is great to be used to detangle wet hair but rather than brushing from top to bottom, it is important to move from bottom to top to avoid any breakage as hair is weakened when it is wet.
7) Keep your scalp healthy
Scalp massage has been proven to stimulate hair growth, increased hair thickness, and keep the hair healthy.
Coconut is a popular fruit to treat any hair loss ailments.
Coconut oil can be used not only for scalp massage but also as a leave-in treatment for the hair as it is predominantly made up of lauric acid which gives it a long and straight structure, making it easily absorbed deep into the hair shaft.
You can also add essential oils such as lavender oil and peppermint oil into the main carrier oil before your scalp massage for the added benefits of reducing hair fall or repairing damaged hair.
Coconut milk can also be used as a mask to prevent hair loss and promote hair regrowth. To use coconut milk as a hair mask, you need to first heat it up and then apply it when it is warm to the hair ends.
Onion juice is another option if coconut is not available for you. You can use onion juice on your hair and scalp as a leave-in mask before washing it off in the shower.
Green tea rinses are extremely popular due to their antioxidant properties. You can use green tea as your final rinse after shampoo to ensure you leave its healthy hair benefits to prevent hair fall.
8) You probably need to eat more protein
As the hair follicle is made out of mostly protein, it is important to ensure that you are eating enough every day to ensure healthy hair growth.
If you are a vegetarian, you can consume more soy-based products, beans, or legumes as they are also high in protein.
You can also find a good protein shake to supplement your daily protein needs.
9) You may have a vitamin deficiency
There are times when hair loss occurs when you have a vitamin deficiency or when there is an underlying medical condition. The lack of certain vitamins and minerals like vitamins A, B, C, D, E, zinc, and iron can affect your hair growth.
It is important to consult a doctor to find out which vitamin you may be deficient in and begin consuming supplements to maintain healthy hair, skin, and even muscle tissue.
Other than the vitamins mentioned above, supplements that can help with hair growth and reduce hair fall include saw palmetto, calcium, and selenium.
10) Get regular haircuts
Getting regular trims is important to make sure there are no split ends that cause further hair fall problems.
It is also common knowledge that long hair tends to have a greater hair fall volume compared to shorter hair.
Therefore if hair fall is a problem then getting a shorter haircut may work to reduce the hair fall as well.
Once the hair fall has improved, then you can start to grow your hair again.
Consult a dermatologist for better results
You should begin consulting a dermatologist when you don’t see a change in hair loss even after making lifestyle changes to compensate for it.
Your dermatologist should give you a physical exam and ask about your diet, hair care routine along with your medical as well as your family’s medical history.
The tests your dermatologist may perform include:
1) Blood test – To uncover any medical conditions or to look for any vitamin deficiencies.
2) Pull test – The doctor will gently pull several dozen hairs to see how many come out. This is done to check the shedding process.
3) Scalp biopsy -The doctor will scrape a few samples from the scalp and pluck a few hairs to examine under the microscope. This is done to check if there is an infection.
4) Light microscopy – The doctor uses this instrument to examine hairs that are trimmed at their bases. This is done to check if there are disorders in the hair shaft.
Once the dermatologist has uncovered the hair loss problem, they can prescribe one of the following treatments:
1) Minoxidil (Rogaine) – Minoxidil comes in liquid, foam, and shampoo forms. It is easier to apply as foam on wet hair.
2) Finasteride (Propecia) – This is a prescription drug that comes in pill form for men. Many men taking finasteride experience a slowing of hair loss, and some may show new hair growth. It may take a few months to see if it’s working for you.
3) Other medications – Other oral options include spironolactone (Carospir, Aldactone) and oral dutasteride (Avodart).
4) Low-level laser light therapy – These devices come in wands and helmets and they can be expensive but results have shown that it does help stimulate red blood cells in the scalp thus promoting hair growth.
If everything you have done to prevent hair fall doesn’t work then you can go for the hair transplant surgery.
Hair Transplant Surgery
Surgery is the last thing most people will opt to do as it is extremely invasive but its results have been proven to work.
During a hair transplant procedure, a dermatologist or cosmetic surgeon removes hair from a part of the head that has hair (usually the nape area) and transplants it to a bald spot. Sometimes a larger strip of skin containing multiple hair groupings is taken.
This procedure doesn’t require hospitalization, but it is painful so you’ll be given a sedation medicine to ease any discomfort.
Possible risks include bleeding, bruising, swelling, and infection.
You may also need more than one surgery to get the effect you want and if your hair loss is genetic, you may need to perform this surgery again in the future.
Hair loss or hair fall is extremely common, especially when we age. But it can be seen that the most common cause of severe hair loss is genetics.
Usually, genetic hair loss is characterized by hair fall at the top of the scalp in women and a receding hairline, and a bald spot at the crown in men.
Making lifestyle changes may help stop or reduce hair fall and even help you regrow some of your hair.
Home remedies, lifestyle and dietary changes, and over-the-counter medication may improve the appearance of thinning hair.
If you are unable to fix the issues at home on your own, it is time to head to a trichologist to help you with your hair fall.