Hair Loss

Hair loss, medically termed alopecia, represents a condition of losing hair either from the scalp, entire body, or any other particular part of the body.

The severity of the condition ranges from mild hair thinning to complete baldness. Furthermore, losing hair can be permanent or temporary, affecting both men and women of any age. Alopecia has several different causes, and therefore we must distinguish between the many different types.

Because it may result in various psychological issues, affect well-being, and drastically change appearance, many people opt for hairloss treatments. In many cases, losing hair is treatable. Several treatment options exist, both surgical and non-surgical.

Hair Loss Symptoms

In most cases, a person first notices a large amount of hair on the hairbrush or in the tub drain after washing their hair. They also see their hair is either becoming thinner or missing. The hairline may change, or bald patches may appear. Read all about it.

Hair Loss Treatments

FUE, DHI or FUT? Hairline reduction surgury or Palatet rich plasma? What are these types of treatments and which one is best for your hair loss ailment? All you need to know about the topic is in this section here. Read all about it.

What is hair loss?

While it is completely physiological to lose some hair every day, sometimes the hair loss may be a sign of some underlying medical condition and may cause concern.

Healthy adult persons may normally lose 50-100 hair follicles each day. It is not even noticed in most cases, as there are approximately 100 000 hairs on the scalp. Normally, new hairs replace those who have fallen out, and that kind of daily loss occurs without notice. However, if you notice sudden, prominent hair loss, or if you develop thinning or bald patches, lose hair in clumps, or simply become worried about your alopecia, you should see your doctor, as there is probably a medical reason for your lost hairs. They can determine what is causing the hair loss and therefore suggest suitable treatment options.

Hair loss itself is not health-threatening or dangerous, so there is usually no reason for concern. However, such a condition may cause psychological distress and should be treated. On the other hand, some people still decide to let their hairloss run its course unhidden and untreated.

The most common hair loss types are the male- and female- pattern baldness, alopecia areata, and hair thinning referred to as the telogen effluvium.

There are many other, less common causes of why you are losing your hair. These include skin conditions, autoimmune diseases, trauma, some medications, radiation therapy, chemotherapy, thyroid dysfunction, HIV/AIDS, malnutrition, infections, systemic lupus erythematosus, sarcoidosis, trichotillomania (compulsive pulling of the hairs), air and water pollutants, and others. Additionally, the periods related to hormonal changes such as pregnancy, puberty, or menopause may also cause temporary hair thinning or general hair loss.

Although balding can occur at any age and is not sex-limited, older men are more commonly affected. It is male-pattern baldness which is probably the most well-known alopecia type.

Differences and similarities between male- and female- hair loss

It’s a condition that affects both men and women and represents a challenge for any affected individual. Hair loss and hair thinning may occur for many reasons and may have various potential causes that differ between males and females.

Androgenic alopecia represents the most common type of hair loss. It is often referred to as male- or female- pattern baldness. In fact, the cause of this type is the same for both sexes. It is proven that the hormone dihydrotestosterone (DTH), a derivative of the male sex hormone testosterone, is causing androgenic alopecia in men but also women. Testosterone is converted to DHT in the hair follicles with the aid of the enzyme 5-alpha reductase. Once the testosterone is converted to DHT, it binds to the receptors in the hair follicles, shrinking them and preventing the hair from surviving and growing. Although this process is the same for men and women, it is important to note that women have only a fraction of the amount of testosterone found in men.

There are differences in the hair loss pattern between the sexes.

In men – there is first a gradual hair loss in the frontal area of the scalp, with a receding hairline, accompanied by the gradual hair thinning in the temporal regions. On the other hand, in women – the hairline is preserved. Still, there is diffuse hair loss in the crown area, accompanied by gradual hair thinning over the entire scalp. Sometimes, losing hair or thinning of the temporal area may also occur. However, it is not as severe as in men. Furthermore, men can typically experience losing hair at an earlier age than women, who usually experience female-pattern hair loss after menopause. Also, it is usually more noticeable in men.

Due to these differences in androgenic alopecia in men and women, the treatments are also somewhat different.

When does Alopecia occur?

When we think about hair loss, we usually relate it to an older age. Although this is the most commonly the case, it can occur anytime during a lifetime.

It is well known that people notice some hair loss with age. At certain age, hair growth slows and also starts to lose color. It is part of the normal aging. However, in hereditary – male- or female- pattern baldness, as the most common type, hair gradually falls out as the person grows older. It starts in middle age and is most commonly noticeable around the 50s. In women, it is most prominent after menopause. As previously noted, this is hereditary and runs in families for both sexes. So, in case you have relatives with male- or female- pattern baldness, you are at increased risk of losing your hair as you age.

Interestingly, hair loss may appear at a younger age. In fact, it may begin as early as puberty, triggered by sex hormones. Excessive use of hair styling products, eating disorders, or restrictive diets may also cause alopecia in the younger population. Furthermore, in the condition known as hypotrichosis, the person develops abnormal hair patterns, presented as bald thinner patches of hair or general thinning. Hypotrichosis also occurs at a younger age. In this condition, the person’s hair growth appears normal after birth. However, this hair is shed shortly after that and replaced with abnormal or sparse hair growth. The new hairs are brittle, short, delicate, and may lack pigmentation. Baldness may develop by 25 years of age.

Otherwise, hair loss may occur at any age if there are other causes, such as certain medical conditions, traumatic events, surgeries, or even childbirth. Other causes discussed below may also cause hairloss at any age the causes occur.

Causes

A multitude of reasons may cause the loss of hair. 

• Genetics. This is the most common cause of hair loss, known as androgenic alopecia. Both men and women can be affected in male– or female- pattern baldness. The hereditary form of hair loss is related to aging. In case genetics is causing your situation, it means that you have inherited genes that make your hair follicles shrink and eventually stop growing hairs. 

• Hormonal changes. Several types of hormonal changes may cause permanent or temporary hair thinning or even hair loss. For example, polycystic ovary syndrome (PCOS), pregnancy, childbirth, menopause, or thyroid dysfunction may all lead to loss of hair. Furthermore, cessation of taking birth control pills can cause temporary hair loss. 

• Medications. Hair loss may be caused by the potential side effects of certain medicines. These medications are most commonly used in the treatment of cancer (including chemotherapy and radiation therapy), arthritis, depression, high blood pressure, heart problems, or gout. However, if this is the case, you should not stop taking the medications abruptly. Always consult your doctor first. 

• Medical conditions. Certain medical conditions may cause hair loss, such as alopecia areata. In this condition, the immune system attacks hair follicles and causes balding and you may lose hairs either from the scalp or anywhere on the body. Other diseases may also cause hair loss, particularly skin conditions and hair growth conditions. For example, scalp psoriasis or scalp infections may lead to loss of hairs. Moreover, trichotillomania, characterized by compulsive pulling of the hairs, is a significant cause of hair loss.

• Stressful events. Experiencing hair thinning or hair loss following the physical or emotional trauma or shock is not rare. Furthermore, losing hair in depression or during stressful periods is quite common. 

• Strict diets and nutritional deficiencies. Low protein, iron, or other nutrients’ levels can cause hair thinning.

• Excessive hairstyling. Aggressive hair treatments, permanents, coloring, or hairstyles tightly pulling the hair back, such as ponytails, may damage the hair and cause hair loss.

Symptoms of hair loss

Symptoms of hair loss depend on the cause. As the first sign of hair thinning or balding, you may notice a large amount of hair on the hairbrush after hair brushing or in the tub drain after you wash your hair.

Hairstyling may also reveal the first signs of baldness, as you may notice that your hair is generally becoming thinner, that your hairline has changed, or you may notice that the first bald patches have appeared.

Gradual hair thinning in the frontal area of the scalp, known as receding hairline, is usually the symptom of male-pattern balding. On the other hand, in the female-pattern hair loss, women may notice a broadening of some part in their hair.

The Norwood scale, also known as the Hamilton-Norwood scale, represents the main and the most common classification system for measuring the extent of male-pattern hair loss. This scale presents easy-to-reference images which show different stages of balding. The Norwood scale consists of 7 different stages of hair loss. Similarly, the Ludwig scale classifies the female pattern baldness and ranges from stages I to III.

Bald spots, either circular or patchy, located anywhere on the scalp, beard, mustache, or eyebrows are also one of the hair loss symptoms. These bald spots follow the painful and itchy skin before the hair falls out.

Trauma, physical or emotional, may cause loosening of hair. In that case, the hair suddenly starts to thin. During the washing or brushing of your hair, you may experience handfuls of hair falling out.

Patches of scaling on the scalp indicate ringworm infection. It may go along with the broken hairs, swelling, redness, or sometimes oozing.

General hair thinning may be a symptom of excessive hair styling. Still, in prolonged traction, tight hair pulling, traction alopecia may appear as a recession of the hairline.

In some medical conditions, or as a side effect of certain medical treatments, you may experience total-body hair loss.

Treatment and management

Hair loss may cause you to lose self-confidence as your appearance changes, which may significantly affect your quality of life. However, the good news is it does not have to be like that.

Several treatment options are available for balding hair, ranging from natural and homeopathic remedies to hair transplant surgeries. Besides, one may be lost and overwhelmed by the number of available options, their effectiveness, and their costs. Choosing the appropriate treatment can be very challenging. Therefore, it is crucial to identify the exact cause and type of hair loss in managing it to find suitable treatment options.

While some people decide to hide hair loss, using cover combs, wigs, hairpieces, or micropigmentation, others seek solutions.

If there is an underlying disease causing the balding, treating the disease will most of the time also resolve the loss of hair. If not, other treatment options should be considered.

In some cases, medications may help, although with limited success rates. Medications which include minidoxil, finasteride, and dutasteride are available for hair loss treatment, primarily in male-pattern baldness. However, they have shown to be more efficient in preventing further hair loss than re-growing lost hairs. Corticosteroids and immunosuppressants can also be used. Platelet-rich plasma (PRP) injections are also increasingly used, aiming to promote hair growth.

In most cases, surgical – hair transplant procedures are the best option. Surgical options involve follicular unit transplantation (FUT), follicular unit extraction (FUE), and direct hair implantation (DHI).

The exact choice depends on several factors, which you should discuss with the specialized surgeon in hair transplantation procedures. The hair transplantation procedures could provide natural-looking results. Besides these transplant procedures, a scalp reduction is a procedure in which a surgeon removes part of your scalp affected by hair loss.

The management of hair loss should be guided by the medical professional and adjusted according to you and your expectations.