Hair. It’s more than just something that grows out of our scalp. It is a source of pride, a standard by which beauty is judged, a way to stand out, and a way to be identified. It's no wonder, then, that hair loss—medically known as alopecia—is so distressing for those who experience it. Successful treatment of alopecia depends upon its cause, as well as upon prompt intervention, as it can become more difficult to overcome alopecia the longer that it is left untreated. Timely and appropriate treatment are key for maintaining healthy, luscious locks!
Though alopecia is common, there’s still a culture of shame surrounding its diagnosis. Some people are embarrassed to bring it up with their doctors; others engage in complex and protracted plots to conceal their hair loss from loved ones. Knowing that hair loss is common can help you feel less alone, and knowing what's normal and what's not can encourage you to seek treatment. Check out these alopecia statistics:
- 40% of men have hair loss by the age of 35, with 65% experiencing hair loss by 60, and 80% by 80.
- Half of all women experience some hair loss as they age, and 80% report noticeable hair loss by the age of 80.
- Normal hair loss is around 100 strands per day. People suffering from alopecia typically lose more hair, and regrow hair at a slower pace or not at all.
- Male- or female-pattern baldness, also known as androgenic (androgenetic) alopecia, is the most common form of hair loss in both men and women.
- Women are more likely than men to talk to their doctors about hair loss.
It's difficult to quantify the psychological toll that hair loss can take, but statisticians have posed a number of questions to explore how hair loss affects well-being. They've found that about half of hair loss sufferers say they'd spend their entire life savings to regain their hair, with 30% being willing to give up sex forever if it meant regrowing their hair.
How Do I Know if I am Losing My Hair?
Especially for people—mostly men—whose parents lost their hair, fear of hair loss can become an all-consuming concern. Some people spend endless hours in front of the mirror, inspecting themselves for signs of balding. Don't waste your time dissecting your appearance in front of the mirror, or endlessly fretting about symptoms that may be perfectly normal. Instead, know the symptoms of hair loss. Some of the earliest signs you can expect to see include:
- Your scalp becoming more visible under your hair; this suggests the hair may be thinning.
- Hair line receding away from your forehead.
- Large clumps of hair falling out; this is particularly common with illness and medication-related alopecia.
- A change in hair texture. Your hair may be thinner, coarser, and shorter.
- Hair that falls out before completing the growth cycle; many people experiencing hair loss find that they can't grow their hair as long as they once did.
- Changes in hair health; your hair may have more split ends, feel brittle, or look frizzy or dry.
Androgenic alopecia—also known as androgenetic alopecia, or male- or female-pattern baldness—is the most common form of hair loss, affecting 30 million women and 50 million men in the US. The degree to which one is affected depends upon factors such as genetics, lifestyle, and how quickly one addresses the problem. For some, hair loss slows or stops at a certain point, but for many, the hair loss can continue until they are partially or completely bald.
Causes of Androgenic Alopecia
Androgenic alopecia is a genetic, that is, hereditary, condition. Popular myths suggest that if your mother's father had it, you'll get it, too, or that if no one in your family has this form of baldness, you're not vulnerable. But genetics is a complex field, and androgenic alopecia is not caused by a single gene, but rather a complex interplay between multiple genes, hormones, and environmental factors.
The condition begins with testosterone—a hormone that men possess in larger quantities than women, helping to explain why men are more vulnerable to this form of hair loss. Testosterone converts to its more potent form, dihydrotestosterone (DHT), under the action of an enzyme called type II 5-alpha reductase. This enzyme is located within the hair follicles, allowing DHT to act directly on the hair growth mechanism.
Under certain genetic influences, more of the available testosterone is converted to DHT, thus more DHT is present to affect the hair follicles. As well, follicles tend to become more sensitive to the effects of DHT as you age.
Symptoms of Androgenic Alopecia
For men, male-pattern baldness typically follows a characteristic pattern. If you have these symptoms, you can be reasonably certain you're suffering from androgenic alopecia, and not some other form of hair loss:
- A receding hair line, with hair loss beginning at or around the forehead.
- Hair loss that forms an M-shape, with baldness concentrated at the crown of the head and around the forehead.
- Thinning hair all over the head.
- No hair loss in other areas of the body, such as the eyelashes or eyebrows.
Women with female-pattern androgenic alopecia experience a diffuse thinning of hair over the entire scalp. As with men, the hair thinning and hair loss is a result of DHT’s effects upon the hair follicles. Female-pattern alopecia becomes more apparent after menopause due to the dramatic decrease in progesterone, which is a natural inhibitor of the 5-alpha reductase enzyme. Decreasing estrogen also plays a role as it normally helps maintain the anagen (growth) phase of the hair cycle.
Treatment for Androgenic Alopecia
Androgenic alopecia can be difficult to treat, and most people get the best results when they begin treatment early.
Two drugs, Minoxidil and Finasteride, have proven helpful for some individuals. Minoxidil encourages hair regrowth (about 40% of users experience a regrowth of hair within four to six months), however, growth is only maintained as long as the product is used. Finasteride doesn't directly treat the hair. Instead, it inhibits the enzyme that converts testosterone to DHT, potentially helping to reduce future hair loss.
Because both of these options are drugs, however, it is important to discuss any potential benefits against their potential risks, with your doctor. (Further reading on Minoxidil side effects)
Though androgenic alopecia may be frustrating, it's not a disease. Alopecia areata, by contrast, is an autoimmune condition. About 1 in 10 hair loss sufferers has alopecia areata. Alopecia areata is characterized by hair loss in discrete, circular areas on the scalp. The loss often occurs rapidly. Some people with alopecia areata eventually experience hair loss all over the head, or hair loss on other areas of the body.
Causes of Alopecia Areata
Autoimmune disorders including alopecia areata occur when the body doesn’t recognize parts of itself as “self,” and begins attacking cells as though they were foreign. In the case of alopecia areata, the body attacks the hair follicles, causing them to deteriorate and resulting in hair loss. The condition is still poorly understood, but researchers have identified a number of mechanisms and risk factors that contribute to the development of alopecia:
- Heredity: if a family member had the condition, you're more likely to get it, too. Most autoimmune conditions are the result of genetic anomalies.
- Issues with your metabolic or endocrine (hormone) systems.
- A history of other autoimmune disorders. People with these conditions may suffer from alopecia areata.
There is some evidence that alopecia areata begins when T cells—specialised white blood cells that help fight off infection—cluster around the hair follicles as though they were fighting a type of infection. Much research into alopecia, therefore, has focused on reversing this process.
Symptoms of Alopecia Areata
Alopecia areata typically begins as a discrete bald spot. The spot may expand, or the hair loss may spread to other areas of the body. If the spot is sufficiently small, you may at first think you're suffering from androgenic alopecia. Check your symptoms and talk with your doctor before self-diagnosing. Some symptoms of alopecia areata include:
- Coin-sized spots of hair loss on the head.
- Losing hair in other areas of the body, such as the eyelashes or eyebrows.
- Hairs take on an exclamation mark shape, showing normal thickness at the root, but getting very thin toward the tip.
- Changes in nail health, especially splitting, thinning, loss, or discoloration.
Treatment for Alopecia Areata
Alopecia areata is still poorly understood. In many cases, the hair will spontaneously regrow, suggesting that temporary imbalances in the immune system might play a role. Currently there’s no cure for it, and treatment often focuses on minimizing the symptoms. Options may include:
- Treatment with Minoxidil or Finasteride. Though these drugs target androgenic alopecia, some people experience varying degrees of success with them.
- Topical immunotherapy. Since alopecia areata is an autoimmune condition, applying products that stop the immune reaction, such as Cyclosporin, may be effective.
- The use of corticosteroids. Research suggests that injections of corticosteroids may be of benefit, though these drugs also carry a significant risk of side effects.
Other Forms of Alopecia
Though alopecia areata and androgenic alopecia are the most common reasons for hair loss, dozens of medical conditions can lead to alopecia. This is why it's so important to talk to a medical professional before treating your symptoms at home or self-diagnosing.
Every person and every body is different, so how you react to a medication is not necessarily the same as how someone else will react. Many medications can lead to hair loss, but some are more likely to do so than others, including diabetes and high blood pressure medications, retinoids, chemotherapy agents, and drugs that affect the hormones, including contraceptives such as birth control pills. If you experience hair loss related to these drugs, the loss will generally stop once you stop the drugs. Always discuss with your doctor first before ceasing any prescribed treatments, however.
Telogen effluvium is due to a shift in the normal hair growth cycle. Normally, every hair on your head is in a different phase of the cycle, but when your body undergoes a traumatic experience such as childbirth, a switch to a new medication, or a serious illness, the hair growth cycle can be altered. A larger percentage of hair can enter the telogen phase and be shed all at once. This is especially common in women immediately after childbirth. During pregnancy, estrogen slows down the process of hair loss by causing your hair to remain for a longer length of time in the growth (anagen) phase than it usually does. When estrogen decreases after childbirth, more hair then rapidly enters the telogen phase, making the hair loss more noticeable. This is nothing to be concerned about unless you notice visible bald patches or have other health symptoms. Telogen effluvium usually resolves on its own as your hair naturally shifts back into the hair growth cycle.
About 3% of the population struggles with chronic anxiety and stress that causes them to pull out their hair. This condition, known as trichotillomania, is a compulsion that can be very difficult to overcome. Over time, it damages the hair follicles, causing hair to fall out and grow more slowly. Usually hair will regrow once the pulling stops, but if trichotillomania is allowed to persist for an extended period, it can cause permanent damage to the hair follicles. Prompt treatment of the psychological issues that lead to compulsive hair-pulling is the first line of defense against this form of hair loss.
Traction alopecia isn't actually a disease or condition. It is caused by styling techniques that apply sustained tension onto the follicles, causing stress and damage to them and, eventually, hair loss and poor regrowth. The solution in this case is to avoid hair styles that involve putting traction upon the hair.
Anagen effluvium is not a medical condition unto itself. Instead, it's a shift in the hair's growth and behavior, usually due to another medical condition. Anagen effluvium occurs when the hair follicle experiences a change in cell division or metabolism, leading to rapid hair loss, a slowing of hair growth, and thinning of the hair. It often extends beyond the hair on the head, affecting the eyebrows, eyelashes, and body hair, too. The most common cause of anagen effluvium is chemotherapy for cancer.
In most cases, anagen effluvium causes an overall narrowing of the hair shaft, producing thinner, more brittle hair. Hair loss usually stops after chemotherapy stops, but because anagen effluvium thins the hair, it can leave your hair looking weak and brittle for several months until all of the old, thin hairs are replaced with newer, thicker hairs.
Miscellaneous Diseases and Conditions
Diseases of the endocrine and metabolic systems may also induce alopecia, such as thyroid conditions (both under- and overactive thyroid), adrenal gland problems, anemia, and other issues. If your doctor has not yet uncovered a cause for your alopecia, continue pushing to get an answer, since hair loss can sometimes be the first symptom of a serious medical issue.
The field of hair loss treatment is still in its infancy, and new technologies, such as hair transplants and laser treatments, are offering hope to millions of hair loss sufferers. With more research, we may eventually find a cure. For now, a healthy lifestyle that includes a natural supplement such as Hair Essentials™, formulated specifically for nourishing healthy hair growth, and a strong alliance with a doctor you trust are your best tools in the fight against alopecia.