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Picture this — you are brushing your hair and find several hair strands stuck in the bristles. You sigh and toss the hair strands away, but the issue stays at the back of your mind all day. If you can relate to this scenario, then this article is for you.
Shedding old hair and growing new ones in its place are completely normal parts of the hair growth cycle. Most people generally lose 50–100 hair strands per day; (1) a problem only occurs when you start losing more hair than that number.
Hair loss can be a very stressful experience for people suffering from it. Plus, stress can make the problem worse by triggering the release of a hormone called cortisol. Cortisol adversely affects the functioning of the hair follicles, causing extra shedding.
Types of Hair Loss
The four most common types of hair loss include:
1. Telogen effluvium
In this type of hair loss, a large number of hair follicles on the scalp are pushed into the resting phase (telogen) but do not exit it to enter the next phase of hair regrowth.
The causes of telogen effluvium include:
- Childbirth or postpartum changes in the body
- Chronic illnesses
- Surgery
- Stress
- Nutritional deficiencies or insufficient diet
- Some medications such as antithyroid medicines, heavy metals, beta-blockers, etc.
- Endocrine and thyroid disorders (hyperthyroidism, hypothyroidism, etc.)
Telogen effluvium is usually reversible.
2. Androgenetic alopecia
The most common type of hair loss, androgenetic alopecia occurs in a specific pattern. It is characterized by a receding hairline, and the hair loss at the temples and crown of the head forms an “M” shape.
This type of alopecia can affect anyone, but it is much more common in men than in women and is therefore referred to as male-pattern baldness.
Androgenetic alopecia is caused by many different genetic factors and hormonal triggers.
- Androgens can play a significant role in causing androgenetic alopecia. A specific androgen known as dihydrotestosterone (DHT) can attach to the hair follicles, disrupting their function and slowing down hair growth. As a result, your follicles produce shorter, thinner, and weaker hair.
- Hormonal imbalances caused by ovarian cysts, birth control pills, menopause, etc., can also trigger androgenetic alopecia.
3. Alopecia areata
Alopecia areata is a skin disorder that results in the loss of clusters of hair in localized areas of the scalp. The good news is the condition is usually not permanent and can be resolved with appropriate and timely treatment.
Alopecia areata is an autoimmune disease, wherein the immune system mistakes normal hair follicles for foreign bodies and attacks them, leading to hair loss. (2)
4. Traction alopecia
Traction alopecia is brought about by repeated strain and stress on the hair. (3) It is mainly caused by regularly styling your hair in tight buns or ponytails that put a lot of strain on hair roots. Over time, traction alopecia causes scarring of the hair follicles and eventually permanent hair loss.
Common Reasons for Hair Loss
These are some of the most common reasons for hair loss:
1. Nutritional deficiencies
Nutritional deficiencies are known to cause hair loss. Following diets extremely low in essential nutrients such as protein and iron causes excessive hair shedding. (4)
Make sure you consume a balanced diet that provides enough vitamins, proteins, lipids, and iron.
2. Age
Aging contributes significantly to hair loss. There is a progressive decline in the production of natural oils within the scalp as you get older, which leaves your hair roots dehydrated and weak. This, in turn, paves the way for hair thinning.
3. Genetics
Genetic predisposition is probably the most common reason for hair loss, especially in men. Sadly, there is not much you can do to prevent or cure hair loss caused by genetic factors.
If you have a history of balding and hair thinning, take care of your hair as much as you can by avoiding the use of products that contain harsh chemicals. Avoid shampoos that contain parabens, polyethylene glycol, and sulfates.
Instead, go for hair-plumping products and shampoos that make your hair appear thicker.
4. Fungal infections
Scalp ringworm, also known as tinea capitis, is a common cause of hair loss. (5) This condition causes patchy hair loss, leading to bald spots and a red, itchy scalp. In extreme cases, it causes pus-filled blisters on the scalp.
5. Hormonal problems
Male and female hormones affect hair growth in their own way.
A deficit of female hormones, namely, estrogen and progesterone, slows down your hair growth. In addition, as estrogen and progesterone levels drop throughout perimenopause and menopause, the body creates more androgens.
Excess androgens make your hair follicles regress or shrink, which leads to more hair falling out of your scalp.
Treatment Modalities for Hair Loss
Several treatment options are available for most types of hair loss. These include medications, surgeries, and other procedures.
Topical treatment
Minoxidil
Minoxidil is used in the treatment of male-pattern baldness. It induces hair regrowth in the bald parts of the scalp by stimulating the hair follicles. However, overuse can cause excessive hair production in areas unaffected by hair loss. (6)
Oral medications
1. Antiandrogens
Medicines that inhibit excess production of androgens may help treat female-pattern baldness. Spironolactone, birth control pills with estrogen, and oral contraceptives are all examples of antiandrogen medicines.
2. Corticosteroids
Corticosteroids are immunosuppressants that can treat hair loss caused by autoimmune diseases. Your doctor will determine the correct dosage for you based on your age and the severity of the disease.
3. Finasteride
Finasteride is used in the treatment of male-pattern baldness. It can increase hair growth and reduce hair loss.
Note: Finasteride should not be given to pregnant women as it can harm the fetus. (7)
In-Office treatments
1. Hair transplantation
Hair follicles from a different part of the skin are surgically extracted and then transplanted into the bald spots on your scalp. Hair transplantation is most commonly used to cure male-pattern baldness.
2. Scalp reduction
The hairless area of the scalp is surgically removed and hair-bearing areas are stitched together. Scalp reduction can be done as a standalone treatment or alongside a hair transplant.
3. Platelet-rich plasma
A small amount of your blood is drawn and placed in a machine that breaks the blood down to its components. The separated plasma from the blood is then injected into hairless areas of your scalp to stimulate hair regrowth.
Platelet-rich plasma is typically used for treating androgenetic alopecia and telogen effluvium.
4. Peptide sprays
A specific enzyme called 5-alpha reductase (5-AR) converts testosterone into DHT, which is known to increase hair loss. (8) DHT binds to androgen receptors on the hair follicles in your scalp, causing them to shrink and eventually stop building new hair fibers.
Copper peptides can inhibit the function of 5-AR, reducing DHT levels in the body and thereby curbing hair loss.
5. Growth factor concentrate (GFC)
A highly concentrated growth factor preparation is made from your blood to stimulate the hair follicles and increase hair growth. GFC is usually used in the treatment of androgenetic alopecia and telogen effluvium.
6. Stem cell hair therapy
Stem cell therapy stimulates the natural growth of hair on the scalp. Patients who are partially bald can benefit from this method. It is commonly used in the treatment of male-pattern baldness.
Diagnosing Hair Loss
Your dermatologist will diagnose your condition after taking your medical history and examining your hair. If they suspect a vitamin deficiency, disease, hormonal issue, or infection, you will be asked to get a scalp biopsy and blood tests.
Hair Growth Cycle
Hair follicles are structures in the epidermis that produce new hair. Arteries underneath them provide necessary nutrients to the hair.
Hair growth takes place in a cyclical process that consists of three important phases:
- Anagen (Growing phase): The anagen phase is the most important phase of the hair growth cycle wherein your hair follicles give rise to new hair shafts. Most of the hair on your scalp is in the growth phase, which can last up to 2–5 years.
- Catagen (Transition phase): The catagen phase lasts for around 10 days. During this stage, the hair stops growing and the hair follicles shrink in size.
- Telogen (Resting phase): The telogen phase is known as the “resting phase.” After a 3-month phase, some hair will fall out from the scalp, and then new hair will grow from the same hair follicles.
Final Word
Hair is a very important aspect of one’s appearance, and losing it can be very distressing for some people. If you are suffering from any form of hair loss, do not panic. Book an appointment with a dermatologist and discuss your issues with them.
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