Hair loss: what it is, causes and remedies

With this long article I hope I have shed some light on the fact that baldness is just one of the many ways we can lose hair . It is certainly among the most serious as, if not taken in time, it has irreversible effects. However, as you have seen, the hair loss theme is an extremely vast topic with many facets. It can affect both men and women and, in some cases, even children.

If you did not find the information you were looking for, or you have any doubts that you would like to clarify, feel free to leave a comment in the space provided at the bottom of this page.

 

The helphairless website has always focused on androgenetic alopecia which represents only a part, albeit a very important one, of the Hair Loss theme . However, I also receive several requests for topics that go beyond baldness in the strict sense, so I thought I’d write this general guide on the various types of hair loss, the causes and possible pharmacological remedies, natural or just “aesthetic” to try to counter it.

Put simply, the functioning of the hair bulb has the following 3 phases:

  1. active phase (Anagen): in which it produces and makes the hair grow and can last 4 years for men and up to 6 years for women and children;
  2. stasis phase (Catagen): in which the hair progressively ceases its vital functions. Typically lasts up to 3 weeks:
  3. fall phase (Telogen): in which the hair is in effect dead and ready to fall due to the new growth that literally “pushes” it out. It lasts from 2 to 4 months.

In a healthy person, therefore, the life cycle of the hair can last up to 6 years and therefore the hair is reciprocated several times over the course of life.

Hair loss causes

If no factors (pathological or not) intervene to vary or block the phases of the cycle, there is no problem when you see your hair falling out because it is normal to have on average 15% of hair in the telogen phase and therefore are ready to to fall. It is not possible to know precisely  how many hairs are lost per day , but a fall of up to 100 hairs per day is to be considered physiological.

In practice, the hair falls out but then grows back healthy and strong as before, so the problem does not arise.

When there is an abnormal hair loss it is necessary to understand first of all if it is a temporary phenomenon or if there are underlying pathologies.

Unfortunately, it is not easy to identify the causes of hair loss on your own, so I recommend that you always go to a dermatologist who specializes in trichology . This will, in most cases, save you time and pinpoint the exact problem . Most of the time the savings are also in economic terms since you will avoid wasting money unnecessarily on do-it-yourself treatments that very often turn out to be wrong.

Below I will make an overview of the numerous types of  hair loss that exist, dividing them according to their pathological nature or not:

Pathological causes

A very basic method to understand if you are a victim of pathological hair loss is given by the presence of itchy head and pain in the scalp. These factors, together with an increased production of sebum , are almost always present in the cases we are going to examine.

 

Androgenetic alopecia

Well, we have talked extensively about this type of hair loss since androgenetic alopecia is the main theme of our site.

Here I will limit myself to saying that it is the common male pattern baldness that affects 3 out of 4 men over the course of their life.

Also known by the name of Telogen Defluvium or Androgenetic Defluvium , it manifests itself with a progressive miniaturization of the bulbs that leads to a thinning of the hair that advances according to a typical path starting from the classic receding hairline up to the cleric.

The yardstick for evaluating progress is known as the Norwood scale. It is a disease of genetic origin and, although to a lesser extent, it can also affect women, especially if they are in menopause. If you want to learn more, I invite you to click the link at the beginning of the paragraph that will take you to our guide.

Tricotillomania

Although it is not due to a real “disease” that directly involves the hair, I have included trichotillomania among the pathologies as at the base there is a real obsessive-compulsive disorder that leads the affected individuals to literally pull their hair from head. At the base of this pathology there are undoubtedly inner and profound motivations that must be treated through appropriate therapies and psychiatric paths . It is however reversible and therefore eliminating the cause that leads to pulling the hairs, they will return to grow regularly.

 

Seborrheic dermatitis

The seborrheic dermatitis affects most often the scalp but can also occur in other parts of the body where there are many sebaceous glands . It manifests itself in the form of inflamed and red patches where the skin forms greasy and yellowish flakes that tend to peel off. It generally causes discomfort and itching but in severe cases it can cause real pain.

Telogen effluvium

It is a type of hair loss which, as the name suggests, is linked to abnormal telogen hair loss . It can be in acute form caused by a strong traumatic or stressful event that brings up to 85% of the hair in telogen with consequent abundant fall in the following 3 months even of hundreds of hairs a day.

There is also a chronic form in which the triggering event has a less traumatic nature and is more linked to states of anxiety and inner discomfort that last over time. The hair loss is less than the acute form but continues over time . It has no miniaturization and therefore the hair can grow back.

Hair Loss and Stress

it is a series that is difficult to interpret even by expert doctors and differs from the telogen effluvium we have just seen because it presents typical symptoms of androgenetic alopecia with the presence of thinning and miniaturized hair. However, stress and the psychological situation can emphasize the problem. Find out more in our article on stress alopecia .

 

Alopecia areata

Alopecia areata results from an immune system problem that attacks the hair follicles as it does not recognize them as its own.This leads to patchy hair loss in the affected areas. In the more advanced forms it can involve the entire face (alopecia totalis) to arrive, in the most severe form, all the hair of the body (alopecia universalis).

It does not cause miniaturization of the bulbs which can therefore return to producing perfectly healthy hair in the periods in which the disease is latent. So it is reversible

Cicatricial alopecia

Very rare disease in which following an inflammatory process there is a real destruction of the hair bulb which is replaced by scar tissue. Obviously this is a type of irreversible hair loss as the follicle is destroyed.

Thyroid problems

The variations both in excess and in defect of thyroxine , the main hormone produced by the thyroid gland, have consequences on the hair and all skin appendages (nails and hair). This is because thyroxine plays an essential role in the active Anagen phase that regulates hair and hair growth and which we talked about at the beginning of the article. In addition to increased hair loss, people with thyroid problems often have brittle hair that looks dull and dull.

Anagen effluvium

It is observed in conjunction with the intake of chemotherapy drugs in which cellular metabolism is inhibited, especially of the follicular cells. There are also other treatments that can have the same effects. It occurs as a hair loss and patchy hair in the first phase, and then spreads in an all-encompassing way. Hair regrowth resumes once the treatment has ceased its action.

Physiological causes

Now we will deal with the main types of hair loss that do not have to do with diseases of any kind, but mainly depend on physiological factors :

Seasonal hair loss

While it is the most common and perfectly normal type of hair loss , it is one of the most worrying as it affects all individuals.The fall of seasonal hair occurs between late spring and early summer and then reappear in the fall .

There are various theories that attempt to explain it by involving the variations in the light / dark ratio between the various periods of the year and their influence on hormonal levels which in turn contribute to regulating the hair cycle. Still there are those who see in the stressful life of modern times, improper nutrition, pollution … and so on and so forth.With this I do not mean to belittle the various hypotheses but, much more simply, in my opinion the school of thought that tends towards a seasonal change is more concrete  . A legacy of the past, still written in our genes which, in fact, has to do with the shedding of the hair that many animals have as a result of the temperature variations characteristic of seasonal changes.

In practice, we too “change our hair” albeit obviously to a lesser extent 😉

Traumatic events

This category includes all those events that we ourselves inflict on our hair … voluntarily or not. I don’t mean psychological trauma, but physical trauma. An example is sunburn caused by too much summer sun which can cause damage to the scalp resulting in excess free radicals and fall in the following weeks or months.

Among the traumas that can cause damage to the scalp, and therefore affect hair loss , we can include all those treatments with aggressive substances such as colorings or of poor quality shampoo that can literally ruin the hair shaft. Even very frequent exposure to more common substances such as pool chlorine or sea ​​salt can damage the hair structure.

Of course these are minor problems that can at best make the hair dull and dry or make it fragile and therefore easily breakable. However, in principle it is only the hair shaft that is damaged and with regrowth everything tends to settle down (as long as you eliminate the event or substance that causes the problem)

Obviously, intolerances or allergies caused by these substances must be excluded, which in this case can lead to irritation and dermatitis of the scalp with consequent alteration of the life cycle.

Hormonal fluctuations and hair loss

We have already seen that hormones such as DHT or thyroid ones can be the basis of real pathologies that lead to abnormal hair loss. In this section, however, I include changes in hormone levels that are not due to diseases in the strict sense but to particular physiological states.

 

Post Partum Hair Loss

For example, this type of scent affects women at the end of pregnancy and in fact many during breastfeeding experience a strong increase in the fall.This is due to estrogen (female hormones) which rise in early pregnancy and, among others, have the ability to lengthen the anagen phase .

Here then explains why pregnant women often have much more beautiful hair. After gestation, however, estrogen returns to standard levels and therefore a lot of hair passes into telogen and falls out within the next 3 months or so.However, it is not a disease, but a temporary increase in fall that resolves spontaneously in the majority of cases.

Excess of cortisol and hair

Known as the stress hormone , cortisol, if at high levels and for too long, can negatively affect the activity of the cyclic AMP hormone . The latter is a kind of messenger that transmits the signal to the bulb matrix to start the production of keratocytes (the material the hair is made of) and melanocytes (the pigment that gives color to the hair).

This signal interruption causes the hair to go into the telogen phase and consequently fall out within 2-3 months.

And nowadays, having altered cortisol is relatively simple unfortunately since stressful events are enough to raise its level.

Melatonin

 

You have probably already heard that melatonin is the sleep hormone and is involved in the regulation of the sleep and wake cycle.

However, some animal studies have shown its influence on hair growth.

There are not many data on humans, but I managed to find this collection 1) which examines 5 studies carried out to evaluate the effects of melatonin in men and women suffering from androgenetic alopecia.

The first pharmacodynamic study on the topical application of melatonin through a 0.1% solution carried out on 40 women suffering from androgenetic alopecia where, at the end of the 6 months of testing, an increase in anagen hair was noted compared to the group that used placebo.

Also with regard to melatonin it is not difficult to alter its levels since it is only produced between midnight and 3 am.

Therefore, for melatonin and cortisol, it is enough to have an unregulated rhythm of life and the hair can be affected.

WARNING: I’m not saying that if you miss a night’s sleep, or if the boss makes you angry at work… you will lose tons of hair. It is not the one-off episodes that create problems, but the conditions of stress and recklessness over time . Certainly they will not be the direct cause of diseases such as androgenetic or areata alopecia … but it is a fact that abnormal and prolonged values ​​over time can affect the life cycle of the hair.

Diet and food shortages

Following an unregulated diet or one that neglects, in whole or in part, certain macronutrients is one of those factors that, indirectly, can cause abnormal hair loss. Not so much because what you eat in a single meal can directly affect the hair bulbs, but for any food shortages that can occur as a result of drastic diets or significant weight loss in a short time.

Among the elements that have primary importance for the health of the hair, it is worth mentioning Iron and B vitamins . It is also very important to monitor the levels of vitamin D which I have extensively covered in this site.

Smoke and hair

 

It is well known that smoking is bad for you, and among the many effects, all negative, that smoking brings … hair problems should not be excluded.Basically everything is due to nicotine which, being a vasoconstrictor , reduces blood circulation in the scalp resulting in less oxygenation and supply of nutrients to the hair bulbs.

To this must be added the inflammatory effect of this substance in the body with consequent greater release of free radicals and therefore cell damage .From here you can understand why many smokers’ hair often appears brittle and dull.

In short, quitting smoking will also be good for your hair.

Traction alopecia

Here too we are in the presence of hair loss not due to pathologies or our genetics, but to our behavior. Traction alopecia is in fact caused by hairstyles that cause continuous traction of the hair . In the initial phase, or in any case in milder cases, it manifests itself with inflammatory phenomena such as folliculitis , itching, etc …

However, if the traction phenomenon persists, there is real hair loss with the formation of alopecic patches without hair. Fortunately, it is a reversible problem as it is sufficient to eliminate the traction by changing your hairstyle.

Hair loss remedies

When looking for information on the main hair loss remedies, you are literally inundated with a multitude of information and products. As you can imagine after having seen the way in which I have structured this article, I first of all consider it necessary to distinguish between drug therapies and natural remedies.

Pharmacological remedies

Obviously, the topic is vast and it is not possible to deal with everything here. However, below I will substantially explain the drugs used to treat cases of hair loss due to the diseases that we have at the beginning of this page.

For many of these you can find in-depth guides with dedicated pages on this site.

  • Minoxidil : drug approved for the treatment of androgenetic alopecia but has properties of hair growth stimulator that make it suitable for other hair problems as well. It works by increasing blood circulation and synchronizing the hair cycle in the anagen phase.
  • Finasteride : it is also officially approved for common baldness and, in my opinion, represents the main pillar in the treatment as it reduces the conversion of testosterone to DHT which is the trigger in predisposed people. Being an antiandrogen drug, by its nature it is only useful for treating androgenetic alopecia.
  • Dutasteride : is part of the antiandrogens and therefore acts in a similar way to finasteride. On the contrary, it is also more powerful and consequently can cause greater side effects. To date, it is not approved in America and Europe for the treatment of androgenetic alopecia. For this purpose it is prescribed off label by some dermatologists but to date there are no official protocols for AGA
  • Ketoconazole : thanks to its anti-fungal and anti-inflammatory properties, it is used in lotions and shampoos to treat seborrheic dermatitis and generally states of irritation and trichodynia of the scalp.
  • Cortisones : used in the form of intramuscular injections to block phases of acute telogen effluvium. They also give good results in less severe cases of alopecia areata. While for chronic telogen effluvium or mild forms, topical applications are used. Hydrocortisone butyrate is widely used in the lotions to calm the mild inflammatory state characteristic of most forms of fall. In fact, in my personal therapy it is present.
  • Immunosuppressants : in the most severe cases of alopecia areata, cyclosporins are used which reduce the activity of the immune system by blocking the attack against its own follicles and thus allowing their activity to resume.

It should be remembered that ALL the aforementioned drugs can be used on medical prescription issued by a specialized doctor.

  • Low Level Laser LLLT : Laser hair therapy  technically does not fall into any of the 3 categories of remedies I have identified (pharmaceuticals, natural and aesthetic). I prefer to insert it here because, in my view, it has more affinity with drug therapies. Low-level laser therapy (LLLT) is already used successfully in many areas and also with regard to hair it can be useful in certain cases thanks to its proven ability to intervene on circulation and accelerate cellular metabolism. It is not decisive, but it can be an excellent adjuvant to strengthen the effectiveness of drugs.

 

Natural Hair Loss Remedies

Here a world opens up as there are so many supplements and foods with allegedly beneficial properties for the hair. On this site we have already treated some with greater interest in those effective against androgenetic alopecia, some other forms of hair loss and finally those with recognized ability to keep the scalp healthy. Here are the main ones.

  • Vitamins : as already mentioned, all the B vitamins useful for skin health and hair shine have great importance. Then follow those with strong antioxidant properties such as A, C and E. An excellent remedy against seborrheic dermatitis is instead represented by vitamin H, better known as biotin. If you want to learn more, I invite you to read our guide on the most important vitamins for hair . A separate case is represented by vitamin D3 which due to its characteristics and functions performed not only for the hair but for the whole organism can be almost assimilated to a hormone. Given its importance, I invite you to read our in-depth analysis on vitamin D where its influence on hair loss is also treated.

ATTENTION: the integration of vitamins must be carried out after the deficiency has been ascertained with specific tests prescribed by the doctor. Of course they are not drugs, but taking them unnecessarily is useless and in some cases harmful.

  • Serenoa Repens : has antiandrogenic properties since it manages to reduce the conversion of testosterone into dihydrotestosterone. It is useful in prostate and urinary tract disorders, while for the hair it is a valid help in cases of mild androgenetic alopecia. In my opinion, and also according to the numerous studies carried out that you can see in the specific guide, serenoa repens is currently the only valid natural alternative to finasteride and dutasteride albeit with obviously lower results than drugs.
  • Horsetail : in general, horsetail is known for its diuretic and purifying properties, but in the trichological field it is used for its high content in minerals including potassium and especially silicon, which are very useful for remineralizing and strengthening the skin appendages, i.e. hair and nails when they appear dull and weakened.
  • Zinc : this mineral is very important for the functions it performs in the male body, especially. In fact, it optimizes testosterone levels but at the same time has a mild antiaromatase function so it keeps the level of estrogens (female hormones) under control. Regulates cell regeneration by promoting protein synthesis and therefore also the keratocytes of which hair and nails are made. Its effects are enhanced by the combined use with vitamin A. A deficiency can lead to hair loss and in fact it is one of the values ​​that trichologists ask to be monitored in analyzes for check-ups.
  • Magnesium : magnesium is also an important mineral for the general health of the organism that performs fundamental functions at the muscular and skeletal level. At a trichological level it is useful as it maintains cellular metabolic activity at optimal levels and allows the absorption of vitamins C, E and group B which, as we have seen, are very important for the hair. It also seems to intervene positively in avoiding the appearance of white hair (study). This is also one of the values ​​that dermatologists monitor with analyzes for their trichological patients.
  • Mela Annurca : in chronological order it is probably the most recently released family of hair supplements. The first product was Applemets Hair , which we covered extensively on our site. In short, I can say that this type of product was developed in Italy on the basis of university studies that have shown an effective acceleration of hair and nail growth (test)
  • Neem oil : a very interesting product for its antibacterial and antifungal properties, it manages to keep the scalp healthy and hydrated and is a good natural alternative to keep itchy head and seborrheic dermatitis at bay. There will be an in-depth study in the near future.

Antioxidants

This type of substance carries out a protective action on a general level, reducing damage from cellular oxidation throughout the body. However, they are also very important for hair health and below we will see some of the most used for this purpose:

  • NAC (n-acetyl cysteine): it is known above all for its protective properties for the liver and detoxifying the whole organism. In practice it is able to counteract the oxidative processes and cellular aging and therefore it is also useful for hair health.
  • Green tea : thanks to the antioxidant action of the polyphenols and the anticarcinogenic action of the catechins it contains, it counteracts the action of harmful free radicals. Furthermore, its intake has been associated with an increase in the SHBG protein which keeps a part of testosterone bound. Therefore its use could have a rationale in the context of a therapy against androgenetic alopecia.
  • MSM (methylsulfonylmethane): is a compound that can be found in nature and derives from sulfur. The sulfur amino acids of which it is rich, are very important to keep the protein structures strong and therefore, since the hair is made up of proteins, it increases the speed of growth and quality

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