Conditions We Treat

Hair loss

To many people, hair is an important form of self-expression, and it is also an important indicator of health. Hence, hair loss can be a source of concern both for overall well-being as well as a cause for low self-esteem. There are many factors that can lead to excessive hair loss, including stress, hormonal changes, side effects of medications or treatments, as well as genetics.

Types of hair loss

Hair loss, also known as alopecia, can be divided into two categories, cicatricial alopecia and non-cicatricial alopecia [1]. Non-cicatricial alopecia is more common.

Types of non-cicatricial alopecia include:

Androgenetic alopecia — Androgenetic alopecia is also commonly known as male pattern or female pattern baldness. It is the most common cause of hair loss and is genetically inherited.
Alopecia areata — Alopecia areata is an autoimmune disease that causes hair loss. Round patches of baldness are seen on the head in this type of hair loss.
Telogen effluvium — Telogen effluvium refers to hair loss due to shedding of hair in their telogen phase (the resting phase) [2].
Anagen effluvium — Anagen effluvium occurs when hair is shed during the anagen phase (growing phase).

Cicatricial alopecia refers to permanent and scarring alopecia, where hair follicles are replaced by fibrosis [1]. Cicatricial alopecia is fortunately much rarer. Available treatments for scarring alopecia are targeted at slowing down the progression of hair loss while preserving the remaining hair.

Causes of hair loss

View this post on Instagram

A post shared by Livingstone Dermatology (@livingstonedermatology)

Hair loss can be temporary or permanent depending on the causes or triggers. Among the common causes of hair loss are:

Genetics – A major factor for male and female pattern balding (androgenetic alopecia) is genetics. Studies have also shown that androgenetic alopecia is a polygenic condition, which means that it may be caused due to multiple genes [3]. Genetic predisposition can cause the hair follicles to be susceptible to the effects of dihydrotestosterone (DHT), which causes hair follicles to shrink and stop growing hair [1]
Age – With age, the hair growth cycle slows down and eventually stops growing. This gradually causes hair to thin.
Hormonal changes – Hormonal changes due to menopause or imbalance in polycystic ovary syndrome (PCOS) can show symptoms of hair thinning.
Illness – Some illnesses can cause hair shedding [1].
Childbirth – Some women experience postpartum hair loss due to an increase in telogen effluvium after childbirth [4].
Cancer treatment – Chemotherapy or radiation therapy may cause hair loss in cancer patients.
Stress – Stressful events in your life can have an impact on hair growth, hence causing hair loss. This can be reversed when the stress has subsided.
Medication – Certain medications can induce telogen effluvium or anagen effluvium. These medications include antidepressants, birth control pills, antibiotics, beta-blockers, hormone replacement therapy, chemotherapy, blood thinners, and cholesterol medications.
Underlying conditions – Scalp conditions such as scalp psoriasis or scalp infections due to ringworm or folliculitis can cause hair loss. Thyroid disease or nutrient deficiencies such as iron, biotin, or zinc can also lead to hair thinning.

When do I need to see a doctor?

It is normal to lose between 50 to 100 strands of hair per day due to the hair growth cycle. Seeing a few strands of hair in the shower drain or your hair brush are not a cause for concern. However, if you are seeing abnormal amounts of shedding or hair loss, it may be time to visit a dermatologist.

Additionally, patches of bald spots or thinning hair can also indicate a hair loss problem.

How to prevent hair loss

Some forms of hair loss are temporary and the hair may regrow with proper care. Some tips to prevent excessive hair loss include:

Managing stress – Stress in our daily life may cause hair to fall out, reducing the cause of stress can reverse it.
Maintain a healthy diet – Nutrient deficiencies may disturb the hair growth cycle, causing hair follicles to shed more [5]. Deficiencies in vitamins (vitamin A, vitamin B, vitamin C, and vitamin D) and minerals (iron and zinc) are associated with increased hair loss [6].
Develop a hair care routine – Keeping your hair healthy by building a proper hair care routine can reduce hair shedding. A clean and healthy scalp can ensure a healthy hair growth cycle.
Avoid damaging hair styling – Hair styling methods can damage and weaken hair, causing it to shed. Tight ponytails or braids can pull at the root and potentially lead to hair loss.
Getting proper treatment for medical conditions – Potential causes of hair loss such as illness, hormonal imbalance, or scalp infections require medical intervention to resolve the underlying cause.

Treatments for hair loss

Depending on the cause of the hair loss, your dermatologist may employ the following treatments.

Medications – Common hair loss medications are minoxidil and finasteride. Both these medications come in both topical and oral formulations. There are also various botanical extracts which have been proven to be helpful for hair loss for patients who are not suitable for the above medications.
Laser therapy – Lasers and low-level light therapy works by stimulating cell proliferation to the hair follicles and increasing blood flow to the scalp [7]. Some of these can be performed at home whilst some are performed in office.
Microneedling – Tiny needles prick the surface of the scalp, which induces a process of healing. Growth factors produced in the treated area will encourage formation of new blood vessels [7].
Hair transplant – Hair transplant involves the dermatologist extracting healthy follicles from existing hair on the head and transplanting the follicles in the areas without hair [7]. The two common methods of hair transplant are follicular unit transplantation (FUT) and follicular unit extraction (FUE).

Losing hair can be a cause of concern or insecurity. With proper diagnosis and understanding of the cause, it can either be reversed or treated to prevent further hair loss. Schedule an appointment with our dermatologist now if you have concerns regarding your hair and scalp health.

Frequently Asked Questions

Can my hair regrow?

Hair can regrow after hair loss if the root cause of hair loss is removed or resolved. Hereditary hair loss has no cure and may not be reversible, but treatments are available to improve hair growth and slow down hair loss.

What is the most common cause for hair loss?

The most common causes for hair loss include genetic predisposition and ageing.

Can home remedies cure hair loss?

Home remedies may help mitigate hair loss and promote hair growth, but results may vary from person to person and provide modest results.

When it comes to more significant hair loss, evidence based medical treatments tend to be more effective and can reliably yield more results. This can be beneficial in cases where hair loss is advanced or rapidly progressing.

Is surgery required for most patients with hair loss?

A dermatologist may occasionally perform biopsies to confirm the diagnosis in the minority of cases. However, most cases of hair loss can be diagnosed clinically without the need for any surgery.

References

Alessandrini A, Bruni F, Piraccini BM, Starace M. Common causes of hair loss – clinical manifestations, trichoscopy and therapy. J Eur Acad Dermatol Venereol. 2021 Mar;35(3):629-640. doi: 10.1111/jdv.17079. Epub 2021 Jan 8. PMID: 33290611.
Park AM, Khan S, Rawnsley J. Hair Biology: Growth and Pigmentation. Facial Plast Surg Clin North Am. 2018 Nov;26(4):415-424. doi: 10.1016/j.fsc.2018.06.003. Epub 2018 Aug 16. PMID: 30213423.
Lolli F, Pallotti F, Rossi A, Fortuna MC, Caro G, Lenzi A, Sansone A, Lombardo F. Androgenetic alopecia: a review. Endocrine. 2017 Jul;57(1):9-17. doi: 10.1007/s12020-017-1280-y. Epub 2017 Mar 28. PMID: 28349362.
Gizlenti S, Ekmekci TR. The changes in the hair cycle during gestation and the post-partum period. J Eur Acad Dermatol Venereol. 2014 Jul;28(7):878-81. doi: 10.1111/jdv.12188. Epub 2013 May 20. PMID: 23682615.
Natarelli N, Gahoonia N, Sivamani RK. Integrative and Mechanistic Approach to the Hair Growth Cycle and Hair Loss. J Clin Med. 2023 Jan 23;12(3):893. doi: 10.3390/jcm12030893. PMID: 36769541; PMCID: PMC9917549.
Almohanna HM, Ahmed AA, Tsatalis JP, Tosti A. The Role of Vitamins and Minerals in Hair Loss: A Review. Dermatol Ther (Heidelb). 2019 Mar;9(1):51-70. doi: 10.1007/s13555-018-0278-6. Epub 2018 Dec 13. PMID: 30547302; PMCID: PMC6380979.
Devjani S, Ezemma O, Kelley KJ, Stratton E, Senna M. Androgenetic Alopecia: Therapy Update. Drugs. 2023 Jun;83(8):701-715. doi: 10.1007/s40265-023-01880-x. Epub 2023 May 11. PMID: 37166619; PMCID: PMC10173235.

Related Services

Paediatric Dermatology

Cosmetic Dermatology

Your Journey to Healthy Skin Starts Here

Whether you’re dealing with a specific skin concern or seeking to enhance your natural beauty, Livingstone Dermatology is here to guide you on your journey to healthy, radiant skin.

Schedule an appointment today and experience the Livingstone standard of care in a welcoming, professional environment.