Hair Loss Facts
Hair loss or alopecia is among the most prevalent health issues of the modern world. To gain a broader understanding about hair loss and balding condition, it is vital to learn the nature, structure and development of the hair.
On a daily basis, an average person loses fifty to a hundred hair shafts. This is only natural; the body will replace the lost hair strands with some new ones as part of the renewal process in the system. However, due to various factors and triggers, the process of hair growth gradually slows down—leading to the onset of hair loss and hair thinning problems.
The Hair Structure
The hair is created from fibrous structural proteins known as keratin. Each hair strands is made up of three (3) homocentric layers: the cuticle, the cortex and the medulla.
- Cuticle - The cuticle, which is composed of hard shingle-like layer of overlapping cells, is the outmost layer of the hair shaft that serves as its protective covering for the softer inner structures like the medulla and the cortex.
- Cortex - The cortex, which contains the melanin, the enzyme responsible for the natural color of the hair strands, is the layer located underneath the cuticle that determines the texture, strength and elasticity of the hair.
- Medulla - The medulla, which is composed of keratin and is the hair shafts’ deepest layer, is responsible for transporting nutrients and gases on the cortex and the cuticles of the hair.
The Hair Growth Cycle
The hair has its own cycle of development. When this cycle is disrupted, it induces the onset of hair thinning or, worse, hair loss. The hair growth cycle is divided into three (3) phases: the Growth Phase (Anagen), the Transitional Phase (Catagen) and the Resting Phase (Telogen).
- The Growth Phase: Anagen -
The Growth Phase lasts for 2 to 8 years. Within this stage of hair growth, the follicles begin to grow back to their full sizes. A new hair bulb is also created at the base of each follicle, which contains specialized dermal papilla cells that are capable of regrowing new hair strands. About 90 per cent of hair is in the Anagen Phase at any given time.
- The Transitional Phase: Catagen -
The Transitional Phase lasts for 2 to 4 weeks. Within this stage, no pigment is created and the follicle stops producing hair. The follicles do not require sufficient nutrients since they are slowly disintegrating and are expected to shrink (miniaturize) at about 1/6th of its normal diameter. At some point, the hair roots will diminish and the dermal papilla cells will separate itself from the base of the follicle. Moreover, the base of the follicle moves upward towards the surface of the skin.
- The Resting Phase: Telogen - The Restating Phase lasts for 3 to 4 months. Within this stage, the hair begins to shed at normal levels and the hair does not grow but stays attached to the follicle while the dermal papilla stays in a resting phase below. At the end of the Telogen Phase, the follicles go into the Growth Phase wherein the base of the follicle and the dermal papilla will reconnect and new hair will start growing. In cases when the old hair strands have not been shed, the new hair strands push it out and the hair growth cycle will start all over again.
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Causes of Hair Loss
Regardless of age, sexual orientation or status in life, all people may experience hair loss and hair thinning problems due to various influences or triggers. The following are the factors that induce the onset of hair loss and hair thinning which affect the millions of people all over the world.
DRUGS - Medications that are intended to alleviate health conditions can induce hair loss as one of its side effects. Some medications that cause hair loss are: anticonvulsants, anticoagulants, beta blockers, anti-neoplastics, antidepressants and chemotherapy drugs.
- Ageing. The speed at which the hair follicles grow begins to deteriorate with ageing. As people grow old, the hair growth cycle is affected, resulting to the production of shorter, finer and thinner hair strands.
- Dihydrotestosterone (DHT). A hormone produced by the combination of the male hormone, testosterone, and the enzyme, 5-alpha reductase. DHT is the primary cause of hair loss and hair thinning conditions in both men and women.
IMPROPER HAIR CARE
- Hairstyles. Cornrows, dreadlocks and tight ponytails and braids may cause the hair to break easily, setting the stage for hair loss and hair thinning problems.
- Heated Styling Tools. Hot curling irons, permers, blow dryers and straighteners may weaken the hair strands, causing the hair to become brittle, coarse, dry, dull and lifeless.
- Hair Treatments. Hair sprays, mousses, dyes and gels that contain harsh chemical formula may cause hair damage, dryness and split-ends.
Read more on Causes of Hair Loss
- Diseases. Hair loss and hair thinning problems can be a symptom of diseases like thyroid problems (e.g., hypotrichosis, hyper and hypothyroidism), Hashimoto’s disease, Hodgkin’s lymphoma, leukemia, endocrine disorders and autoimmune condition (e.g., lupus).
- Scalp Infections. Kerion, folliculitis, demodex parasiti, piedra and tinea capitis are fungal, bacterial or viral infections which induce balding condition.
- Trichotillomania. An impulse–control problem that triggers the desire to pull, twist or tug the hair strands, resulting to patchy hair loss.
- Menopause. The decrease of the female hormones (e.g., progesterone and estrogen) and the increase of DHT levels during menopause can induce the onset of temporary hair loss.
- Childbirth. Hormonal imbalance during pregnancy and after childbirth (2-3 months) causes temporary hair loss. The hair will resume its natural rate of development on the fourth months after giving birth.
Exposure to chemicals, caustic xrays, gasses and other pollutants are common environmental factors that induce the onset of hair loss and hair thinning conditions. Dust, heat and wind are other environmental factors that cause the hair to become dry, coarse and lifeless, which can set the stage for hair thinning problems.
- Dust. The particles or contaminants of something found on the grounds or surfaces, which are carried by air, can cause hair to become dry, dull and coarse.
- Heat. A condition of a body viewed as having a relatively high degree of warmth (e.g.., ultra violet rays emitted by the sun.)
- Wind. The natural and appreciable movement of the air from one area of high pressure to another area of low pressure.
- Bad Habits. Alcohol found in beverages and nicotine in cigarettes may trigger the onset of hair loss and hair thinning problems when consumed in greater amount.
- Malnutrition. The lack of vitamins and minerals in the body causes the onset of hair loss and hair thinning problems. Anorexia and anemia are two eating disorders that exhibit hair loss or hair thinning problem as one of their symptoms.
- Stress. Emotional and physical stress affects the growth of the hair follicles. Since stress may hinder the proper flow of blood in the scalp, the supply of oxygen and nutrients to the roots is limited; hence, weakening the hair follicles and producing finer and thinner hair strands.
Types of Alopecia
Adults and children, regardless of gender and age, may be affected with hair loss and hair thinning problems. There are different types of alopecia; these types vary depending on where the disease occurs in the body or what triggers the condition. In other words, the type of alopecia or hair loss is defined by who it affects and on what part of the body the sign of alopecia becomes evident.
- Alopecia Androgenic — a type of alopecia that is hereditary. Androgenic alopecia, which is referred to as male or female pattern baldness, is the most common type of hair loss experienced by men and women. With women, the pattern of hair loss is dispersed all over the scalp while the frontal hairline generally remains intact. With men, on the other part, the pattern of baldness occurs on the vertex of the scalp and in the front area.
- Alopecia Areata (AA) — a type of alopecia that occurs in random patches and appears all over the body. Alopecia areata, which is an autoimmune disease, targets the growing cells in the hair follicles, causing them to shrink; thus, affecting the hair growth cycle.
- Alopecia Barbae. A type of alopecia which exhibits the loss of hairs on the beard area.
- Alopecia Ophiasis. A type of alopecia areata that occurs around the neck and the regions above the ears. In the early stages of alopecia ophiasis, a single patch of hair loss is visible, which will then spread all over the scalp.
- Alopecia Totalis. A type of alopecia areata which is characterized by the loss of hair on the entire scalp. Alopecia totalis is caused by an autoimmune disorder.
- Alopecia Universalis. A type alopecia areata that is severe in nature. It is characterized by the loss of hair in all parts of the body, including the scalp, eyelashes, eyebrows, underarms and pubic area.
- Diffuse Alopecia Areata. A type of alopecia areata that causes partial hair loss all over the scalp. In some cases, hair loss which resembles typical male or female pattern of hair loss is noticeable. Diffuse alopecia areata exhibits similarities with anagen effluvium and telogen effluvium.
- Perinevoid Alopecia Areata. A type of alopecia areata that is characterized by spots of skin having properties different from the surrounding general skin area. Around these pigmented spots are bald patches with characteristics like alopecia areata.
- Reticulated Areata Barbae. A type of alopecia areata which is characterized by irregular patterns of hair loss. Generally, the regions of hair loss interspersed with areas with normal hair growth.
- Anagen Effluvium — a type of alopecia characterized by a pathologic loss of anagen hairs due to the treatment of conditions such as chemotherapy and radiation therapy. With anagen effluvium, the temporary hair loss occurs in tiny patches.
- Alopecia Mucinosa — a type of alopecia wherein the hair loss is accompanied by the appearance of scaly patches on various parts of the skin, face and neck. Alopecia mucinosa is also known as follicular mucinosis.
- Scarring Alopecia — a type of alopecia that is permanent. Scarring alopecia, which is referred to as cicatricial alopecia, is triggered by varied group of rare disorders that destroy the hair follicles, replacing them with scar tissues.
- Telogen Effluvium — a type of alopecia that occurs when large quantity of hair strands enter the telogen stage, causing thinning and rapid shedding. Telogen effluvium is triggered by various factors like recent surgery, stress (e.g., physical and emotional), medications, hormonal imbalance during pregnancy and malnutrition.
- Traction Alopecia — a type of alopecia that is a result of extreme force applied during hair brushing or styling. Traction alopecia affects the area around the edge of the hairline, making the bald patch and hair loss noticeable around the face and forehead.
- Trichotillomania — a type of alopecia that is characterized by an overwhelming desire to pull, tug or twist the hair, causing permanent hair loss. With trichotillomania, the hair loss is limited and the resulting patch forms an angular pattern.
Hair Loss in Women
Hair loss in women is quite subtle and somewhat unpredictable. In fact, a woman experiencing this condition may not recognize the signs that she is slowly losing her crowning glory—until the hair loss has progressed and becomes more pronounced.
Female hair loss, like male hair loss, is a multi-factorial condition that is influenced by various triggers. Since a woman’s body works differently than that of men, the primary cause of hair loss in women is not the overproduction of dihydrotestosteron (DHT) in the scalp but the fluctuating hormone levels. In fact, experts revealed that the most common cause of female baldness is usually hormonal imbalance in the body which happens during menopause and pregnancy.
Other risk factors that trigger the onset of hair loss and hair thinning conditions in women are: infections (e.g., piedra, tinea capitis and kerion); underlying medical conditions (e.g., autoimmune disorders and thyroid problems); unhealthy lifestyle (e.g., extreme dieting and over-stress); bad habits (e.g., cigarette smoking and alcohol drinking); cosmetics (e.g., harsh chemical treatments) and medications (e.g., birth control pills and chemotherapy drugs).
Women’s hair loss and hair thinning problems are characterized by different patterns. To identify the patterns and classify the stages of the female hair loss, the Ludwig Scale is used. This tool is helpful in identifying how advance the hair loss or baldness is by categorizing the condition into four (4) phases. Phase 1 is considered the mildest while Phase 4 is revealed to be the most advanced case of hair loss in women.
Phase 1 — is characterized by a pattern of diffuse hair thinning condition that begins on top of the head and proceeds all over the scalp, in the area of the parting. With this stage, it’s hard to determine any major sign of hair loss since it’s evenly spread throughout the entire scalp. In this early development of female hair loss, the victim needs to consult a doctor in order to be given immediate proper treatment to prevent its progression.
Phase 2 — characterized by an overall hair appearance that looks thinner and finer thinner. When a woman is in the Phase 2 of the Ludwig Scale, the hair loss is more visible. She has most probable lost over half of her hair strands and the parting will be more extensive. Within this stage of hair loss, the patient needs to have a focused treatment to prevent the condition from worsening.
Phase 3 — characterized by excessive hair loss or balding problem that is very noticeable. There are parts of the scalp with more hair; however, the hair thinning is evenly distributed on the entire scalp. During this level of hair loss, treatments through topical and oral medications have no use. Physicians may suggest hair restoration hair systems and transplant surgery as the means to end the onset of hair loss.
Phase 4 — characterized by hair loss that has reached a complex degree, where more scalp is evident and the hair is also less palpable. This stage is considered the most advance level of female pattern baldness wherein the use of topical and oral medications is hopeless. The best option to undertake when a woman is experiencing Phase 4 pattern of hair loss is to cover up the head using wigs and hair systems.
Hair Loss in Men
All of us are susceptible to hair loss and hair thinning problems. In fact, all people will experience this cosmetic problem at any time in their lives.
Men, in general, are more at risk of hair loss and balding problems compared to women. Most men start to experience hair thinning conditions as early as their adolescence. Others who are in their twenties or thirties may experience early signs of receding hairlines. These hair loss and hair thinning conditions may get worse, ultimately resulting to the onset of baldness. Even though the speed at which men lose their hair is very individualized, research revealed that an approximated 25 per cent of men in their twenties, 40 per cent of men in their forties and 50 per cent of men in their fifties exhibit various signs of hair loss.
For men who are experiencing various patterns of hair loss, it is crucial to know how far the hair loss has progressed in order to prevent its further onset. A tool known as the Hamilton–Norwood Scale helps determine the ways how pattern baldness occurs in men. It provides a comparative analysis on how mild or severe your hair loss condition is.
The Hamilton–Norwood Scale is divided into two parts: (1) the “A” for the anterior view and (2) the “V” for the vertex view. The former is characterized by a receding hairline from the front of the scalp while the latter shows the receding hairline from the crown area of the scalp.
- Level I — characterized by a slight recession of the hairline that generally rests on the upper brow crease. Level I is said to be a mild case of hair loss that is not noticeable by patients.
- Level II — shows a development to the adult hairline, which is visible above the upper brow crease. Level II hair loss condition is the time when patients begin to recognize that they may be losing their hair.
A. Shows a visible minimal receding hairline in the front or the side of the scalp.
V. Exhibits a visible tiny thinning circle in the crown area of the scalp.
- Level III — characterized by a hair loss condition that is noticeable and more serious than Levels I and II. Level III is considered the earliest stage of male pattern baldness; hence, more aggressive actions are needed in order to help treat and prevent its further onset.
A. Exhibits the same receding pattern as Level II; however, the hairline gets deeper on the back portion of the head.
V. Shows an early sign of hair loss located in the crown (vertex) area. When the bald spot grows bigger, the person with this condition may observe some frontal thinning of the hair.
- Level IV— exhibits frontal hair loss condition and enlargement of the vertex, although there is still a solid band of hair located across the top that separates the vertex and the front. Level V hair loss condition shows the vertex area, which is most of the time balding.
A. Shows that the frontal region almost reaches the top (vertex) of the head.
V. Displays balding condition that is quite noticeable. The front area of the head also begins to thin dramatically towards the vertex.
- Level V— exhibits a bald vertex area; there are no hair strands visible in the front-temporal area. The bald spot in the front and crown area continues to enlarge and the bridge of hair separating the two begins to break down. Level V is relatively similar to Level IV; however, the band separating the two bald areas (crown and front) is much thinner, accompanied by the development of shorter and finer hair strands.
- Level VI— occurs when the connecting bridge of hair is no longer noticeable, leaving a single large bald area located on the front and at the top of the scalp. On the other part, the hair on the sides of the scalp remains moderately high.
- Level VII— shows an extensive balding problem with only a wreath of hair remaining in the sides and back portion of the scalp. Level VII is considered the most severe case of male pattern baldness, wherein the band of hair remaining is narrow and the quality is weak.
Stage A — characterized by patterns that are less common than the regular pattern (<10%), but are significant since the hair loss is most dramatic in the front wherein the patients look very bald even though the hair loss is minimal.
Treatments for Hair Loss
The modern world offers a variety of products and procedures to help prevent the onset of hair loss and hair thinning problems.
Whether the hair loss is a mild or severe case, there are various hair loss treatments that aim in helping people attain thicker, fuller and healthier hair strands. Here are the major types of treatments for hair loss and hair thinning problems.
- Finasteride — a Food and Drug Administration (FDA) approved oral medication that serves as an androgen inhibitor, a substance that impedes the overproduction of the hormone dihydrotestosterone (DHT) in the scalp. Finasteride circulates through the blood stream and binds DHT into an unusable form, thereby stopping the onset of hair loss and promoting the growth of healthier hair follicles.
- Minoxidil — a topical solution that is a potent vasodilator, a substance that expands the capillaries and blood vessels of the body to allow efficient flow of blood in the scalp, thereby delivering adequate supply of oxygen and nutrients to the hair roots for optimum follicle growth. This FDA-approved medication also helps control the overproduction of dihydrotestosterone (DHT) in the scalp, encouraging the growth of thicker and healthier hair strands.
Surgical Hair Restoration
- Hair Transplant— the surgical technique that removes small portions of the hair-bearing scalp, which is located in the sides or back portion of the head (donor site), and transplanting these hair grafts to the balding spot (recipient site) of the patient's scalp.
Non-Surgical Hair Restoration
- Laser Phototherapy — a cutting-edge technology that uses phototherapy or light healing in the form of low level laser light (LLLL) and light emitting diode (LED) to reactivate dormant and weakening hair follicles. Exciting the mitochondria of the follicles and repairing damaged tissues or cells in the scalps help encourage the development of thicker and healthier hair strands.
- Hair Systems — the kind of hair replacement that involves the use of thin, light and transparent synthetic membranes, which are woven in with the existing human hair strands and attached to the scalp, to create a natural-looking head of hair.
Herbal Hair Loss Remedy
- Aromatherapy — an ancient form of healing that relaxes and energizes the body with the use of oil extracted from the flowers, fruits, barks, roots and seeds of various herbs for the purpose of changing an individual’s disposition, cognitive function and health. These plant essences known as essential oils are excellent nourishing, cleansing and strengthening agents that promote the development of thicker, fuller and shinier hair strands.
Holistic Hair Loss Treatment
- Acupuncture — a complex therapy used to maintain good health by stimulating proper blood flow to all parts of the body, including the scalp. Acupuncture is done by inserting small sterile needles to various points in the body; hence, encouraging proper blood flow and supporting the development of the hair follicles.
- Ayurveda — an ancient form of alternative healing that works on the principle that an individual’s health depends on the three (3) doshas: pitta, vata and kapha. Balancing the Pitta dosha through proper lifestyle change, application of herbs, meditation, yoga, scalp massage and exercises can help stop further hair loss and promote healthier hair.
- Body Detoxification — a method of ridding the body of toxins and harmful chemical substances for it to function efficiently and properly, ensuring good health and a sense of wellbeing. Through regular physical activities, a person can get rid of toxins to promote healthy hair and body.
- Homeopathy — an unconventional form of medicine that treats an individual’s ailment by triggering the body's natural process of healing. Homeopathy takes into consideration the psychosomatic links, a term used to describe the influence of the mind on the body and vice versa, with respect to a disease or condition.
- Meditation — an ancient art of healing that promotes internal peace, resulting in overall health the body. Meditation helps overcome hair loss by reinvigorating the mind and the body to get rid of tiredness and stress, which is among the many factors that induce the onset of baldness and thinning hair.
- Scalp Massage — an art of healing that involves rubbing, kneading and putting pressure on the scalp skin with the use of the fingers and hands to improve circulation. This act of manipulating exterior layers of muscles and tissues helps promote relaxation and delivers adequate supply of nutrients and blood to the hair roots for optimum hair growth.
- Yoga — an ancient Indian form of breathing exercise that restores the balance and harmony of the body and emotions. Yoga increases the body's flexibility and capability for relaxation, aiding in overcoming anxiety, indigestion, stress and poor blood circulation, which serve as triggering factors that influence the onslaught of hair loss and hair thinning problems.