Hair loss is something most of us associate with men — that embarrassing comb-over an uncle favours or our partner’s rapidly expanding bald patch. It is not, however, something most women expect to have to deal with.
And it often is a health issue, caused by an underlying medical condition.”Everybody loses at least 100 hairs a day,” says Dr Kevin Alexander of the Hair Loss Clinic in Johannesburg. This is perfectly normal. The body has a natural need to replace old hairs with new ones, and the old hair falls out when it is pushed out by the new hair growing through.”In certain instances, natural hair loss may become excessive. For example, following severe emotional or physical trauma or following a hormonal stress, as is the case after pregnancy.”
The good news is that these are temporary conditions, and provided there is no other underlying problem, your hair will usually self-correct within a few weeks. True hair loss, however, leading to a permanent thinning of the scalp hair or even bald spots, means that you have an underlying inherited or pathological condition.
CAUSES OF HAIR LOSS
IN YOUR GENES
By far the most common condition leading to permanent hair thinning in both men and women, is the inherited condition of alopecia androgenetica, simply known as male/female pattern baldness. It’s in your genes, so you have your parents to thank. “It can be inherited from the maternal as well as the paternal side of the family and can go back six generations,” says Dr Alexander.
“It is a complex pattern of inheritance which can skip generations and often, people who have inherited the condition don’t know of anyone else in their family who is similarly afflicted. About 95% of all men and women seeking help for hair loss have alopecia androgenetica, and roughly 40–50% of women will experience some form of hair thinning from alopecia androgenetica in their lifetime.”
ANTIBODY ATTACK
“Another less common cause of hair loss is a condition known as alopecia areata. In this condition, the body fails to recognise its own hair follicles as belonging to itself and mounts an antibody attack on its own hair follicles. This leads to a sudden and dramatic loss of hair, which can occur overnight and usually starts in patches. This condition could spread to involve the entire head or even the entire body.”
Other causes of hair loss include thyroid problems, iron deficiency anaemia, fungal scalp infections, specific hormonal problems and numerous other, less common, causes.
STRESS AND TRAUMA
Extreme stress and trauma can cause temporary hair loss by creating a hormonal flux in the body. “Since the hair follicles have genetic receptors which are sensitive to hormonal changes, the hair can fall out prematurely. We see the same thing happening in women after pregnancy due to the massive hormonal flux created by the drop in oestrogen about four to six months after giving birth.
“The prognosis for full recovery of one’s hair is excellent, provided that there is no underlying pathological or inherited condition such as alopecia androgenetica. If there is an underlying condition present, then the hairs which grow back to replace the ones which have fallen out will be thinner and finer than the lost hairs, leading to permanent thinning of hair. In the case of alopecia androgenetica, the stress or trauma acts as an accelerating factor, speeding up the permanent thinning,” says Dr Alexander.
CHEMOTHERAPY
One of the most devastating side-effects of chemotherapy is hair loss — and it’s not just your head that’s affected. Cancer patients lose their eyebrows, eyelashes and body hair too. This is because chemotherapy is a toxic substance to any cell in the body that has a rapid turnover rate, such as cancer cells, blood cells and hair follicle cells.
“The effect is not permanent and most people will start growing their hair back about three months after completing their chemotherapy treatment,” says Dr Alexander. “It usually grows back exactly as before, but there have been odd cases reported of better growth, worse growth or even colour changes. The colour changes are usually from dark to grey or white. In these cases, the melanocytes, which are pigment-producing cells, have been affected by the chemotherapy or by something else either related or unrelated to the underlying illness,” he says.
DIET
Of course diet also has a role to play in the health of your hair, but diet does not influence hair loss to the extent that most people believe. “The hair requires certain minerals, vitamins and nutrients (eg. zinc, calcium, iron, folic acid and biotin) which are generally found in most well-balanced diets. Of these, iron is the most important, but you need to be extremely deficient in iron before this translates into actual, visible hair loss. On the other hand, overdosing with vitamin A in supplement form could eventually lead to hair loss.
“Very few cases of hair loss are caused by diet alone, and so altering one’s diet and treating the condition with hair vitamin supplementation or other natural remedies is unlikely to be successful.
“It’s the genetic factor that is overwhelming in terms of its influence on hair loss,” explains Dr Alexander. “I often use the example of the homeless guy on the street corner, begging for food, who usually has a thick mop of hair, and the tri-athlete who cycles past him who is going bald!”
SELF-INFLICTED HAIR LOSS
Medical conditions aside, you can inflict hair loss on yourself, says Eunice Bester, a stylist with 30 years’ experience in the haircare industry, who has owned several salons and is now sales and technical director for Eco Sales, a sub-distributor for Joico International hair products.
“Crash diets can cause temporary hair loss,” she cautions. “When a person diets, certain proteins and minerals that are essential to maintaining healthy hair are excluded.” This can be clearly seen in bulimia and anorexia nervosa, where pronounced hair loss is one of the symptoms of the condition.
“Excessive use of heat also burns the hair, while incorrect brushes and excessive tension on the hair causes it to stretch and break,” she adds. “It’s also essential to protect the hair against sun and heat. Just as we use sunscreen on our skin to protect it from the sun’s UV rays, the same principle should be applied to the hair, as the hair is an extension of our skin.”
But you can’t cause hair loss by over-washing, says Dr Alexander: “The only chemical treatments I know of that may cause hair loss are straightening or relaxing lotions and perming lotions. These have the potential to permeate right through to the follicle base and permanently denature the entire protein structure of the hair. It is a rare but very devastating complication of hair straightening or perming procedures.”
This is because most causes of hair loss work at the level of the hair follicle, he explains, and unless a chemical is able to penetrate through to the level of the hair follicle itself, it is unlikely to cause hair loss. Most chemicals used in hair treatments exhibit their effect in terms of the condition of the hair above the level of the scalp.
TREATMENT AND PREVENTION
The less common causes of hair loss, such as iron deficiency and thyroid problems, can be prevented if they are diagnosed and remedied early, as hair loss is usually a late sign of these conditions. Another preventive measure would be to ensure when taking your daily dose of vitamins, that you don’t overdose with vitamin A.
There’s not much you can do to prevent the occurrence of either female pattern baldness or alopecia areata, although both conditions are now treatable — and you won’t have to resort to Donald Trump-style mane manipulation or surgical procedures such as hair transplants.
“There has been a recent ‘revolution’ in terms of medical treatment (prescription tablets and lotions) for hair loss in both men and women,” says Dr Alexander. “We are now seeing results with medical treatments which, a few years ago, were thought to be impossible to achieve. “We have safe and effective drugs which are specific to gender, such as the new male anti-baldness pill Propecia, which cannot be given to women, but which can cause hair regrowth in 66% of men and prevent further loss in 83% of men. We also have a female-specific anti-baldness pill which should not be given to males. The prescription lotions we use can be safely used by either sex.
“All of these medicines have a sound scientific basis, and have been extensively tested in clinical drug trials worldwide, where they have been found to be effective and safe,” says Dr Alexander.
Unfortunately, you will have to use the treatments for the rest of your life, but when you run your hands through a full head of hair again, no doubt you’ll agree that it’s a small price to pay.
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