Hair loss, also known as alopecia, can affect your scalp or your entire body. It can be temporary or permanent, and it can have different causes and patterns. Hair loss can be distressing and affect your self-esteem, but there are treatments available to help you.
What causes hair loss?
There are several possible causes of hair loss. These include:
Major stressors, such as a prolonged illness, job loss, or a bereavement. This kind of hair loss is known as telogen effluvium. It usually occurs within three months of the stressful event and affects the entire scalp. The hair usually grows back within six to nine months.
Some medications, including antidepressants, beta-blockers, levodopa, and chemotherapy drugs. These can cause hair loss by interfering with the normal cycle of hair growth. The hair usually grows back once the medication is stopped or the dose is adjusted.
Hormonal changes, such as pregnancy, childbirth, menopause, thyroid disorders, and polycystic ovary syndrome (PCOS). These can cause hair loss by affecting the balance of hormones that regulate hair growth. The hair usually grows back once the hormonal levels normalize.
Hereditary hair loss, also known as androgenetic alopecia or pattern baldness. This is the most common cause of hair loss, affecting both men and women as they age. It is caused by a combination of genetic and hormonal factors that make the hair follicles shrink and produce thinner and shorter hairs. In men, this typically causes a receding hairline and bald patches on the crown. In women, this typically causes a widening of the part and thinning of the hair on the top of the head.
Autoimmune conditions, such as alopecia areata, lupus, and sarcoidosis. These can cause hair loss by making the immune system attack the hair follicles or the skin around them. This can result in circular or patchy bald spots on the scalp, beard, eyebrows, or other parts of the body. The hair may or may not grow back, depending on the severity and duration of the condition.
Infections, such as fungal infections (e.g., ringworm), bacterial infections (e.g., folliculitis), and viral infections(e.g., herpes zoster). These can cause hair loss by damaging the hair follicles or the skin around them. They may also cause itching, pain, redness, swelling, or oozing. The hair usually grows back once the infection is treated.
Physical or chemical damage, such as excessive styling, heat, chemicals, traction, or friction. These can cause hair loss by breaking or weakening the hair shafts or damaging the hair follicles. This can result in split ends, dryness, brittleness, or bald patches. The hair may grow back if the damage is stopped and the scalp is allowed to heal.
How is hair loss diagnosed?
To diagnose the cause of your hair loss, your doctor will likely give you a physical exam and ask about your medical history, family history, diet, and hair care routine. You might also have some tests, such as:
Blood test. This can help uncover medical conditions that can cause hair loss, such as thyroid disorders, iron deficiency anemia, or hormonal imbalances.
Pull test. Your doctor gently pulls several dozen hairs to see how many come out. This helps determine the stage of the shedding process.
Scalp biopsy. Your doctor scrapes samples from the skin or from a few hairs plucked from the scalp to examine them under a microscope. This can help determine whether an infection or an autoimmune condition is causing hair loss.
Light microscopy. Your doctor uses a special instrument to examine hairs trimmed at their bases. This can help uncover possible disorders of the hair shaft.
How is hair loss treated?
The treatment for hair loss depends on the cause and the pattern of your hair loss. Some treatments aim to prevent further hair loss or stimulate new hair growth, while others aim to cover up or camouflage the bald areas.
Some of the treatment options include:
Medications. There are some medications that can help treat certain types of hair loss by affecting the hormones or enzymes that regulate hair growth. For example:
Minoxidil. This is an over-the-counter topical solution, foam, or shampoo that you apply to your scalp once or twice a day. It can help slow down hair loss and stimulate new hair growth in some people with hereditary hair loss or alopecia areata. It may take at least six months to see results, and you need to keep using it indefinitely to maintain the benefits. Possible side effects include scalp irritation and unwanted hair growth on the face or hands.
Finasteride. This is a prescription oral medication that you take once a day. It can help slow down hair loss and stimulate new hair growth in some men with hereditary hair loss. It may take a few months to see results, and you need to keep taking it indefinitely to maintain the benefits. Possible side effects include decreased sex drive, sexual dysfunction, and increased risk of prostate cancer. Women who are or may be pregnant should not touch crushed or broken tablets.
Spironolactone. This is a prescription oral medication that you take once or twice a day. It can help treat hair loss in some women with hormonal imbalances, such as PCOS or menopause. It works by blocking the effects of androgens (male hormones) on the hair follicles. Possible side effects include irregular periods, breast tenderness, fatigue, and potassium imbalance.
Oral dutasteride. This is a prescription oral medication that you take once a day. It can help treat hair loss in some men with hereditary hair loss. It works by inhibiting the enzymes that convert testosterone to dihydrotestosterone (DHT), which is the hormone that shrinks the hair follicles. Possible side effects are similar to finasteride.
Surgery. There are some surgical procedures that can help restore hair growth in some people with permanent hair loss due to scarring or pattern baldness. For example:
Hair transplantation. This is a procedure where your doctor removes small pieces of scalp with hair from the back or sides of your head and implants them into the bald areas. This can create a natural-looking appearance of fuller hair, but it may require several sessions and can be expensive and painful. Possible complications include infection, bleeding, scarring, and unnatural-looking results.
Scalp reduction. This is a procedure where your doctor removes some of the bald skin from your scalp and stretches the remaining skin with hair over it. This can reduce the size of the bald area, but it may also cause scarring, tightness, or unnatural-looking results.
Scalp expansion. This is a procedure where your doctor inserts a balloon-like device under your scalp skin and gradually inflates it over several weeks to stretch the skin with hair over the bald area. This can prepare the scalp for a hair transplantation or a scalp reduction, but it may also cause discomfort, infection, or unnatural-looking results.
Scalp flap. This is a procedure where your doctor moves a flap of scalp skin with hair from one side of your head to another, covering the bald area. This can create an immediate appearance of fuller hair, but it may also cause scarring, infection, or unnatural-looking results.
Laser therapy. This is a treatment where you expose your scalp to low-level laser light for several minutes at a time, usually two or three times a week. It can help stimulate blood flow and cellular activity in the scalp, which may improve hair growth in some people with hereditary hair loss or alopecia areata. It may take several months to see results, and you need to keep using it indefinitely to maintain the benefits. Possible side effects include scalp irritation and headache.
Alternative therapies. There are some alternative therapies that claim to help treat hair loss by improving your overall health or addressing specific factors that may affect your hair growth. For example:
Acupuncture. This is a therapy where thin needles are inserted into specific points on your body to stimulate energy flow and balance. It may help reduce stress and inflammation, which may improve hair growth in some people with telogen effluvium or alopecia areata. However, there is not enough scientific evidence to support its effectiveness for hair loss.
Aromatherapy. This is a therapy where essential oils are applied to your scalp or inhaled to stimulate your senses and mood. It may help reduce stress and improve blood circulation, which may improve hair growth in some people with telogen effluvium or alopecia areata. However, there is not enough scientific evidence to support its effectiveness for hair loss.
Herbal remedies. There are some herbal remedies that claim to help treat hair loss by affecting the hormones or enzymes that regulate hair growth or by providing nutrients or antioxidants that support the hair follicles. Some examples are saw palmetto, ginkgo biloba, green tea, stinging nettle, and ginseng. However, there is not enough scientific evidence to support their effectiveness for hair loss, and some of them may have side effects or interact with other medications.
Diet and supplements. A balanced and nutritious diet is essential for your overall health and well-being, as well as for your hair health. Some nutrients that are particularly important for hair growth are protein, iron, zinc, biotin, vitamin C, vitamin D, and omega-3 fatty acids. You can get these nutrients from various foods, such as eggs, meat, fish, nuts, seeds, beans, lentils, spinach, broccoli, citrus fruits, and avocados. If you have a deficiency of any of these nutrients, you may need to take supplements to correct it. However, you should always consult your doctor before taking any supplements, as some of them may have side effects or interact with other medications.
Hair care products and practices. The way you treat your hair can also affect its health and growth. Some hair care products and practices that can help prevent or reduce hair loss are:
Using gentle shampoos and conditioners that are suitable for your hair type and scalp condition. Avoid harsh chemicals, sulfates, parabens, and fragrances that can dry out or irritate your scalp and hair.
Using natural oils and masksthat can nourish and moisturize your scalp and hair. Some examples are coconut oil, olive oil, aloe vera gel, honey, yogurt, and egg. You can apply these to your hair once or twice a week, leave them on for 15 to 30 minutes, and then wash them off with a mild shampoo.
Using herbal rinses that can stimulate blood circulation and enhance hair color. Some examples are rosemary, chamomile, sage, and henna. You can steep these herbs in hot water for 15 to 20 minutes, strain the liquid, let it cool down, and then use it as a final rinse after washing your hair.
Avoiding excessive heat stylingsuch as blow-drying, curling, or straightening your hair. These can damage the hair cuticles and make them more prone to breakage. If you do use heat styling tools, use a lower temperature setting and apply a heat protectant spray or serum beforehand.
Avoiding tight hairstyles such as braids, ponytails, buns, or cornrows. These can pull on your hair and cause traction alopecia. If you do wear these hairstyles, make sure they are not too tight and change them frequently to avoid stress on the same areas of your scalp.
Trimming your hair regularly to get rid of split ends and keep your hair healthy. You can trim your hair every six to eight weeks or whenever you notice signs of damage.
Natural Home Remedies for Hair Loss
Some natural home remedies for decreasing hair loss are:
Aloe vera. Aloe vera is a plant that has soothing and healing properties for the scalp. It can help reduce inflammation, irritation, and dryness that may contribute to hair loss. It can also stimulate blood circulation and nourish the hair follicles. To use aloe vera for hair loss, you can apply its juice or gel to your scalp and massage it gently. Leave it on for a few hours or overnight, and then wash it off with lukewarm water. You can also mix aloe vera with organic triphala powder and use it on your hair for 3 to 6 months to treat hair loss.
Coconut oil. Coconut oil is a natural moisturizer and conditioner for the hair. It can help prevent hair breakage, split ends, and damage caused by heat or chemicals. It can also penetrate the hair shaft and nourish the hair from within. To use coconut oil for hair loss, you can warm up some oil and massage it into your scalp and hair. Leave it on for at least an hour or overnight, and then wash it off with a mild shampoo. You can also use coconut milk, which is rich in nutrients that support hair growth. You can make coconut milk at home by grinding the grated coconut and squeezing out its juice. Apply this to your scalp and hair and leave it on for 15 to 20 minutes, and then rinse it off.
Rosemary oil. Rosemary oil is an essential oil that has antioxidant, anti-inflammatory, and antibacterial properties. It can help improve blood circulation, stimulate hair growth, and prevent hair loss caused by aging or hormonal changes. To use rosemary oil for hair loss, you can dilute a few drops of it with a carrier oil, such as jojoba or olive oil, and massage it into your scalp for a few minutes. Leave it on for at least half an hour or overnight, and then wash it off with a mild shampoo. You can also add rosemary oil to your shampoo or conditioner, or use rosemary herbal rinse by steeping some rosemary leaves in hot water, straining the liquid, letting it cool down, and using it as a final rinse after washing your hair.
Onion juice. Onion juice is a natural remedy that has been used for centuries to treat hair loss. It contains sulfur, which is a component of keratin, the protein that makes up the hair. Sulfur can help boost collagen production, which is essential for hair growth. Onion juice can also increase blood flow to the scalp, reduce inflammation, and fight infections that may cause hair loss. To use onion juice for hair loss, you can peel and chop one onion and blend it in a blender or juicer. Strain the juice and apply it to your scalp and hair. Leave it on for 15 to 30 minutes, and then wash it off with a mild shampoo. You can also mix onion juice with other ingredients, such as honey, yogurt, or coconut oil, to enhance its benefits.
Hair loss can be a frustrating and upsetting problem that can affect your self-confidence and quality of life. However, there are many natural ways to treat it or at least slow it down. The best treatment for you depends on the cause and pattern of your hair loss, as well as your personal preferences and budget.
Before trying any natural remedy for hair loss, it is advisable to consult your doctor to rule out any underlying medical conditions that may require treatment. You should also be aware of the possible side effects or interactions of any herbs or supplements you use.
Remember that natural remedies for hair loss may take time to show results, so be patient and consistent with your treatment regimen. You may also need to combine different remedies or try different ones until you find what works best for you.
Hair loss is not a life-threatening condition, but it can affect your emotional well-being. Therefore, it is important to seek support from your family, friends, or a professional if you feel depressed or anxious about it. You are not alone in this journey, and there are many resources available to help you cope with it.
Dr. Karuturi Subrahmanyam, MD, FRCP (London), FACP (USA)
Internal Medicine Specialist
Phone : 85000 23456