Hair Loss

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Hair loss, or alopecia as it is medically known, is a general term describing the loss of hair from not only the head but any part of the human body. While up to 50% of people aged 50 years or older suffer hair loss to the point of thinning or balding, losing a certain amount of hair during the course of each day is perfectly normal.

Natural Hair Growth Cycle

Throughout our lives the body sheds on average 50 to 100 hairs per-day through its natural growth-cycle. The growth-cycle leading to eventual natural hair loss is:

  • Anagen: the active growth stage for hair follicles and lasts 2 to 7 years for scalp hair and typically only several months for eyebrow, facial and body hair. This length of time is genetically determined but can also be interrupted by external factors such as stress, diet and illness. At the end of the anagenic phase the follicle then enters the catagen phase.
  • Catagen: a short transitional phase lasting 2-3 weeks. The follicles shrink to about a 1/6 of their normal length and a new hair forms underneath the existing one without the old hair falling out.
  • Telogen: the resting phase of the follicle during which the old hair is finally shed from the body. Anywhere from 50 to 100 telogen-phase hairs are shed from an average human body during the course of each day.

Causes of Hair Loss

So, a certain amount of hair loss throughout the course of each day is perfectly normal and can be attributed to the natural life-cycle of the human hair. More rapid hair loss that is not considered normal can be caused by a number of factors:

  • Hereditary hair loss (androgenic alopecia) is a common form of hair loss in men, and sometimes in women, due to the anabolic effect of naturally occurring androgens within the body. Also known as “male/female pattern baldness,” it can be inherited from one or both parents.
  • Health problems and their treatments. Diseases that can cause hair loss range from fungal infections like tinea capitis, both hyper and hypothyroidism, to discoid lupus (DLE). Treatments for cancer such as radiation and chemotherapy can both contribute as well.
  • Stresses of both a physical and psychological nature. Stressors can range from job-related all the way to emotional disorders, childbirth, chronic illness or vitamin deficiency or anemia.
  • Damage to your hair from repeated heat or chemical application can cause hair loss due to breakage.
  • Traction from braiding or putting hair in ponytails can lead to hair loss due to traction alopecia, while compulsive hair-pulling known as trichotillomania can cause hair loss as well.
  • Hair loss due to aging. As we grow older our hair naturally gets thinner and more brittle causing the body to have an increased amount of hair loss.

Knowing all of these factors, both genetic and external, can go a long way to mitigating the amount of hair loss that you experience. Certain factors such as diet stress and disease can be easily identified and addressed, while others such as male pattern baldness can crop up unexpectedly. Despite this there are still many options available to address male pattern baldness and other types of hair loss. The most important thing is for your doctor to identify the type of hair loss, and then taking the steps to address for treatment.

Non-Surgical Treatment Options

For those suffering from hair loss, there are several medicinal options:

  • Propecia (Finasteride): Propecia is generally viewed as the first-line treatment option for male pattern baldness. Propecia is a steroid that works at inhibiting 5-alpha reductase, an enzyme that converts the body’s testosterone to dihydrotestosterone (DHT). DHT is the primary cause of male pattern baldness. By blocking the body’s production of DHT, Propecia stops the progression of hair loss in close to 90% of those that use it. Propecia is only effective for as long as it is taken (hair loss generally restarts within 6-12 months from ending the medication). It is effective in stopping hair loss in both the front of the head/hairline as well as the crown.
  • Rogaine (Minoxodil): Rogaine is the recommended second line treatment in male pattern baldness. Rogaine is a vasodilator that is primarily effective in stopping and regrowing hair in the vertex/crown region of the scalp. While the initial application may cause further “shedding” of telogen or “end phase” hairs, in most cases these are quickly replaced by new and thicker hairs. Like Propecia, Rogaine is only effective as long as it is used. Gains made in stopping hair loss are usually lost within 6 to 12 months after stopping Rogaine. Rogaine is available in varying strengths for men and women.
  • Corticosteroids such as Dutasteride (Avodart) and Ketoconazole (Nizoral/Sebizole): while both of these drugs have been shown to positively affect stopping hair loss, they are not yet FDA approved for administration as hair loss treatments. Avodart is used to reduce prostate growth, while ketoconazole is used to treat various fungal infections including athlete’s foot and ringworm.

Hair Loss Surgery Options

Finally, if drug treatment does not work, there are a couple of surgical options to consider:

  • Follicular Unit Transplantation (FUT): A strip of hair-bearing skin is removed from the back or side of head. The hair follicles are then extracted from the strip and transplanted into he desired areas.
  • Follicular Unit Extraction (FUT): Hairs are removed individually from the donor area using a special punch tool and then transplanted into the desired areas.

Whether you are in the initial stages of hair loss or have suffered hair loss for years, the sooner you consult with your physician to identify which type of hair loss you suffer from, the sooner you can begin your treatment. This not only will help you psychologically and emotionally but will also give your treatment option its best chance at success.
