- An introduction to hair loss
- Types of hair loss
- Causes of hair loss
An introduction to hair loss
The word “alopecia” is the medical term for hair loss and it can take a range of different forms.
Most hair loss is perfectly normal. However, there is a fine line between regular and excessive loss of hair and making the right choices early on can help curb your hair loss experience before it becomes more serious.
So are you a hair loss sufferer?
Take the Tug Test
While bald areas are an obvious sign of hair loss, it can be difficult to tell whether your hair is getting thinner. To find out try the tug test: hold about 15 or 20 hairs between the thumb and index finger and pull slowly and firmly. If more than six hairs come out there may be a problem.
Take the Shower Test
Another easy technique to determine if you might be experiencing excessive hair loss is via a simple observation when you shower. The normal, regular rate of hair loss is around 50-150 hairs daily. So if you start to notice the rate increase, it’s time to take action.
Understanding the hair growth cycle and how hair loss occurs
Hair follicles produce a new hair every two to six years (dependent on age) and within the following three distinct phases:
The Anagen or growing phase lasts two to five years and determines the length of our hair. Approx 90% of the hairs on our head are in the growing phase.
When the Anagen growth phase comes to an end, hair enters into a Catagen phase which lasts between one and two weeks. Hair stops growing during this phase, the hair follicle shrinks and part of it starts to die.
The Telogen or resting phase lasts around five months. There is no growth during this time. At the end of the resting phase, the hair is shed and the follicle starts to grow a new hair. Approx 10% of the hairs on our head are in this phase at all times.
Noticeable hair loss occurs when hairs enter the Telogen or resting phase too early causing excess shedding of the hair.
Did you know?
- Hair grows at a rate of about 1cm a month
- Each follicle grows an average of 20 hairs in a person’s lifetime
- Scientists in Taiwan* discovered men who smoked 20 or more cigarettes per day had a greater chance of developing baldness
- Approximately one in five people suffering from hair loss have a close family member with the same condition
- Hair loss can often start after a stressful life event such as bereavement, shock, getting married or moving house
- Hair loss affects men, women, young people and children
- On average women spend over £27,000 looking after their hair in their adult life**
- When progesterone hormones return to normal levels after pregnancy, hair that should have fallen out during the last nine months will do so all at once
- The way you style your hair could be causing your hair loss
Types of hair loss
Age-related Alopecia is common in people over the age of 50 when the rate of hair loss increases above 50-150 hairs per day. Hair grows in cycles ranging from two to six years and when you get older, this cycle slows down and will eventually stop (dependent on the individual’s lifespan). This means that towards the telogen phase of the hair growth cycle, the hair may not begin at the start of the cycle again.
- Diet and lifestyle
Alopecia Areata :
Alopecia Areata is a condition that often begins in early childhood, teenage years or young adulthood. The most common type of Alopecia Areata involves hair loss in one or more round spots (about the size of a large coin) on the scalp. The area of hair loss may tingle or be slightly painful.
Hair tends to fall out over a short period of time, with the loss commonly occurring more on one side of the scalp than the other. Because it causes bald spots on the scalp, especially in the first stages, it is sometimes called spot baldness. Alopecia Areata can take two other forms.
In approximately 1%-2% of cases, the condition can be identified as Alopecia Totalis, or Alopecia Universalis.
Alopecia Totalis is the name given to complete hair loss on the scalp. The British Association of Dermatologists estimates that 14-25% of people with Alopecia have Alopecia Totalis.
Alopecia Universalis causes complete absence of head and body hair, including eyelashes and eyebrows, along with underarm and genital hair. This is the most severe form of Alopecia Areata and is also one of the rarest.
- Auto-immune disease
- Illness & Stress
- Thyroid dysfunction
Androgenic Alopecia :
Androgenic Alopecia is believed to be the most common and wide spread hair loss type known today. Medical News Today reports that more than 70% of all men and about 50% of all women will be afflicted with androgenic alopecia at some point in their lives.
In men it is commonly known as Male Pattern Baldness.
It often starts around the late 20s to 30s and affects over 50% of men over the age of 50. Hair is lost in a well-defined pattern, beginning above both temples and thinning at the crown. Over time, the hairline recedes to form a characteristic “M” shape and often progresses to partial or complete baldness.
In women, it is often known as Female Pattern Baldness and differs to the male version. The hair becomes thinner all over the head, rather than receding, and it rarely leads to total baldness.
- Diet & lifestyle
- Polycystic Ovary Syndrome (PCOS)
Telogen Effluvium is when an abnormal amount of hair falls out (over 50-150 hairs per day) usually creating a thinning appearance of hair while the scalp will look relatively healthy.
This type of hair loss is most commonly noticed when excess hair is found on your pillow or in the shower. Telogen Effluvium is a form of temporary hair loss and identification is easiest by looking at causes (below).
- Illness & stress
- Post birth
- Diet & lifestyle
Traction Alopecia is commonly identified when hair loss is in the frontal and temporal regions. It is also easily distinguished when the hair is either weak or where the hair around the bald patches is comparably healthy and strong. Identification is easiest by looking at causes (below) which relate to overzealous styling of hair.
Anagen Effluvium is hair loss related to chemotherapy or radiation therapy that is used to treat cancer. Initially it causes patchy hair loss, which often then becomes total hair loss.
Alopecia Mucinosa is a relatively rare form of hair loss that leaves scaly patches on the skin, in which the follicles are unusually prominent and irritated/spotty.
- The causes of alopecia mucinosa are relatively unknown.
Hair loss can be a consequence or side-effect of other primary medical concerns, including:
Trichotillomania (a psychological impulse control disorder causing the individual to pull out hair)
Tinea Capitis (A fungal ringworm infection contracted from animals which can cause hair to appear stubbly)
Causes of hair loss:
Hair follicles reduce in the rate which they replenish with the course of age and this is a completely normal process. This is in alignment with the rest of the human body – where age affects the ability for the body to regenerate itself.
Diet & lifestyle:
With age the body becomes less and less able to utilize protein consumed via diet – which in turn affects the rejuvenation of hair as protein is an essential nutrient supporting hair follicles.
The progression of Androgenic Alopecia is also believed to be influenced by a poor diet which can affect new hair growth as well as an inactive lifestyle which can reduce hair producing androgen (hormone) levels.
In addition, Telogen Effluvium can be significantly brought on by changes in diet like crash dieting, anorexia, and low protein intake as the hair is not receiving essential nutrients.
The immune system makes white blood cells (lymphocytes) and antibodies to attack bacteria, viruses, and other ‘germs’. If you have an auto-immune disease, your immune system ‘mistakes’ parts of your body as foreign and can mistake hair roots (hair follicles) as ‘foreign’. This causes mild inflammation leading hairs to become ‘weak’ and fall out.
Auto-immune disease is also often passed down through family.
An over active or under active thyroid gland can often lead to hair loss due to changes in hormone levels. Research conducted by the University of British Columbia found a strong relation between people with Alopecia Areata also having thyroid disease.
Polycystic Ovary Syndrome (PCOS):
Polycystic ovary syndrome (PCOS) affects approximately 5% of all women and is the most common hormonal disorder among women of reproductive age. Women with PCOS can experience loss hair due to a hormone imbalance and increased sensitivity to male hormones such as testosterone. A male hormone called dihydrotestosterone (DHT), which is converted from testosterone, binds to sites on hair follicles and appears to make the follicles go into their “resting” phase sooner, which in turn starts to cause the hairs produced by those follicles to become thinner and thinner with each growth cycle.
Hair loss can be genetically passed from either the mother or the father via a gene called the AR or the androgenic receptor. Androgens are hormones (such as testosterone) that stimulate hair growth when they bind with androgen receptors (AR).
Studies suggest that some genes determine a disjointed relationship between the AR and androgens which can lead to an increased risk of patterned hair loss in men and women.
Illness & Stress:
Temporary hair loss can be caused by illness such as iron-deficiency/anaemia, severe infection, major surgery and periods of psychological stress in an individual’s life. When an individual experiences stress or illness, chemicals in the body transmit signals to the hair follicles, causing them to enter the resting phase. During this phase there is no new hair growth.
In addition, it is also believed that psychological stress and extreme shock can significantly trigger auto-immune disease of the hair follicles, leading hairs to become ‘weak’ and fall out.
When we are stressed, we can also often eat badly which prevents our bodies from getting the vital nutrients needed to support the hair follicles. See Diet & lifestyle
The rise in progesterone hormones during pregnancy keeps hair growing for longer. But after delivery, the progesterone hormones return to normal levels, causing the hair that should have fallen out during the last nine months to do so all at once. This hair loss tends to peak between three and four months after delivery as the hair follicles rejuvenate themselves but is temporary with hair growth returning to normal within six to 12 months.
Hormonal changes brought on by pre-menopause and menopause can also lead to hair loss. During this time estrogens and progesterone levels in a woman’s body fluctuate and decrease. These changes can affect the function of the hair follicle resulting in extended resting phases and notable hair thinning.
e Medicine (the online evidence-based medical reference) states that medications can significantly bring on Telogen Effluvium, of which the most frequently cited are beta-blockers, anticoagulants, retinoids (including excess vitamin A), propylthiouracil (induces hypothyroidism), carbamazepine, and immunizations.
Traction Alopecia is caused by tight ponytail-hairstyles, use of strong coloring chemicals, over-tight braids and hair extensions. The condition is often temporary and once the ‘traction’ element has been removed, normal growth often returns. However, in some cases it can be permanent.