by Medical Aesthetic Doctor, Marisa Heyns
Hair; a unique feature that defines who we are. We like it short; we like it long; we like it up and we like it down. For some of us, it is an extension of our personality. Socially, across all cultures and ethnicities, a good head of hair is a symbol of health, vitality, and attractiveness. Hair is a big deal. A whopping 80 billion dollars is spent on the US hair industry alone per year.
Table of contents
- Why am I losing my hair?
- Understanding hair growth and hair loss
- Hair loss causes conditions
- How do I know if I am losing my hair?
- Treating for hair loss and thinning
- Do hair loss treatments work?
- Can baldness be reversed?
- Our top treatments for hair loss and thinning
- How do I manage my hair wellness?
Why am I losing my hair?
Did you know? On average we have about 100 000 – 150 000 strands of hair on our head, and, as part of normal upkeep, we can lose about 100 – 150 hairs per day. However, it is when we start noticing an increasing amount of hair lost on our brushes, our pillows, our clothes, and down the drain, that we should start to be concerned.
When we start losing our hair, our self-esteem and confidence can take a serious knock, to the point that some people even opt to shave their heads and make their husbands do crazy things #oscars2022.
Hairloss, also known as the medical term alopecia, affects many people around the world at some stage of their lives. Alopecia may present as hair thinning or as hair loss. It can be patchy or diffuse with a gradual onset, or, more worryingly, be sudden!
Yet I find it interesting that many people who lose hair only seek help when hair loss is already in an advanced state. As you will find out, identifying and managing alopecia early on, will yield far better results in maintaining that healthy mane.
Understanding hair growth and hair loss
To better understand hair loss, let us see what normal hair growth is all about. Hair grows from tiny little nests called hair follicles that anchor each hair into the skin. The base of the hair follicle is called a hair bulb, where living cells divide and grow to build the hair shaft. Each hair follicle has its own blood supply to nourish the cells in the hair bulb and deliver nutrients and hormones that modify hair growth and structure at different times of life.
The hair on our heads is extra special because it keeps growing (for 2-6 years!), becoming thicker and longer with time. Each hair has a cycle of growth, rest, and ultimate shedding. Up to 80-90% of the hairs on our head are in a growing phase and 10%-20% are in a resting and shedding phase.
Hair loss causes and conditions
If you think about it, hair is more than just a feature, it is a living unit of cells. And the functioning condition of the hair follicle is super important to maintaining healthy hair growth. Any process whether it is physiologically inevitable due to aging or pathological (an abnormal or exaggerated process), the hair follicle becomes stressed as its functioning becomes impaired, which results in poorer production of hair, leading to the thinning of hair and the eventual falling out of hair. Sometimes the stress on the hair follicle is so acute, that hair loss can be abrupt.
There are many causes of hair loss. I will explain some of the more common ones, how they present themselves and how we can manage them.
Male and female pattern hair loss
Also known as androgenic alopecia, this type of hair loss presents with gradual thinning of the hair as hair follicles are put under strain due to an increase in circulating androgens (sex hormones). This stress results in a shorter growth of the hair leading to shorter thinner strands of hair. In men, there is a characteristic pattern of hair thinning and loss with a receding hair line in the temples and forehead as well as the crown. Hair loss may lead to eventual baldness. In women, thinning of the hair is generally distributed, and thankfully does not lead to baldness.
Telugium effluvium
Telogen effluvium is a form of temporary hair loss that usually happens after stress, a shock, or a traumatic event. We have been seeing a lot of clients with this type of hair loss Post COVID. The good news is that this condition is temporary and usually resolves within 3-6 months. The pattern of hair loss is usually general, covering the entire head, and is generally seen as thinning.
Underlying chronic disease and illness
The skin alone without hair can tell us a lot about our daily habits, as well as what is going on inside our bodies. Clients suffering from chronic illnesses such as cardiovascular disease, thyroid problems, aneamia (low iron levels), kidney disease, and the list goes on, even severe vitamin deficiencies such as Vit D can lead to hair thinning and loss.
Autoimmune disease
Autoimmune conditions can directly or indirectly affect hair growth and hair follicle function. Alopecia Areata a condition that directly affects the hair follicle can lead to patchy hair loss that might even become more general in severe cases and is usually brought on by stress. There is unfortunately as with most hair loss issues, no cure. But usually, the condition resolves. Other autoimmune diseases such as lupus, Hashimoto’s, Grave’s disease, Chron’s disease, and Psoriasis can also lead to hair loss and thinning.
Traction Alopecia
This type of hair loss occurs due to the constant pulling of the hair. It is very common among ladies who like to braid their hair. For some of us, it can also occur during times of stress when we physically pull out our hair. Generally, this pattern is for those ladies who like to wear their hair in braids – the constant pulling effect on the hair causes weakness in the attachment to the hair follicle.
Scarring Alopecia
I mention this rare cause of hair loss because it is one of those situations where you do not want to sit around and wait. Scarring alopecias are caused by inflammatory conditions that destroy the hair follicle beyond repair, meaning that no hair will grow in the affected areas. If your doctor suspects this, a dermatologist should ideally be involved in the treatment. Generally, we treat these conditions with steroids to stop the inflammatory process. Fortunately, this type of hair loss is not very common accounting for 6 % of alopecias.
How do I know if I’m losing my hair?
So how do you know if you have hair thinning or hair loss or both? Well unless you have noticeable bald spots, the diagnosis can be tricky. Here you need a skilled doctor (hint-hint, Dr. Nerina Wilkinson + Associates) to take a full medical history and to examine your scalp. We use a dermascope that can look at the scalp condition, the hair follicles, and the hair. All of this information can assist us in better giving you a diagnosis and prognosis.
Nowadays we also have DNA tests, that can tell you about the type of hair loss you are prone to. Nifty!
Treating hair loss and thinning
Just as we approach skin care we can manage our hair with home care, oral supplementation and medication, and treatments.
In-clinic treatments for hair loss and thinning
Thankfully as a result of ongoing research, we are seeing a lot of advances in hair loss treatments.
Ultimately if you are just wanting to maintain healthy hair, or you are actively focusing on managing thinning or losing hair. The treatment approach will always include a hair loss treatment supplemented by good home care.
The choice in hair loss treatments is generally weighed against the cause, the chronicity, and the severity of the hair loss. Unfortunately, we find that there are no cures to most causes of hair thinning or hair loss. And just as we understand that looking after our skins, we need to look after our scalp, hair follicles, and hair in order to optimize functioning to maintain healthy hair growth.
Home care products for hair loss and thinning
Ever wondered why we don’t wash our face with shampoo or conditioner? The scalp after all is just skin. Specialised skin with hair follicles that grow an abundance of hair. Generally, shampoo and conditioners contain ingredients to look after the hair only (not the scalp or follicles too). It’s almost like painting our nails to make them look good. Ingredients include detergents that can strip the healthy oils from the scalp, all sorts of surfactants too, and thickeners including xanthan gum, wax, and gelatin. Oh yes, and foaming agents and perfumes to make it feel like we are doing something good whilst enjoying the smell of ‘clean hair’! Once we get to grips with the fact that it really is the health of the hair follicle that is important to ensure hair growth, we need to change our approach to washing and cleansing our scalps, not just our hair!
Invest in a hair care product with ingredients like growth factors and peptides, essential vitamins, and specialised active ingredients that protect, feed, and stimulate the hair follicle to grow, whilst gently maintaining the health of the scalp surface. We of course can also gladly assist you in choosing the correct product for your type of hair loss.
The frequency of hair wash is also important to consider. Washing our hair on a daily basis can also lead to unnecessary hair thinning and loss. Rather aim to wash once to twice a week. Your hair will thank you I promise…
Oral supplements for hair loss and thinning
Healthy living is sometimes just not enough to maintain healthy hair follicle functioning. Oral supplementation with vitamins and minerals can definitely enhance hair growth, but on its own will not manage existing hair loss and thinning to the degree that in-clinic treatments will do.
There are also medicinal options available such as Minoxidil, Finasteride and Spironolactone have shown very promising results in managing androgenic alopecia. The downside, you have to keep taking it, and systemic medication may have side effects. A topical preparation of some of these medicines can be useful for those of you who do not like taking medication. Again, the results last as long as you keep on applying them.
Do hair loss treatments and products work?
There is a multitude of hair loss treatments and products available to clients, which can be quite confusing to someone desperate to fix their current hair situation. A better understanding of what we are trying to achieve with treatments is, therefore, key to achieving successful results. As mentioned before, there is no cure for hair loss. If you understand that the hair follicle is the final common denominator to why things go wrong, then the ideal treatment needs to focus on repairing or upregulating the functioning of the hair follicle.
The aim of non-invasive treatments is all focused to provide better blood, oxygen, and nutrient supply to the hair follicle, feeding the hair follicle active ingredients that can promote better hair growth, and even blocking the negative action of androgens.
Unfortunately, once the hair follicle has died, meaning no more hair is being produced, there is nothing we can do to revive it. It is therefore vital, to treat hair thinning and loss as soon as it starts to happen, or better yet – even long before! #hairprejuvenation
Can baldness be reversed?
As mentioned before, treatments are aimed at keeping the hair follicle alive for as long as possible. However, once the follicle has died, we cannot revive it, even with the best-intended treatments. Here, the only remedy would be a hair transplant. This is a super-specialised procedure where thriving hair follicles (usually at the back of the head) are harvested and implanted into the scalp at the affected site.
Our top treatments for hair loss and thinning
For hair wellness and maintenance of your current hair situation, we look at noninvasive treatments such as active ingredient-laden injectables. One of our favourites is GFIT (Growth Factor Induction Therapy) treatments, using patented growth factor technology in the form of a serum that a gently stamped into the scalp with a nifty needling device.
For a more advanced approach to hair loss, we choose Scalp PRP injections. The powerful regenerating action of platelet-rich plasma (PRP) presented in 100’s studies shows a clinically significant improvement in hair loss. The growth factors that are released by your own platelets act as powerful switch-on messengers to keep the hair follicle going.
How do I manage my hair wellness?
No one likes a bad hair day, and losing hair is definitely something to lie awake about at night. In fact, it can downright be a depressing situation. I think the important take-home message is that most of us will at some time in our life, experience some form of hair loss. In most cases, we cannot stop the process of hair follicle decay. Having said that there is a lot we can do to keep those hair follicles working to produce the best hair possible.
Feel free to schedule your Hair and Scalp Wellness Consultation with one of the Aesthetic Doctors at Dr. Nerina Wilkinson + Associates to start your hair wellness journey today. capetown@drnwilkinson.co.za
Written by Dr. Marisa Heyns
