What causes Hair loss? How can I reverse hair loss?
Hair has traditionally been a symbol of beauty and youth. A lush mane is a sign that one is healthy. Hair is basically a protein filament that grows from the follicles in the dermis of the skin. Hair styles and colours are forms of expression and differ based on culture and tradition from place to place. No wonder why hair loss had led to anxiety and loss of confidence for many men and women across the globe!
So where do we start?
The two main components of a hair strand are 1) the part beneath the skin, called the hair follicle, or, when pulled from the skin, the bulb. This organ is located in the dermis and maintains stem cells, which not only re-grow the hair after it falls out 2) the shaft, which is the hard filamentous part that extends above the skin surface. Keratin is the main protein in hair and the natural colour is determined by the melanin pigments. Hair grows through different stages of growth just like any other living cell.
About 40% of men and women experience some form of hair-loss by 45 years of age. The number rises steadily after that with every year.On an average we lose 50–100 strands of hair a day. Hair loss is defined as a loss of more than 100 strands of hair per day over 2 weeks (but who gets to count?!)
What are common causes of Hair loss?
Hair loss could be due to several factors, either solitary or a combination of these factors –
- Genetic — hereditary hair loss, both male pattern and female pattern follow genetic patterns
- Hormonal — thyroid, cortisol, testosterone, Dihydrotestosterone(DHT) oestrogen
- Chronic disease states — thyroid disease, lupus and other autoimmune diseases
- Medications — cancer chemotherapy, steroids, blood pressure medication, blood thinners
- Infections — bacterial and fungal infection of the scalp (Tinea capitis, Dandruff, folliculitis)
- Nutritional deficiency- Vit B complex especially biotin, Zn, folate, iron deficiency
- Stress (telogen effluvium)
- Heavy metal poisoning or pollution
Hair loss is mostly reversible (non scarring type), while certain scalp infections could lead to irreversible hair loss (scarring type). Male pattern hair loss (Androgenic alopecia) makes up for 95% of hair loss in both men and women across the world. Alopecia areata (mostly autoimmune or acute stress related) and telogen effluvium are other forms of hair loss.
So how do we treat hair loss? Would the hair grow back?
Male pattern and female pattern hair loss are reversible if intervened early. Later stages or advanced alopecia, often are irreversible, one may restore hair through hair transplant only. Understanding the cause for hair loss and early intervention often reverses or delays progressive hair loss. Treatments can be divided into:-
- Medical- Minoxidil sprays of varying concentrations (2.5%-10%) are often used to reverse hair loss. Other DHT blockers like finesteride (Propecia) and dutesteride are used for male pattern baldness. Several hair supplements containing essential vitamins and minerals have proven effective in restoring hair (example is Biotin hair complex capsules, Viviscal hair supplements, etc). Certain products like shampoos, hair masks, serums are available to augment hair loss treatments. Recent advances in growth factor technology and peptides (AQ Hair complex, polynucleotides or PNs) have rendered useful combination treatments for reversing hair loss and restoring hair growth. These serums are delivered to the scalp via micro-needling, meso injections, Laser or RF micro-channeling, etc.
Platelet Rich Plasma (PRP) has also been proven to reverse male pattern baldness through various growth factors. Another treatment that has encouraging results in mild to moderate hair loss is stem cell micro-grafting (REGENERA Hair) where extracted stromal stem cells (autologous cells from own scalp) are injected back into balding areas of the scalp, this restores hair growth by 30–40%. Low level Laser Therapy (LLLT) or cold LASER improve hair growth though cell stimulation. This is often done as a maintenance treatment at home or done in the clinic in conjunction with hair loss treatments to enhance the results.
2. Surgical — Hair transplant involves harvesting hair follicles from areas of the scalp and grafting them in areas of hair loss. Follicular Unit extraction (FUE) and Follicular unit strip method (FUS) are two type of hair transplants. Isolated hair follicles that are harvested are then transplanted either manually by the surgeon or through robotic assistance. FUE with the recent advances has less scarring compared to the strip method. The end results depends on the technique of the surgeon, scalp condition and number of surviving hair follicles. The number of follicles transplanted vary from a few hundred to a few thousand depending on the area for treatment.