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Hair Loss: The Most Detailed Ultimate Guide Ever

Dr. Ahmad Chaudhry M.B.B.S.
By Dr. Ahmad Chaudhry M.B.B.S.
Updated on January 16, 2024

Hair loss is a distressing condition, but you don’t have to face it alone

This definitive guide cuts through confusion with facts from trusted medical sources and verified studies.

Within, you’ll learn about different loss types and causes. You’ll also discover all treatment methods – from simple lifestyle tweaks to surgical options.

By the end, this guide will help you understand your options and choose solutions tailored for your individual hair goals.

No more scary unknowns – just clear answers to regain your confidence.

CHAPTER 1. Understanding Hair

A woman looking in the mirror loving hair hair, pink, flat style.

It might be a weird question to ask, but what is hair? The science behind it is far more complex than it looks on the surface. Hair is not just an asset that enhances a person’s appearance; it also plays an important role in gender identification, sensory transmission, and more.

What Is Hair?

The hair’s structure is composed of 80% keratin, a fibrous structural protein, 10% water, and 5 to 10% pigments and lipids. It grows spontaneously throughout our life, renewing itself according to a natural cycle.

Biologically speaking, the hair we have on our heads is technically dead. The only part of them that is alive is the root embedded in the scalp. Hair has two parts:

Follicles

Also known as hair bulbs, follicles are located between the layers of the dermis and hypodermis. This is where the keratinocytes are produced, along with melanin.

Hair follicle close up, sliced, medical, flat style.

Shaft

This is the visible part of our hair, which comprises dead keratin-filled cells and is made up of three distinct layers: the medulla, cuticle, and cortex.

  • Medulla: The innermost layer of the hair shaft and consists of a soft, oily substance.
  • Cuticle: A thin, protective layer that contains the nutrients essential to hair growth. It has a tightly formed structure, featuring scales that look like overlapping shingles.
  • Cortex: This is the main component of the hair that contains long keratin chains, which give the hair elasticity, resistance, and shine. Both the cortex and the medulla hold the hair’s pigment.

Why Does Hair Exist?

At 22 weeks, a developing fetus will start growing hair follicles. There are about 5 million follicles on the body, with 1 million on the head and about 100,000 on the scalp alone.

The function of human hair depends on the body part from which it grows. You may notice that people have different places where they grow hair, and not everybody has the same hair texture or length in a certain area.

One important function of hair is protecting the skin from environmental factors. It translates external input as sensory stimuli and transmits it into the brain.

Additionally, scalp hair is the only part of the body that can be modified to change a person’s appearance. It gives humans a sense of individuality and allows them to socially communicate.

What Does Healthy Hair Look and Feel Like?

A woman on Instagram, receiving likes and follows for healthy hair, flat style.

To achieve optimal hair growth, your hair needs to stay in the Anagen phase for as long as possible.

This is possible by maintaining a healthy diet, using the right hair care products, and avoiding any processes that can disrupt hair growth, such as chemical treatments like bleaching, coloring, and perming.

But what does healthy hair look like? Here are a few signs:

  • Silky-Smooth and Bouncy: This is the result of a flat-lying cuticle. If you’ve seen a hair commercial before, then you know what we mean by the cuticle being ‘flat’. It protects a sponge-like shaft beneath and works best when its scales are tightly overlapped on top of the cuticle. Light reflects off it, making the hair shiny.
  • Good Elasticity: Elasticity is the measure of your hair’s strength, meaning it’s responsible for keeping your beautiful curls or waves intact all day. Having poor hair elasticity can lead to excess breakages, such as split-ends.
  • Less Hair Fall: We all know by now that shedding is a normal part of the hair’s growth cycle, but losing too many strands daily can be a sign of a more serious health issue.

Is There a Difference Between Hairs on Our Body?

To understand the difference between scalp hair, facial hair, body hair, and pubic hair, you need to know about the two major types of hair follicles: terminal (androgenic) and vellus.

Terminal Hair Follicle

These hairs are bigger and are extended into the subcutaneous fat tissue during hair growth. Their growth is influenced by hormones and lies within the second layer of the skin. Terminal hairs are at least 0.06mm in diameter and are found on the scalp, face, armpits, and pubic area.

Vellus Hair Follicle

At birth, vellus hair is what you have most on your body. It is thin, short, and more translucent compared to terminal hair. Vellus hair may seem unnecessary, but it’s responsible for regulating your body temperature and helping sweat evaporate from your body.

How Does Hair Grow?

Stages of Hair Growth, flat style, sliced, close-up.

Hair growth depends on several factors. These include age, weight, metabolism, hormones, medications, sleeping habits, etc. All hair on our body goes through three stages of growth.

At the very beginning, a follicle (hair root) is formed. It looks like a sac and is located under the skin. What we see is a tiny opening in the skin that is a tissue formed from a follicle.

Interestingly, the human body contains more follicles than the body of animals like chimpanzees, gorillas, etc., but it seems to us that we have less hair because most are light.

Therefore, we do not see them. After the formation of follicles, three different phases take place: anagen, catagen, and the last phase called the telogen phase.

1. Anagen phase or active hair growth phase

The first hair growth phase lasts for several years. Precisely, because of this melanin pigment, hair can only be laser-destroyed at this stage.

Many microstructures such as papillae and bulges also occur and are responsible for controlling hair growth.

2. Catagenic or regressive phase

During the second phase, the hair begins to die, but it does not fall out. It only separates from the roots. As a result, the blood supply become completely stopped.

Melanin production is also reduced, and stem cells no longer produce hair. The catagen phase lasts for three weeks.

3. Telogen phase or rest phase

In the last stage, the hair is ready to fall out because it is no longer associated with any microstructure. The process of growing new hair begins. The telogen phase lasts for five or six weeks.

People who experience stress, tension, or illness for an extended period are at this stage for a longer time, resulting in greater hair loss and a lower rate of regrowth.

CHAPTER 2. What Is Hair Loss?

A guy sad, stressed and experiencing bald hair, flat style.

Hair loss refers to excessive loss of hair, which can be triggered by multiple reasons.

Hair loss is one of the most common complaints seen in the field of dermatology.

According to reports, androgenetic alopecia (AA), which is a form of hair loss, affects 50 million men and 30 million women in the United States. To make matters worse, 50% of men over the age of 50 will experience some form of male-pattern baldness.

When people start going through these changes, they are often desperate for any solutions to reverse the process of hair loss. Unfortunately, people tend to believe everything they read online, especially when dealing with a chronic condition.

You see, being desperate is a great opportunity for shady advertisers to promote their ‘magical’ hair loss remedy that grows back your hair in 24 hours! In reality, most of these campaigns only seek financial profit even if it involves scamming people.

How Does Hair Fall?

Hair grows in several cycles, which consist of:

  • A long growing phase (anagen)
  • A short growing phase (catagen)
  • A resting phase (exogen)

When the resting phase ends, the hair falls, allowing new hair follicles to grow in the new cycle.

In general, about 40 hairs (up to 78 in men) reach the exogen phase every day. In other words, you can expect up to 78 hairs to fall if you are a man.

If this number exceeds 100 hairs per day, it becomes pathological, and medical care is necessary.

The downsides of hair loss

For most people, hair loss is merely an aesthetic issue that doesn’t hold any serious complication to a patient’s health. However, this condition can lead to several mental health problems, including low self-esteem, constantly being self-conscious, and depression.

Eventually, this can negatively impact patients’ quality of life, which is very problematic.

Additionally, hair loss affects a considerable portion of the population from both genders, exacerbating the situation even further.

In some cases, patients may visit the doctor’s office about their hair loss and find out that there is an underlying condition triggering it, including hypothyroidism, autoimmune diseases, and infections.

Overall, hair loss has psychological and organic complications that should get promptly assessed.

The causes of androgenetic alopecia

Genes and Family History

THREE WOMAN HAVING CHROMOSOMES ON THEIR HEAD, FLAT STYLE

Having a family history of hair loss is one of the non-modifiable risk factors that significantly increase your risk of developing this condition.

Unfortunately, researchers are yet to pinpoint the exact genetic alteration that triggers hair loss.

Testosterone and DHT

High levels of dihydrotestosterone (DHT) in the scalp often leads to androgenetic alopecia.

Stress

Researchers identified physical and emotional stress as potential triggers of reversible hair loss (i.e., telogen effluvium).

The triggers of this condition are well-documented and include:

  • Severe emotional stress
  • Complicated surgeries
  • Chronically elevated core temperature

The way this happens is by shifting the person’s hair to the telogen phase. As a result, the hair falls but no follicles replace it, which leads to reversible hair loss.

Lack of Blood Supply

As the hair follicle grows, new blood vessels surround it to supply the cells with oxygen and nutrients, eliminate waste products, and ensure the growth of the follicle.

The loss of these blood vessels is linked to certain types of hair loss.

Alopecia Areata

Alopecia areata is an autoimmune disease that triggers your immune cells to attack the hair follicles. As a result, your hair falls.

Tinea Capitis

Tinea capitis is a fungal infection that may cause bald spots, flakiness, broken hair, and other inflammatory signs in the scalp.

Thyroid Conditions and Hair Loss 

Severe thyroid disease (e.g., hypothyroidism, hyperthyroidism) can lead to hair loss. Usually, the baldness is diffuse, including the entire scalp area rather than specific spots. 

Additionally, the hair appears uniformly sparse. The treatment of the underlying thyroid disease is generally sufficient to reverse hair loss; however, it may take months before any results are apparent.

Scarring Alopecia

Scarring alopecia is a form of hair loss that presents with scarring in the scalp. 

Common causes of scarring alopecia include rare autoimmune diseases that trigger inflammation and collagen deposition in the scalp, which replaces normal tissues with granulation tissue, preventing the growth of new hair cells.

Unfortunately, this type of hair loss is often irreversible.

Non-Scarring Alopecia

Non-scarring alopecia is a form of hair loss that does not present with any scarring. Your doctor may identify inflammation and irritation of the scalp but no significant scarring.

Lupus

Lupus is an autoimmune, inflammatory condition that affects several organs. When the inflammation spreads to the scalp, you might develop hair loss.

Note that lupus is significantly more common in women relative to men.

Medications

A guy choosing from different hats, flat style.
Cholesterol drugs

Cholesterol drugs belong to a family known as statins, which can lead to hair loss when used for prolonged periods.

Drugs such as atorvastatin and simvastatin are well-documented to cause hair loss. However, the newer generation of statins (e.g., rosuvastatin) does not seem to cause this side effect.

Anticoagulants

The most common drug in this category is warfarin, which is used as a prophylactic and therapeutic agent to manage patients with a high risk of clot formation.

Unfortunately, some patients taking warfarin reported hair loss, but we still don’t have a clear understanding of the underlying mechanism.

Psoriasis medication

Psoriasis is a chronic medical condition characterized by recurrent shedding of the skin due to inappropriate regeneration.

Treating psoriasis with a drug, such as Acitretin (Soriatane), could cause hair loss.

Antihypertensive drugs

There are many classes of drugs used to manage chronic high blood pressure. However, ACE inhibitors are notoriously known to cause hair loss.

Note that the incidence of this side effect is extremely rare, with an incidence of 1%.

Steroids

Since androgenetic alopecia is the result of high levels of dihydrotestosterone (DHT) in the bloodstream, it would make sense that taking exogenous steroids (testosterone and progesterone) can trigger this condition.

Coronavirus hair shedding

If you are seeing falling hair during the pandemic or after you are recovering from the virus, it can be a result of stress, illness or fever. Don’t worry though, it’s most likely temporary and your hair will return to its glory days. It’s not hair loss, it’s hair shedding.

Rare Causes of Hair Loss

Elderly woman in a park, happy, flat style.

These are causes that come at the bottom of your doctor’s differential diagnoses:

  • Surgery
  • General anesthesia
  • A change in medication
  • Childbirth
  • Malnutrition
  • Age
  • Overstyling
  • A high fever
  • Flu
  • Severe anemia

CHAPTER 3. Hair Loss Signs and Symptoms

Woman walking in park, losing hair, hair on hand, flat style.

As we mentioned above, hair loss presents with a variety of signs that could arise early or later in the process. Here are the common signs of hair loss:

Receding Hairline

The most typical pattern of hair loss in men starts at the hairline. 

Your hair begins to thin at the front and temples of your hairline. Over time, hair loss spreads further until you are left with a horseshoe shape on your forehead.

Thinning Of The Crown Area

This is another common sign that indicates a type of alopecia. Thinning that occurs in the crown area of your head is typically the first place that makes people notice hair loss.

You see, balding affects the head in a pattern-like structure. For this reason, thinning of the crown area is generally common among all men who experience hair loss.

Curly Hair

Unlike the two signs listed above, curly hair is not constant among all patients with male pattern baldness. However, when your hair begins to become curly, it might be an early sign that you have a form of alopecia.

Most, curly hair starts at the neck region and over the years. Typically, you will see this sign as the crown area starts to thin.

Loss Of Hair On The Top

Losing hair on the top of your head is another classic sign that you are dealing with male pattern baldness.

Unfortunately, several men who deal with this type of baldness end up with significant hair loss on the top portion of their heads. 

Note that some people experience hair loss in specific patches, which could suggest another problem (e.g., infection).

Age-related Hair Thinning

Elderly man looking solutions on phone to fix hair loss, flat style.

As we age, our hair naturally gets thinner.

For this reason, you should take preventive measures to slow down this process and maintain the integrity of your hair.

You also be wary that rapid-paced hair loss is not a sign of age-related hair thinning. This could be an early presentation of alopecia.

Wider Partings

When your partings start to get wider, it is a sign of hair loss.

This sign is particularly useful for individuals who may not notice that their hair is thinning. 

Therefore, if your hair is thinning out where you part it, you should consider consulting with your doctor for further investigation.

Dandruff

While many people believe dandruff formation is a normal process that occurs in everyone, this is not true.

Dandruff is a common sign that something abnormal is going on your scalp. A prevalent condition that causes dandruff is known as seborrheic dermatitis, which is a type of eczema.

Fortunately, this condition does not typically cause male pattern baldness; however, it is better to consult your doctor if you have dandruff, especially when it occurs suddenly.

Head Sensitivity

Since hair acts as a heat insulator, you can test for male pattern baldness if you develop unusual sensations in hot or cold weather.

For instance, some people may not feel extreme heat in their heads despite the hot weather. If this is the case for you, your hair might be thinning.

Similarly, if you start dealing with more sunburns than usual, it may indicate significant hair loss, which removes the protective layer from your scalp – your hair.

Alopecia Areata

Unlike androgenetic alopecia, this type of hair loss presents with patchy hair loss. Coin-sized patches of hair begin to fall out from the scalp. However, any site of hair growth could be subject to hair loss, including the beard and eyelashes.

Some patients with alopecia areata report itching or a burning sensation in the area before hair loss occurs. Subsequently, the loss of hair could be sudden (i.e., acute), developing in just a few days, or subacute (i.e., a few weeks).

In this condition, the hair follicles do not get destroyed, which allows for their regrowth if the inflammation dampens. Moreover, people who undergo a patchy pattern of hair loss will fully recover without the need for any treatment.

Woman choosing from different combs style.

With that said, 30% of patients with alopecia areata develop an extensive form of hair loss or a continuous cycle of hair loss and recovery. According to reports, 50% of individuals with alopecia areata recover within one year. Finally, 10% of patients will develop a severe form of hair loss known as alopecia totalis or universalis, which translates into complete baldness.

Interestingly, some people with alopecia areata develop signs in their fingernails and toenails before any changes occur in their scalp.

Here are the common signs to be aware of:

  • White spots and lines in the nails
  • Roughness of the nails
  • Nails lose their shine
  • Thinning and splitting of the nails

Other clinical signs of alopecia areata include:

  • Exclamation mark hairs – this is a classic sign of alopecia areata that occurs when a few short hairs grow in and around the edges of the bald spots.
  • Cadaver hairs – when the hair follicle is growing inside the epidermis (i.e., the most superficial layer of the skin), it breaks before reaching the surface.
  • White hair – areas affected by hair loss often undergo depigmentation, where hair appears white.

When To See A Doctor?

Woman heat styling, straightening hair, flat style.

Seeing a doctor after noticing that your hair is thinning is crucial to get the appropriate diagnosis and management plan. 

In some cases, the cause of hair loss is reversible with topical or oral drugs, preventing extensive forms of hair loss that can only be treated with hair graft.

Additionally, the Genetics Home Reference linked hair loss to diabetes, obesity, prostate cancer, and high blood pressure. In other words, hair loss might be an early sign that you have a serious health problem.

Visiting your doctor will also identify hair loss that occurs after a major surgical procedure or severe illness, a side effect of certain drugs, fungal infections, and thyroid disease.

If you are concerned about some underlying diseases that are triggering your hair loss, you should see a doctor.

How Do Doctors Diagnose?

The diagnosis of hair loss depends on the form you have.

For instance, the diagnosis of alopecia areata is fairly easy and mainly focuses on presenting signs. Your doctor will start by assessing the degree of hair loss, then proceed to examine the hair follicles under the microscope (i.e., dermoscopy).

For complicated cases where the diagnosis is still unclear, a skin biopsy might be appropriate. Moreover, blood tests allow for the screening of autoimmune diseases and other systemic ailments.

Fortunately, the highly specific pattern of hair loss seen in alopecia areata makes the diagnosis quick and straightforward.

What Happens At Your Appointment?

During a hair loss consultation, your doctor will ask you questions about your medical history and the drugs/supplements you are currently taking. 

After registering your age, weight, and measuring your vitals (e.g., heart rate, blood pressure), you can expect the following questions:

  • General health – expect your doctor to ask you questions about your health and whether you have any concurrent medical conditions (e.g., diabetes, thyroid disease, high blood pressure).
  • The timeline of your hair loss – your doctor will ask you about the progression of your hair loss. Did it occur over a short period of time? Did it take too long? Have you tried anything to resolve the issue?
  • Other concurrent symptoms – besides hair loss, your physician will inquire about other symptoms without explanation (e.g., tiredness, palpitations, tiredness).
  • Recent history of your health – asking you about recent infections, surgeries, acute illnesses will aid in diagnosing the underlying trigger of your hair loss.
  • Medications – listing the medications you are taking or took recently is also important since some drugs cause hair loss. To be prepared, make sure to write all the drugs you are taking on a piece of paper or your phone before visiting the doctor.
  • Supplements – along the line of pharmacological drugs, your doctor will ask about whether you’re taking any supplements (e.g., vitamins, minerals, herbs, pills). You see, taking too much of certain compounds can precipitate hair loss.
  • Diet – the type of food you eat could also be a lead to what is triggering your hair loss.
  • Stress – when your doctor asks you about whether you are stressed, answer honestly. This trigger is often missed by doctors despite being a major trigger of hair loss.
  • Family History – knowing whether any family member had a similar condition is crucial for diagnosing certain autoimmune diseases (e.g., alopecia areata).

The next step to expect is a physical examination, which includes your scalp, hair follicle, nails, and skin. As we mentioned above, dermoscopy may be useful in diagnosing some causes of hair loss.

Finally, your doctor may order a few blood tests to rule out some diagnoses. If you recently had any blood tests, make sure to bring a copy with you, even if there is no abnormality (it will help out in ruling out diagnoses).

In general, this what occurs when you consult a doctor about hair loss.

Note that you should be forthcoming during hair loss consultation to make the diagnosis easier for your doctor and help him/her choose the right therapeutic plan.

Woman checking out the different doctors, flat style.

Before visiting a doctor, you need to know which specialties that treat hair loss.

For basic forms of hair loss, you can visit a family physician (i.e., primary care physician) or an internist. If your hair loss is the result of reproductive system abnormalities (e.g., polycystic ovary syndrome), consulting a gynecologist is most appropriate.

For all forms of hair loss, you can visit a dermatologist – a medical specialist in skin, hair, and nails. Dermatologists provide advanced diagnostic tools and management plants for hair thinning and alopecia.

CHAPTER 4. How to Treat Hair Loss?

Man walking, searching how to treat hair loss

Your hair loss is a problem that has a multitude of impact on your quality of life. In this chapter, you will find out how exactly do professionals treat it.

Do You Need To Treat It?

Hair loss is a common trigger of psychological problems, especially in susceptible individuals (e.g., young adults, females).

Additionally, some causes of hair loss are reversible and only require the appropriate medical therapy to be resolved. Therefore, it would be a waste not to explore your options to see whether you can reverse hair loss.

In some cases, hair loss might just be a sign that something is not working right. For instance, when you are dealing with thyroid disease, hair loss may be a sign of advanced deterioration. In this scenario, treating hair loss will focus on addressing the hormonal imbalance of your thyroid.

A comprehensive review of your general well-being will allow the doctor to explore any potential diseases you might have, as well as their impact on your integumentary system (e.g., skin, hair, nails).

The next few sections will cover the available treatments for hair loss, which allows you to explore all your options.

Cosmetic Treatments

A woman thinking which wig to use, flat style.

In this category of treatment, the goal is to improve your appearance without actually treating the underlying condition.

1. Hair-Fiber Powders

Hair fiber powders are made using a small number of keratin fibers charged with electrostatic energy. As a result, these fibers attach to existing hair follicles, which conceals areas of severe hair loss.

Overall, hair fiber powders give your hair a fuller look. If you learn how to apply this product properly, it may even go unnoticed under good lighting conditions.

Note that people who suffer from diffuse hair loss may not benefit from this product since its mechanism of action requires existing hair follicles.

2. Synthetic Wigs

Synthetic wigs are a viable solution for individuals with severe hair loss. There are several types of synthetic wigs that suit different individuals.

Make sure to choose the one that matches your hair color and skin complexion.

3. Real-hair Wigs

As the name implies, real-hair wigs are made using real human hair to give you a natural look. Be sure to look for reputable brands of real-hair wigs to avoid scammers.

Medical Treatments

9 different women hairstyles in flat style.

1. Finasteride

Finasteride is a prescription drug used to treat hair loss.

Mechanism of action

Finasteride works by decreasing the amount of the hormone dihydrotestosterone (DHT), which is responsible for androgenetic alopecia.

Dosage
  • Form: oral tablet
  • Strengths: 1 mg
  • Brand: Propecia
  • Typical dosage: 1 mg per day

2. Minoxidil

Minoxidil is another prescription drug that can comes as an oral tablet. Besides treating high blood pressure, minoxidil is approved by the United States Food and Drug Administration (FDA) as a treatment of hair loss.

Mechanism of action

Minoxidil expands the diameter of peripheral blood vessels, which improves the irrigation of hair follicles and promotes their regrowth.

Dosage
  • Form: oral tablet
  • Strengths: 2.5 mg and 10 mg

3. Spironolactone (Carospir, Aldactone)

Spironolactone is a diuretic that treats fluid retention and high blood pressure.

In recent years, doctors started using this drug to treat female pattern hair loss induced by androgenetic alopecia.

This drug is second-line therapy when minoxidil does not work.

Mechanism of action

Spironolactone slows down the production of androgens, which later turn into DHT – the primary hormone that triggers androgenetic alopecia.

In one study, researchers found that 75% of participants with female pattern hair loss reported an improvement in their hair loss after taking this drug.

Dosage

For hair loss, 100–200 milligrams are appropriate. However, your doctor may start you on 25 mg to lower the risk of side effects.

4. Oral Dutasteride (Avodart)

Dutasteride is a prescription drug that also treats androgenetic alopecia.

Mechanism of action

Dutasteride inhibits the action of a class of enzymes known as 5 alpha-reductase inhibitors.

As a result, the levels of DHT drop in your blood, which improves the signs of hair loss. This drug also helps people with enlarged prostates.

Dosage
  • Form: oral capsule
  • Strength: 0.5 mg
  • Brand: Avodart

5. Drithocreme (Anthralin)

Drithocreme, also called Anthralin, is a drug that treats psoriasis, hair loss, and several other dermatological conditions.

6. Diphencyprone

Diphenylcyclopropenone (DPCP) is a new agent used by some centers of dermatology to treat alopecia areata. It is made up of acetone and has a shelf-life of about 6 months.

Mechanism of action

The application of diphenylcyclopropenone to the skin redirects autoimmune attacks on the hair follicles. Consequently, your hair will be able to regrow more efficiently.

7. Janus Kinase Inhibitors

Janus kinase (JAK) inhibitors have a clear effect on alopecia areata.

The mechanisms involved in this process are still unclear. However, several scientific studies confirmed their positive effects on hair loss.

8. Corticosteroid Injections and creams

Corticosteroids are a class of drugs that has anti-inflammatory and immune-regulating properties. These drugs may be beneficial for some cases of hair loss, especially the ones that involve active inflammation of autoimmune reactions (e.g., alopecia areata).

9. Immunotherapy

Contact immunotherapy is the most effective way to treat alopecia areata. The most common drug used is diphenylcyclopropenone (DPCP), which we detailed above.

10. Laser Therapy

Laser therapy (i.e., light therapy) shoots photons into the scalp tissues, which encourage hair cells to grow. It is safe, tolerable, and less invasive than most hair loss treatments.

11. Tattooing

Tattooing your scalp might be helpful to add a personal touch to your bald head.

If you are a fan of tattoos, this option may be for you.

12. Hair Transplant

Hair transplant is a very effective (and expensive) procedure that focuses on grafting new hair follicles into your scalp.

Depending on your preferences and budget, you can opt for artificial or real hair to graft.

13. Scalp Reduction Surgery

Scalp reduction surgery is a procedure that addresses hair loss in men and women. It involves moving the skin with normal hair growth to bald areas on your scalp.

For instance, if the skin on the sides of your head gets pulled up and stitched together, the bald top of your head will be covered with hair.

14. Hair Growth Solutions

There are several hair growth solutions on the market, which use vitamins, minerals, and other hair-promoting substances.

Before trying these solutions, you should speak with your dermatologist.

15. Styling Products

The following products may be beneficial for people who suffer from hair thinning:

  • Women’s Rogaine 5% Minoxidil Foam for Hair Regrowth
  • HairClub EXT Moisturizing Conditioner
  • Kristin Ess Sea Salt Air Dry Mousse
  • Hairmax Ultima 12 Laser Comb

16. Shave Your Head (Yes, really!)

A woman using with luscious hair picking different hats, flat style.

Shaving your head might be a good choice, especially if you are dealing with male or female pattern baldness.

Having a shaved head is esthetically much more appealing than having several patches of baldness spread around your head.

17. Consult A Board-Certified Dermatologist

Consulting with a board-certified dermatologist is the best approach to treat hair loss. Your doctor will take your medical history, perform a physical examination, and order some tests.

Learn more about hair loss consultation by reading chapter 3.

Home Remedies

1. Supplements

Nutritional deficiencies are common causes of hair loss. However, and before you start taking supplements arbitrarily, you may want to speak with your doctor or nutritionist to get some blood tests. This will allow you to make evidence-based decisions and treat your nutritional deficiencies more effectively.

2. Exercise!

A woman exercising, jogging in a forest with breezing wind, flat style.

While extreme physical activity may trigger reversible hair loss, experts recommend getting regular exercise to balance your hormones and keep homeostasis checked.

3. Essential Oils

Some evidence suggests that applying certain essential oils may help moisturize your scalp and nourish hair follicles.

The research in this field is preliminary and more clinical studies are necessary.

4. Garlic

In one study, researchers found that garlic protects skin cells from the damage of ultraviolet light. Another study found that applying garlic gel to bald spots on the scalp may improve alopecia areata. However, the evidence of this study is anecdotal.

More research is warranted.

5. Onion Juice

Adding onion juice to the hair and scalp provides them with sulfur, which supports strong and thick hair. Researchers believe that the mechanism of action involves an increase in blood flow to the hair follicles, which promotes their regrowth.

6. Saw Palmetto

Studies that inspected the effects of saw palmetto on hair loss are scarce but promising. It appears that saw palmetto blocks the activity of 5-alpha-reductase, which is the enzyme that converts testosterone to DHT. This may help patients with androgenetic alopecia.

7. Apple Cider Vinegar

Apple cider vinegar may help with hair loss by warding off bacteria and regulating pH levels. However, these effects may be limited to certain types of hair loss.

8. Coconut Oil

Coconut oils work by moisturizing your hair and removing any toxin buildups from the follicles. This oil penetrates underneath the scalp to reaches the shaft of the follicles.

9. Evening Primrose Oil

Evening primrose oil may be an effective choice in treating hair loss. It is rich in omega-6 fatty acids, which stimulate hair growth and prevent hormonal imbalances.

10. Pumpkin Seed Oil

In 2014, scientists released a large study that examined the effects of pumpkin seed oil on hair loss. The results of the study demonstrated that participants who took the supplements had 30% more hair growth relative to the placebo group.

11. Derma roller for hair loss

Derma roller has become popular in recent months for its magical results on skin, hair, and beard. Not only a tool to get rid of stretch marks, but it’s also very effective in creating microchannels to help topical treatments absorb better.

The action also creates microscopic wounds, so you have to be very careful about the derma roller and how you sanitize it. Poor quality derma rollers can rust and lead to rust getting into your bloodstream. That’s why we recommend these best derma roller for hair for your ultimate safety.

Emotional Help

1. Therapy

As we mentioned at the start of this chapter, hair loss can be a traumatizing event for certain individuals. If you are dealing with a lack of confidence, distorted body image, or just overwhelmed with this issue, you may need to consult with a certified psychologist to get help.

Your therapist will put things into perspective and help you get over the negative thoughts associated with hair loss and physical appearance.

2. Support Groups

Three guys using laptop, yellow, flat style, support group.

Similar to other conditions, you will find support groups for people who suffer from hair loss. Sharing experiences and exchanging helpful tips with others will help you get over your own trouble.

The best way to find these groups is by searching online or asking your local doctor.

CHAPTER 5. How to Choose The Right Product For You

A woman showering, happy, flat style.

After being diagnosed with hair loss, it is time to start looking for products that prevent further thinning of your hair and potentially reverse the process.

However, this task is easier said than done. You need to be aware of several aspects of how hair grows and what it needs to accomplish that. 

The good news is that after reading the chapters above, you are equipped with the necessary knowledge about hair growth and alopecia.

For now, let us explore the ingredients you should be looking for in a product and the ones you need to avoid to promote hair growth.

What ingredients to look for in a hair growth product?

Caffeine-infused products

According to a 2014 study, researchers found that caffeine promotes hair growth.

The study concluded that caffeine stimulates hair growth at the molecular and cellular levels in both genders.

Essential oils

Essential oils are not just good-smelling additives. Recent evidence suggests that these oils can promote hair growth.

In one study, participants who received a daily dose of pumpkin seed oil (400 milligrams) led to significant hair growth in men. The study lasted for 24 weeks, with hair growth reaching up to 40% relative to baseline.

Another study inspected the effects of saline, jojoba oil, 3% minoxidil, and 3% peppermint oil on four groups of mice.

The group that received peppermint oil showed a significant increase in dermal thickness, follicle depth, and follicle number.

Vitamins and minerals

Since hair grows similar to other tissues, it makes sense that it requires vitamins, minerals, and fatty acids for optimal development.

Hair growth vitamins target all hair on your body, not specifically your hair.

If you are going to buy a hair loss product, you need to look for the following nutrients:

  • Vitamin B2
  • Vitamin C
  • Vitamin D
  • Vitamin E
  • Omega-3 and omega-6
  • Zinc
  • Iron

In one study, scientists showed that the intake of omega-3 and omega-6 fatty acids for 6 months helps protect against hair loss.

What ingredients to avoid in a hair growth product?

Just like you need to look for the right ingredients for hair growth, you also need to be wary of the ingredients that exacerbate this condition.

As we discussed in previous chapters, several causes drive hair loss. Therefore, every ingredient we are going to list worsens hair loss in a different mechanism.

For instance, diethanolamine (DEA) triggers inflammation and severe immune reactions in the scalp, which is the last thing you want when you’ve been diagnosed with alopecia areata.

Here are the ingredients you need to avoid when buying a hair loss product:

  • Sodium Lauryl Sulfate
  • Parabens
  • Propylene Glycol
  • Imidazolidinyl Urea
  • Sodium Chloride
  • Diethanolamine (DEA)
  • Fragrance

Choosing the right product for hair loss is a challenging task for laypersons who do not possess the necessary knowledge about hair growth and anti-hair loss products.

Fortunately, you have become an expert in the field of hair loss, which allows you to confidently choose the right products that meet your needs.

CHAPTER 6. How to Prevent Hair Loss (Once And For All)

Guy choosing a hair style, a hair care product looking at laptop, flat style.

Throughout this guide, you probably realized how difficult it is to manage hair loss.

Can you prevent hair loss?

The variety of underlying mechanisms and their complex and poorly understood pathophysiology make this task even more challenging.

For this reason, many experts switched their focus to finding effective ways to prevent hair loss.

The collection of preventive measures take into account the most common hair loss etiologies; however, you should keep in mind that some causes characterized by immune dysfunction (e.g., alopecia areata) are very challenging to prevent.

With that being said, here are the most effective ways to prevent hair loss:

1. Go natural

A woman walking under the sun, in park, happy, flat style.

Going natural with hair loss is never the wrong answer. Choose the products that contain natural ingredients to prevent your hair from falling.

Learn more about this by reading the previous chapter.

2. Watch the chemicals

In the previous chapter, we listed some chemicals that precipitate the hair loss. You need to be very careful before buying hair products that contain shady ingredients.

3. Drugs that can cause hair loss

Several pharmacological drugs trigger inflammation in the scalp, which leads to hair loss. However, each drug has a slightly different mechanism.

Here is a list of drugs to keep in mind:

Cholesterol drugs – drugs such as atorvastatin and simvastatin.

Anticoagulants – warfarin.

Psoriasis medication – Acitretin (Soriatane).

Antihypertensive drugs – ACE inhibitors. 

Antacids – histamine receptor blockers (e.g., cimetidine).

Antiarrhythmic drugs – antiarrhythmic drugs entail 5 classes that treat cardiac arrhythmias, such as atrial fibrillation and atrial flutter. One classic drug that causes hair loss is amiodarone, which belongs to the third class of antiarrhythmics. 

Steroids – exogenous steroids (testosterone and progesterone).

4. Quit the hot stuff

The overuse of hot styling tools (e.g., hairdryer, curling wand) makes your hair dry. As a result, it will become prone to thinning and falling.

5. If you have to, use sponge rollers!

A woman at the hairdresser, barber, using sponge roller, flat style.

You have that one date you need to prepare for? Don’t worry, you can still get curls! You should use sponge rollers as it does not create a lot of stress on your hair.

However, using sponge rollers depletes the oil and moisture from your hair. Sponge rollers also lead to traction alopecia, where the hair follicles themselves become damaged. Avoid this by not wrapping your hair too tightly around the rollers. Also, do not use sponge rollers daily.

6. Stop dyeing your hair!

A guy dyeing his hair, painting his head of hair red, flat style.

While dyeing does not inhibit hair growth, it can damage color-treated hair. In other words, the hair follicle sitting underneath the scalp cannot be damaged by dyeing your hair since the product does not reach that depth. However, hair shedding increases after dyeing your hair.

Before your dye your hair, you may want to speak with your dermatologist to learn about the best practices.

7. No more tight braids

Tight braids lead to traction alopecia, which is the result of repeated hair pulling. Besides braids, a tight ponytail or bun can also lead to this condition.

For this reason, you should avoid anything that severely tightens your hair and causes traction alopecia.

8. Pick the right shampoo

Every shampoo has unique characteristics.

Knowing your hair type and the potential deficiencies you are prone to will help you choose the right shampoo for you.

As a general rule of thumb, always opt for shampoos that contain natural ingredients with minimal chemical traces.

To make the best choice, you may need to speak with your dermatologist.

9. Brush properly

A woman brushing her hair in the bathroom, flat style.

 Brushing your hair frequently can lead to hair loss. This is exacerbated if you are brushing your hair the wrong way.

In one study, researchers examined the effects of brushing on hair loss for 4 weeks. Participants were divided into several groups, where each group brushes their hair in different frequencies.

After 4 weeks, they found that brushing less frequently reduces hair loss.

You always need to be gentle since the scalp is a sensitive region that is susceptible to developing inflammation and irritation after minor injuries.

Monica Davis, a professional hairstylist with 20 years experience and the founder of MyStraightener wrote:

As a hairstylist, I highly recommend brushing only for detangling and styling purposes. However, in both cases, you shouldn’t start brushing without proper hair preparation. You must finish every hair washing with a hair conditioner that matches your hair type and apply serum or hair oil with a thermal protector before drying and styling your hair. Between the washing, you can apply a spray for brushing simplification to reduce hair damage while detangling.

10. Maintain hair hygiene

A guy washing his hair, bubbly, focused, blue, flat style.

Washing your hair regularly with the right product is indispensable to prevent hair loss. When you wash your hair, you will stimulate the scalp, which boosts the process of hair follicle growth.

However, overusing chemicals on your hair to be extra hygienic can be counterproductive.

11. Balanced nutrition intake

Eating a balanced diet is a great way to prevent hair loss.

In one study, researchers found that consuming raw vegetables and fresh herbs (e.g., the Mediterranean diet) reduces the risk of androgenetic alopecia.

Foods such as parsley, basil, and salad greens yielded the best results.

Since the hair follicles are made of a protein known as keratin, it should not come as a surprise that including protein in your diet will prevent hair loss.

Finally, adding a multivitamin to the mix promotes hair growth and prevents follicular thinning. Your multivitamin should contain vitamins A, B, C, D, iron, zinc, and selenium.

“To prevent hair loss, it’s important to be mindful of how your supplements and diet can impact each other. For instance, if you load up your plate with vitamin A-rich foods, like sweet potatoes, kale, or spinach, and are also taking a supplement heavy in vitamin A, you may be doing more damage than good.

While it’s nearly impossible to get too much vitamin A from food alone, it’s much easier to overdo it with supplements, and this can be damaging to your hair. Too much vitamin A over a long period of time can actually cause hair loss. As with all things, finding the right balance is key.” – BeautyMag.com doctor.”

12. Treat underlying conditions

Guy holding a comb, looking at himself in the mirror, flat style.

If your hair loss is the result of an underlying medical condition, treating the disease will most likely reverse hair loss.

However, you may need to act quickly before hair loss becomes irreversible.

1. Thyroid Disease

High or low levels of thyroid hormones in the blood (i.e., hyperthyroidism, hypothyroidism) are notoriously known to alter the normal growth of hair follicles.

Regulating your thyroid hormones by taking drugs (prescribed by your primary care physician or endocrinologist) will allow your hair to grow again.

Note that it may take several months to experience a full recovery.

2. Anemia

Anemia presents with several signs that affect the integumentary system (skin, hair, nails). In the beginning, researchers theorized that the iron deficiency that triggers anemia is also responsible for hair loss. However, there is no solid evidence to support this theory.

Treating anemia with iron supplementation (if it’s the result of iron deficiency) is enough to reverse hair loss.

3. Hormonal Imbalances

Similar to thyroid disease, other conditions that alter the normal balance of steroid hormones can lead to hair loss. 

Fortunately, hormone replacement therapy and other treatment modalities improved the prognosis (i.e., outcome) of these patients.

It is a one-time investment and easy to use. Remember that it does not remove hair permanently but helps in slowing the growth. Other methods used for hair removal are: shaving, waxing, and depilatory creams.

Conclusion

A rockstar playing guitar with long hair, flat style.

Now that you know everything there is about hair loss. What did we miss? What do you want to know about hair loss?

Comment below and we’ll have a dermatologist answer your burning questions!

Reference

Bhat YJ, Saqib NU, Latif I, Hassan I. Female Pattern Hair Loss-An Update. Indian Dermatol Online J. 2020;11(4):493-501. Published 2020 Jul 13. doi:10.4103/idoj.IDOJ_334_19

Freites-Martinez A, Shapiro J, et al. “Hair disorders in patients with cancer.” J Am Acad Dermatol. 2019;80:1199-1213.

Guo EL, Katta R. “Diet and hair loss: Effects of nutrient deficiency and supplement use.” Dermatol Pract Concept. 2017; 7:1-10.

Jakhar D, Kaur I. “Frictional (sock) alopecia of the legs: Trichoscopy as an aid.” Int J Trichology. 2018;10:129-130.

Paus R, Olsen EA, et al. “Hair growth disorders.” In: Wolff K, Goldsmith LA, et al. Fitzpatrick’s Dermatology in General Medicine (seventh edition). McGraw Hill Medical, New York, 2008:753-74.

Senthilkumaran S, Balamurugan N, et al. “Acute Alopecia: Evidence to Thallium Poisoning.” Int J Trichology. 2017; 9: 30-2

Shannon F, Christa S, et. al. “Demographics of women with female pattern hair loss and the effectiveness of spironolactone therapy.” J Am Acad Dermatol. 2015;73: 705-6.

Sperling LC. “Alopecia.” In: Fitzpatrick JE, Morelli JG. Dermatology Secrets Plus (fifth edition). Elsevier, China, 2016:179-84.

Vafaie J, Weinberg JM, et al. “Alopecia in association with sexually transmitted disease: A review.”Cutis. 2005;76:361-6.

Yu V, Juhász M, et al. “Alopecia and associated toxic agents: A systematic review.” Skin Appendage Disord 2018;4:245-60.

American Academy of Dermatology. “Dermatologists can help women win the fight against common forms of hair loss.” News release issued March 4, 2010. Last accessed March 1, 2021.

Sperling LC. “Alopecias.” In: Bolognia JL, et al. Dermatology. (second edition). Mosby Elsevier, Spain, 2008: 987-1004.

Malki L, et al. Variant PAD13 in central centrifugal cicatricial alopecia. New England Journal of Medicine. 2019; doi:10.1056/NEJMoa1816614.

Briggs JK. Hair loss. Triage Protocols for Aging Adults. Waloters Kluwer; 2019.

Hair loss. American Academy of Dermatology. https://www.aad.org/public/diseases/hair-loss/treatment/causes/fall-out. Accessed January 31, 2021.

Hair loss. American Cancer Society. https://www.cancer.org/treatment/treatments-and-side-effects/physical-side-effects/hair-loss.html. Accessed February 2, 2021.

Van Zuuren EJ, et al. Interventions for female pattern hair loss. JAMA Dermatology. 2017; doi:10.1001/jamadermatol.2016.5790.

Shapiro J, et al. Evaluation and diagnosis of hair loss. https://www.uptodate.com/contents/search. Accessed January 4, 2021.

Shapiro J, et al. Alopecia areata: Clinical manifestations and diagnosis. https://www.uptodate.com/contents/search. Accessed January 2, 2021.

Cold caps and scalp cooling systems. https://www.breastcancer.org/tips/hair_skin_nails/cold-caps. Accessed January 31, 2021.

Mirmirati P. Age-related hair changes in men: Mechanisms and management of alopecia and graying. Maturitas. 2015; doi.10.1016/j.maturitas.2014.10.008.

Chemotherapy and you: Support for people with cancer. National Cancer Institute. https://www.cancer.gov/publications/patient-education/chemotherapy-and-you.pdf. Accessed February 3, 2021.

Shapiro J. Lichen planopilaris. https://www.uptodate.com/contents/search. Accessed March 1, 2021.

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