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What to do when you lose your hair

What causes hair loss and what are your options?

01 July 2005
by Brenda Mapane

Hair loss can affect both men and women and can be a huge blow to their self-esteem. The advertisements for the treatment of hair loss might lead one to believe that hair loss is generally a men's issue. However, as many as two-thirds of all women experience hair loss at some point.

At any one time, about 10 percent of the hair on your scalp is in a resting phase. After two to three months, the resting hair falls out and new hair starts to grow in its place. This growth phase lasts for two to six years. Each hair grows approximately one centimetre per month during this phase. About 90 percent of the hair on your scalp is growing at any one time. It is normal to shed some hair each day as part of this cycle: anything between 50 to 80 hairs is considered normal. However, some people may experience excessive hair loss, also known as alopecia, that leads to thin-looking hair or baldness.

What causes hair loss?

A number of genetic, health and lifestyle factors can cause excessive hair loss. For example, about three or four months after an illness or major surgery, you may suddenly lose a large amount of hair. This hair loss is related to the stress of the illness and is temporary.

Hormonal problems can also cause hair loss. If your thyroid gland is overactive or underactive, your hair may fall out. This hair loss usually can be helped by treatment of the thyroid disease. Hair loss may occur if male or female hormones, known as androgens and oestrogens, are out of balance. Again, correcting the underlying hormone imbalance may stop the hair loss.

Many women notice hair loss about three months after they've had a baby. This is also related to hormones. During pregnancy, high levels of certain hormones cause the body to keep hair that would normally fall out. When hormones return to pre-pregnancy levels, that hair falls out and the normal cycle of growth and loss starts again.

Some medicines can cause you to lose hair as a side-effect. This type of hair loss improves when you stop taking the medication. Medicines that can cause hair loss include blood thinners (also called anticoagulants), medicines used for gout, medicines used in chemo-therapy to treat cancer, vitamin A (if too much is taken), birth-control pills and antidepressants.

Certain infections can cause hair loss. Children may have hair loss caused by a fungal infection of the scalp. The infection is easily treated with antifungal medicines.

Finally, hair loss may occur as part of an underlying disease, such as lupus or diabetes. Since hair loss may be an early sign of a disease, it is important to find the cause so that it can be treated.

Types of hair loss

Androgenetic alopecia

This type of hair loss is linked to the male hormone androgen, which is produced in significant quantities from puberty onwards. Your reaction to androgen is genetically determined: if one or both of your parents carry the gene for androgenetic alopecia, you may experience hair loss. This type of alopecia is common in men, but also affects women, causing thinning hair.

Men who start losing their hair at an early age tend to develop more extensive baldness. In male-pattern baldness, hair loss typically results in a receding hairline and baldness on the top of the head. Women may develop female-pattern baldness. In this form of hair loss, the hair becomes thin over the entire scalp.

Telogen effluvium (diffuse hair loss)

This type of hair loss is a general thinning of the hair. It can be caused by medicines, mineral deficiencies, chemicals and fluctuating hormone levels (for instance, after pregnancy). This kind of hair loss is often reversible: once the underlying cause is addressed, hair growth often returns to normal.

Alopecia areata

Alopecia areata is an immune disease that affects almost six percent of the South African population. It varies in severity from small, round patches of hair loss that regrow without medical treatment, to chronic, extensive hair loss that can involve the loss of all hair on the scalp and body.

This type of hair loss affects both genders equally and can occur at any age, although it occurs most often in children and young adults.

The choice of treatment depends on the patient's age and the extent of hair loss. Milder cases often see a greater improvement with treatment than severe cases.

Treatment options

If you notice excessive hair loss, your doctor will probably ask you some questions about your diet, any medicines you're taking, whether you've had a recent illness and how you take care of your hair. Your doctor may also ask questions about your menstrual cycle, pregnancies and menopause. She may want to do a physical exam to look for other causes of hair loss and may conduct blood tests or a biopsy of your scalp to diagnose the type and cause of your hair loss.

Depending on your type of hair loss, there are a number of different treatments available. If a medicine is causing your hair loss, your doctor may be able to prescribe a different medicine. Recognising and treating an infection may help stop the hair loss. Correcting a hormone imbalance may prevent further hair loss. Medicines may help slow or prevent the development of common baldness.

Diet: a diet that contains whole foods ­ particularly the outer skin of plants such as potatoes, cucumbers, green and red peppers and sprouts ­ can give strength to hair because they are rich in the mineral silica. Foods that are high in iron, such as lean meats, are important for people with a known iron deficiency.

Supplements: folic acid, biotin, vitamin B5, para-aminobenzoic acid (PABA), and silica are supplements that may help maintain the colour and thickness of hair. Be sure to check your daily intake of zinc through supplements. Intake of 30mg or higher for more than three months can induce a deficiency of copper and low copper levels can result in hair loss. Speak to a health practitioner before supplementing copper to avoid a copper overdose.

Hormone treatments: physicians prescribe both oral and topical oestrogens to treat hair loss in women ­ although there are no controlled studies to support this use of it. Anne Clavaux from the UCT Skin and Hair Centre warns that women who choose to use oral contraceptives to treat hair loss should take care to select one with little or no androgenic activity, such as norgestimate or ethynodiol diacetate. She also warns that women with androgenetic alopecia should not use testosterone or androgen precursors such as DHEA.

Aromatherapy: the results of one research study suggest that the essential oils of thyme, rosemary, lavender, and cedarwood, mixed with a base oil (such as grapeseed oil) and applied on the areas of hair loss may stimulate hair growth. This double blind, placebo-controlled study enrolled 84 people who massaged either these essential oils or a non-treatment oil into their scalps each night for seven months. Results showed that 44 percent of people in the treatment group had new hair growth compared to only 15 percent in the control group.

Hair-oil recipe

  • 3 drops of essential oil of thyme
  • 3 drops of essential oil of lavender
  • 3 drops of essential oil of rosemary
  • 3 drops of essential oil of cedarwood
  • 1/8 cup of grapeseed oil
  • 1/8 cup of jojoba oil

Mix the ingredients together. Apply several drops of the mixture to areas of hair loss each night, massaging gently into scalp for three to five minutes. Cover your pillow with an old towel. Store the oil tightly covered.