Revive and Thrive: What You Need to Know About Hair Loss

In a society where first impressions hold immense significance and self-assurance reigns supreme, our appearance often plays a vital role in shaping our identity. Yet, for countless individuals grappling with hair loss, the mirror can become a source of distress and a reminder of lost confidence. Psychological studies have revealed that women, in particular, face greater social expectations to have a full head of hair at all ages, making hair loss a deeply impactful experience for them. As an aesthetic practitioner, I have witnessed the impact that hair loss can have on someone’s well-being, both physically and emotionally.

Whether you are experiencing hair loss yourself, supporting a loved one through their journey, or simply seeking to expand your knowledge in the field of aesthetic medicine, this blog aims to be your guide. We will explore the various causes of hair loss, shed light on effective treatment options, and provide practical advice for regaining healthy and vibrant hair.

Understanding the causes of hair loss is paramount to finding effective solutions. The factors contributing to hair loss can be broadly classifies into two categories: non- scarring alopecias (medical term for bald) and scarring alopecias. While scarring alopecias involve irreversible damage to the hair follicles, non-scarring alopecias encompass a diverse range of conditions that present opportunities for treatment and restoration.

Non- scarring alopecias include conditions such as:

Androgenetic alopecia (pattern hair loss)

This is the most common form of hair loss, often referred to as male or female pattern baldness. It is a genetically predetermined disorder characterized by an excessive response to androgens, the male sex hormones. This condition affects up to 50 percent of males and females and it is marked by progressive loss of terminal hair on the scalp that can occur any time following puberty. In males, the early stages of male pattern baldness are typically noticed in their 30s, but it can commence as early as the late teenage years or early 20s. Men typically experience receding hairlines and bald patches. Conversely, women affected by androgenetic alopecia often experience a more diffuse pattern of hair loss, with thinning of hair across the scalp. It is estimated that androgenetic alopecia affects up to 50% of women by the age of 40 years.

Telogen effluvium

“Stress can cause hair loss.”

Indeed, this statement is true, and the underlying mechanism is a condition known as telogen effluvium. Telogen effluvium represents a temporary type of hair loss characterized by excessive shedding of hair. It occurs when the hair follicles prematurely enter the resting (telogen) phase of the hair growth cycle due to physical or emotional stressors. Common triggers for telogen effluvium include childbirth, illness, surgical procedures, significant weight loss, or experiencing high level of stress. The good news is that in the majority of cases, once the underlying cause is addressed, hair regrowth resumes. In other words, telogen effluvium is a reversible condition, and with proper management and resolution of the underlying stressors, individuals can expect their hair to grow back.

Alopecia Areata

Alopecia areata happens when the immune system attacks hair follicles and causes hair loss in round or oval patches. The exact cause of alopecia areata is unknown, but it is believed to involve a combination of genetic and environmental factors. Scientists have linked a number of genes to the disease, and many of the genes they found are important for the functioning of immune system. People with certain autoimmune diseases, such as psoriasis, thyroid disease, vitiligo, are more likely to get alopecia areata, so as are those with allergic conditions like hay fever. Emotional or physical stress, as well as certain illnesses, may trigger its onset in people who are at risk, but in most cases, there is no obvious trigger.

Alopecia areata can begin at any age, but most people develop it during childhood or their teenage years. They have hair loss and sometimes nail changes, but they remain in good health. The hair loss tends to be unpredictable. Hair may regrow without treatment. When the hair regrows, it may fall out again, or it may not. It is also possible to have unpredictable cycles of hair loss and regrowth for years. In cases where nails are affected, you may see dents, ridges or brittle nails, some even develop red nails.

Androgen excess

Hair loss caused by excess androgens and androgenetic alopecia are closely related, but they are not exactly the same. In androgenetic alopecia, the levels of androgen in the body are typically within the normal range. However, individuals affected exhibit an excessive response to androgens, causing hair loss. On the other hand, hair loss caused by excess androgens refers to a broader category of hair loss conditions in which an imbalance or increase in androgen hormones disrupt the natural hair growth cycle, leading to hair loss.

There are conditions, such as polycystic ovarian syndrome (PCOS), and certain hormonal disorders, that can contribute to hair loss due to increased androgen levels. Other accompanying signs of excess androgen may be present, which include acne, hirsutism (excessive hair growth in unwanted areas), menstrual irregularities, galactorrhoea (abnormal milk secretion), and development of husky voice.

Does oily scalp cause hair loss?

Having oily scalp is a common issue that many people encounter at some stage of their lives.

Individuals with pattern baldness, however, are at a higher risk for developing an oily scalp.

Although an oily scalp itself does not directly result in hair loss, it can contribute to the blockage of hair follicles and the buildup of sebum, potentially leading to an increased risk of hair fall.

It may just be a symptom of a bigger issue that can certainly cause hair loss.

The direct reason for oily scalp is excess production of sebum by the sebaceous glands in the scalp. However, there are various factors that can contribute to this occurrence such as hormonal imbalance, diet rich in oily and greasy food, seborrheic dermatitis and improper hygiene.

Scarring alopecia:

Scarring alopecia, known as cicatricial alopecia, encompasses a group of hair loss disorders that affect a small percentage, approximately 3%, of individuals experiencing hair loss.

Within the category of scarring alopecia, each specific diagnosis is relatively uncommon. Examples include but not limited to dissecting cellulitis, eosinophilic pustular folliculitis, lichen planopilaris and follicular degeneration syndrome. It can also be associated with broader conditions like chronic lupus erythematosus, where multiple organs throughout the body can be affected.

Despite the diversity of forms within scarring alopecia, they share a common characteristic – an underlying process that leads to the permanent and irreversible destruction of hair follicles, subsequently replaced by scar tissue. This distinction sets scarring alopecia apart from non-scarring alopecias, as the scarring nature of these conditions poses challenges in terms of treatment.

Scarring alopecia typically manifests initially as small areas of hair loss that progress gradually over many years. While in certain cases, individuals may experience more pronounced symptoms, such as intense itching, burning sensations, and discomfort, accompanied by rapid and progressive hair loss. Affected area may be smooth and clean, or may have blistering, crusting, pustules, redness or other discoloration. As the follicles are below the skin surface, there is usually no “scar” seen on the scalp.

To determine the underlying causes of hair loss, medical history and physical examination are necessary. While visual indicators can provide valuable insights, relying solely on the pattern of hair loss and the appearance of the scalp skin can pose challenges in diagnosing scarring alopecia accurately. Therefore, often when scarring alopecia is suspected, one or more skin biopsies are required to confirm the diagnosis and help identify the particular form of scarring alopecia.

Treatments

When it comes to tackling hair loss and promoting the regrowth of hair, a variety of treatment options are at your disposal. Below are some of the most effective treatments to combat hair loss:

Medications

FDA approved medications can help slow down hair loss and promote regrowth.

Minoxidil, available as a topical solution or foam, is commonly used for both men and women. It stimulates hair follicles,

prolongs the growth phase, and improves blood circulation to the scalp. Finasteride, an oral medication for men, blocks the conversion of testosterone to dihydrotestosterone (DHT), a hormone responsible for shrinking hair follicles.

Platelet-rich plasma (PRP) therapy

PRP therapy is a regenerative treatment that utilizes the healing properties of a patient’s own blood. A small sample of blood is processed to obtain PRP, which is plasma containing higher concentrations of platelets than those found in peripheral blood. PRP is rich in growth factors and has the ability to accelerate wound healing and tissue regeneration, leading to a wider range of applications in the medical f

ield, such as in sport medicine, regenerative medicine, and aesthetic medicine. For hair loss, these platelets are injected into the scalp to stimulate hair growth, improve follicle health, and increase hair thickness. PRP treatment is a minimally invasive procedure and is often performed in a series of sessions for optimal results.

Read more on PRP for hair

Cytokine therapy

What is cytokine?

Cytokine is a cell factor (cell hormone) that controls cell cycle such as cell generation, cell growth, cell proliferation and death. Cytokines that destroy hair follicle cells and cause hair loss include BMP, DKK-1, TGF beta, whereas cytokines that maintain or promote hair growth by proliferating and differentiating hair follicle cells are KGF, FGF9, IGF-1, VEGF, Bfgf, Hoggin, SOD and ATP.

When there is collapse of balance between factors that generate cells and death factors that kill cells in hair follicle, hair loss happens. Cytokine therapy helps by restoring the balance.

As its name suggests, Cytokine-8 therapy contains the 8 types of cytokine growth factors mentioned. They reduce hair loss by suppressing hair loss inducer, promoting hair growth and normalizing hair growth cycle and promoting energy metabolism of cells. They are introduced to the scalp via microneedling metho

d.

Hair transplantation

Hair transplantation is a surgical procedure that involves harvesting hair follicles from a donor area (typically the back of the scalp) and transplanting them to areas with thinning or no hair. However, few questions or criterias should be all answerable when deciding on whether one is a good candidate for hair transplantation, thus careful assessment is required prior to decision making.

Hair transplantation is a surgical procedure designed to address hair loss by harvesting hair follicles from a donor area, typically located at the back of the scalp, and transplanting them to areas with thinning or no hair. Hair transplantation provides a long- lasting solution for hair loss and delivers natural looking results. The vast majority of people who are candidates for hair transplantation are of both sexes with androgenetic alopecia. However, several crucial questions and criteria must be carefully considered to determine whether someone is an appropriate candidate for this procedure. Thorough evaluation and assessment are essential prerequisite prior to decision making.

Read more for Hair Loss Treatments

Lifestyle and self- care tips

In addition to medical treatments, incorporating healthy habits into your lifestyle can contribute to maintaining and promoting hair health.

Healthy diet and nutrition

Consuming a balanced diet rich in vitamins, minerals and proteins is essential for healthy hair. Include foods such as leafy greens, fruits, lean proteins, whole grains, and nuts to provide the necessary nutrients for hair growth. Additionally, consider incorporating supplements like biotin, zinc and vitamin B and D.

Stress management

Chronic stress can contribute to hair loss. Engaging in stress-reducing activities such as exercise, meditation, yoga or mindfulness practices can help promote overall well- being and hair health. Finding healthy ways to cope with stress is crucial in maintaining a healthy hair growth cycle. But of course, this is easier said than done.

Hair care practices

Adopt gentle hair care routines to minimize damage and breakage. Use a mild shampoo and conditioner suitable for your hair type. Avoid excessive heat styling, chemical treatments, and tight hairstyles that can strain the hair follicles. Consider using wide-toothed combs or brushes with soft bristles to avoid hair breakage.

The management stated above may not be applicable for scarring alopecia, because unfortunately, there is currently no cure for scarring alopecia. The primary goal of treatment is to manage symptoms and slow down or prevent further hair loss. The specific treatment approach depends on the type of cicatricial alopecia present. In most cases, anti-inflammatory medications are commonly prescribed. It works by fighting the inflammatory cells causing hair follicle destruction. Antibiotics such as doxycycline or minocycline may be necessary in case of scarring alopecia caused by bacterial infections. Hair transplantation is only suitable for selected cases as the presence of scar tissue beneath the skin’s surface can impede the survival of transplanted hair. However, if there has been no ongoing hair loss for a significant period of time, hair restoration through transplantation may be considered.

PRP therapy for scarring alopecia is less common, but some studies have shown positive results for certain types, such as lichen planopilaris.

Hair regrowth is difficult once the hair follicles are destroyed. However, if the condition is identified at an early stage, medication may be able to prevent inflammation from causing complete destruction of the hair follicle.

Hair loss can be a challenging experience, but no matter where you are on your hair restoration journey, there is always hope. With the right knowledge and treatment options, it is possible to restore healthy hair and regain confidence.