Top 22 Causes of Hair Loss and Best Hair Loss Treatments
A patient reminded me to update my previous post about hair loss. She asked:
I have a hair loss problem. does it get worse if i get pregnant?
Hair loss can be very disconcerting to men and women alike. While it is known that most hair loss is genetic, there are stressors that can make it worse. Here are the top 22 in general order of most common to least common.
It is not uncommon to see hair loss or thinning of the hair in women as they enter their 50s and 60s. Part of this is general aging and general hormonal changes as we age. Another reason is hidden in our genes. Other reasons for hair loss as we get older is due to the causes below. If you see this happening to you and you are young, see the reasons and treatments below.
2. Physical stress
Any kind of physical trauma, like a recent surgery, a car accident, or a severe illness, the flu, and even the death of a loved one, can cause temporary hair loss. This can trigger a type of hair loss called Telogen Effluvium. Since hair has a programmed life cycle (a growth phase, rest phase and shedding phase), a very stressful even can change the hair cycle into the shedding phase. The same thing can happen to chickens who molt. The reason has to do with the complex area of hair proteins, stress hormones, and apoptosis or programmed cell death. Often hair loss can become noticeable three-to-six months after the trauma.
What to do?:
Try to decrease the stressors in your life. My favorite is to pray and meditate daily and ideally go to mass daily and confession weekly. Even if you are not Catholic, these practices are now starting to have some scientific merit. Even if they had no scientific merit, it would not be a waste of time if you have a supernatural outlook.
The great news is that your hair will start growing back as your body recovers.
3. Male pattern baldness
About two out of three men experience hair loss by age 60, and most of the time it’s due to male pattern baldness. This type of hair loss, caused by a combo of genes and male sex hormones, usually follows a classic pattern in which the hair recedes at the temples, leaving an M-shaped hairline.
What to do: There are topical creams like minoxidil (Rogaine) and oral medications such as finasteride (Propecia) that can halt hair loss or even cause some to grow; surgery to transplant or graft hair is also an option.
Female-pattern hair loss, called androgenic or androgenetic alopecia, is basically the female version of male pattern baldness. “If you come from a family where women started to have hair loss at a certain age, then you might be more prone to it,” says Dr. Glashofer. Unlike men, women don’t tend to have a receding hairline, instead their part may widen and they may have noticeable thinning of hair.
What to do: Like men, women may benefit from minoxidil (Rogaine) to help grow hair, or at least, maintain the hair you have, Dr. Glashofer says. Rogaine is available over-the-counter and is approved for women with this type of hair loss.
Pregnancy obviously only affects women, but there are some cases of the common stress of pregnancy causing the hair loss of the husband to worsen temporarily: likely from general lack of sleep. Pregnancy and general hormone changes is one example of the type of physical stress that can cause hair loss. Pregnancy-related hair loss is seen more commonly after your baby has been delivered rather than actually during pregnancy.
What to do: The great news is that your hair will start growing back as your body recovers: it can take a few months though. Be sure to eat a healthy diet, with protein to help the hair grow back strong.
6. Female hormones
Just as pregnancy hormones can cause hair loss, so can any change in one’s hormone balance. Using birth control pills or going off and on birth control can cause Telogen Effluvium and a loss of hair. This is extra likely if you have a family history of hair loss. Menopause may also have the same result due to hormonal changes. The hair follicles will miniaturize and then you start to lose more hair as androgen (male hormone) receptors on the scalp becoming activated.
What to do: If you notice hair loss after starting birth control pills, talk to a MD who knows about natural ways to space children: see http://www.creightonmodel.com/
Such methods have no risk of external hormones.
People with diabetes are more likely to have hair loss. They can also have a condition called Alopecia Areata in which the immune system attacks the hair follicles leading to patches of hair loss on the head and body.
If you have Diabetes or are Pre-Diabetic, be sure to keep your HgA1C (Hemoglobin A1C) below 5.7%. Avoid sugar and carbohydrates.
8. Lack of protein
If you don’t get enough protein in your diet, your body may ration protein by shutting down hair growth, according to the American Academy of Dermatology. This can happen about two to three months after a drop in protein intake, they say.
What to do: There are many great sources of protein, including fish, meat, and eggs. If you don’t eat meat or animal products, here are many ways to get vegan sources of protein. Check out this link: 14 Best Vegan and Vegetarian Protein Sources.
9. Emotional stress
It seems these days that many are under emotional stress. This can be due to stress at work, stress with your spouse or kids, fear of something, divorce, after the death of a loved one, or while caring for an aging parent. Emotional stress usually makes an underlying condition worse and does not primarily cause hair loss.
What to do: Do things to help decrease your stress, anxiety, and fear. Pray and mediate on the positive many times per day. Get your 10,000 steps in, Increase your exercise, call your friends and talk. There are now talk therapy groups. Talk to your priest, rabbi, pastor about what is on your mind. It is usually free and may be more effective for some people than paying for a weekly therapist.
Almost one in 10 women aged 20 through 49 suffers from anemia due to an iron deficiency (the most common type of anemia), which is an easily fixable cause of hair loss. You doctor will have to do a blood test to determine for sure if you have this type of anemia.
What to do: A simple iron supplement should correct the problem. In addition to hair loss, other symptoms of anemia include fatigue, headache, dizziness, pale skin, and cold hands and feet.
Hypothyroidism is the medical term for having less thyroid hormone in your body. This usually indicates an underactive thyroid gland. The thyroid gland is in the middle of your front neck area and produces hormones that are critical to metabolism as well as growth and development and, when it’s not pumping out enough hormones, can contribute to hair loss. Ask your doctor or consult with me on Healthtap to order Thyroid function tests which can see if you have hypothyroidism.
What to do: Synthetic thyroid medication will take care of the problem. Once your thyroid levels return to normal, so should your hair.
12. Vitamin B deficiency
Although relatively uncommon in the U.S., low levels of vitamin B are another correctible cause of hair loss.
What to do: Simple supplementation should help the problem. So can dietary changes. Find natural vitamin B in fish, meat, starchy vegetables, and non-citrus fruits. As always, eating a balanced diet plentiful in fruits and vegetables as well as lean protein and “good” fats such as avocado and nuts will be good for your hair and your overall health.
13. Too much vitamin A
Overdoing vitamin A-containing supplements or medications can trigger hair loss, according to the American Academy of Dermatology. The Daily Value for vitamin A is 5,000 International Units (IU) per day for adults and kids over age 4; supplements can contain 2,500 to 10,000 IU.
What to do: This is a reversible cause of hair loss and once the excess vitamin A is halted, hair should grow normally.
14. Autoimmune-related hair loss
This is also called alopecia areata. This occurs when your overactive immune system sees your hair as a foreign enemy and attacks it by mistake.
What to do: Steroid injections are the first line of treatment for alopecia areata, which appears as hair loss in round patches on the head. Other drugs, including Rogaine, may help in some patients. The course of the condition can be unpredictable as the growing hair can fall back out again.
Lupus is an autoimmune diseases which again can cause an overactive immune system to attack the hair. Some patients with lupus can have permanent hair loss due to the scarring of the hair follicles.
What to do: Talk to your MD about getting treated for Lupus with plaquenil, methotrexate, which will help in some patients. If the hair loss is mild, you might want to try a new hairstyle to camouflage the damage. Short hair, for instance, is stronger than long hair and may hide bald patches better.
16. Dramatic weight loss
Sudden weight loss is a form of physical trauma that can result in thinning hair. This could happen even if the weight loss is ultimately good for you. It’s possible that the weight loss itself is stressing your body or that not eating right can result in vitamin or mineral deficiencies. Loss of hair along with noticeable weight loss may also be a sign of an eating disorder such as anorexia or bulimia.
What to do: “Sudden weight loss seems to shock the system and you’ll have a six-month period of hair loss and then it corrects itself,” says Dr. Hammonds.
Many drugs used to kill the cancer can kill other rapidly divinding cell, such as the hair cells, and cause all the hair to fall out.
Polycystic ovary syndrome (PCOS) is another imbalance in male and female sex hormones. An excess of androgens can lead to ovarian cysts, weight gain, a higher risk of diabetes, changes in your menstrual period, infertility, as well as hair thinning. Because male hormones are overrepresented in PCOS, women may also experience more hair on the face and body.
What to do: Treating PCOS can correct the hormone imbalance and help reverse some of these changes. Treatments include diet, exercise, and potentially birth control pills, as well as specific treatment to address infertility or diabetes risk.
19. Drugs: Antidepressants, blood thinners, and more
Certain other classes of medication may also promote hair loss. a. More common among: 1) certain blood thinners 2) beta-blockers for high blood pressure b. Others: 1) methotrexate (used to treat rheumatic conditions and some skin conditions) 2) lithium (for bipolar disorder) 3) nonsteroidal anti-inflammatory drugs (NSAIDs) including ibuprofen: rarer; 4) antidepressants
What to do: If your MD determines that one or more of your medications is causing hair loss, talk with him or her about either lowering the dose or switching to another medicine.
20. Anabolic steroids
If you take anabolic steroids—the type abused by some athletes to bulk up muscle—you could lose your hair, according to the American Academy of Dermatology. Anabolic steroids can have the same impact on the body as polycystic ovary disease (PCOS), as the mechanism is the same, says Dr. Hammonds.
What to do: This should improve after going off the drug.
Vigorous styling and hair treatments over the years can cause your hair to fall out. Examples of extreme styling include tight braids, hair weaves or corn rows as well as chemical relaxers to straighten your hair, hot-oil treatments or any kind of harsh chemical or high heat. Because these practices can actually affect the hair root, your hair might not grow back.
What to do: In addition to avoiding these styles and treatments, the American Academy of Dermatology recommends the following: 1) do not necessarily shampoo every day 2) using conditioner after every shampoo 3) letting your hair air dry 4) avoid curling your hair or limiting the amount of time the curling iron comes in contact with your hair 4) use heat-driven products no more than once a week.
Trichotillomania, classified as an “impulse control disorder,” causes people to compulsively pull their hair out. “It’s sort of like a tic, the person is constantly playing and pulling their hair,” says Dr. Glashofer says. Unfortunately, this constant playing and pulling can actually strip your head of its natural protection: hair. Trichotillomania often begins before the age of 17 and is four times as common in women as in men.
What to do: Some antidepressants may be effective, but behavioral modification therapy is another option.
The Best Ways to Treat Hair Loss:
1. Nutrition: improve your nutrition: Increase Vitamin B complex rich foods, green leafy veggies, Omega 3 rich foods; more information below 2. If possible, decrease above offending causes of hair loss: try to get more sleep, try to pray, meditate, exercise more to decrease stress.
Shampoo: use gentle shampoo or ones below 3. Laser Light Therapy 4. Hair Replacement Surgery 5. Propecia 6. Minoxidil
7. Bimatoprost (or Latisse): we have used Bimatoprost for years to treat high eye pressure and glaucoma (a potentially blinding disease). When MDs noticed the side effect of increased eyelash growth, a new use boomed. Now below you can see more and more studies showing the benefit of Bimatoprost (or any prostaglandin analog) to make hair grow on the head. The biggest side effect is the cost: it can cost about $150-200 per month for this drug.
Rosmarinus officinalis L. is a medicinal plant with diverse activities including enhancement microcapillary perfusion. The present study aimed to investigate the clinical efficacy of rosemary oil in the treatment of androgenetic alopecia (AGA) and compare its effects with minoxidil 2%. Patients with AGA were randomly assigned to rosemary oil (n = 50) or minoxidil 2% (n = 50) for a period of 6 months. After a baseline visit, patients returned to the clinic for efficacy and safety evaluations every 3 months. A standardized professional microphotographic assessment of each volunteer was taken at the initial interview and after 3 and 6 months of the trial. No significant change was observed in the mean hair count at the 3-month endpoint, neither in the rosemary nor in the minoxidil group (P > .05). In contrast, both groups experienced a significant increase in hair count at the 6-month endpoint compared with the baseline and 3-month endpoint (P < .05). No significant difference was found between the study groups regarding hair count either at month 3 or month 6 (> .05). The frequencies of dry hair, greasy hair, and dandruff were not found to be significantly different from baseline at either month 3 or month 6 trial in the groups (P > .05). The frequency of scalp itching at the 3- and 6-month trial points was significantly higher compared with baseline in both groups (P < .05). Scalp itching, however, was more frequent in the minoxidil group at both assessed endpoints (P < .05). The findings of the present trial provided evidence with respect to the efficacy of rosemary oil in the treatment of AGA.
Dermatol Ther. 2016 Sep;29(5):330-333. doi: 10.1111/dth.12369. Epub 2016 Jun 30.
Minoxidil topical treatment may be more efficient if applied on damp scalp in comparison with dry scalp.
There is yet no consensus among prescribers whether minoxidil (MXD) formulations should be applied on wet/damp or dry scalp and no clear FDA guidelines on the matter. We hypothesized that the use of MXD on damp scalp may lead to higher drug penetration. First, because the drug diffusion and consequent deposition into the hair follicle may be favored when follicle cast is humid. Second, because humidity may also prevent drug crystallization and, therefore, maintain a higher thermodynamic activity for longer periods, which leads to increased penetration. Following in vitro experiments on rat and porcine skin we confirmed the hypothesis, which could markedly improve treatment effectiveness.
Alopecia areata (AA) is a genetic and immune-mediated disease that targets anagen hair follicles. Despite limited evidence supporting the efficacy of corticosteroid treatments, they are often prescribed as first-line therapy because of their favorable safety profile. Prostaglandin analogues are currently being studied as an alternate therapy for scalp AA in adults. Herein we present a case of steroid-resistant multifocal AA that was successfully treated with topical bimatoprost.
Dermatology. 2015;230(4):308-13. doi: 10.1159/000371416. Epub 2015 Mar 4.
Bimatoprost versus Mometasone Furoate in the Treatment of Scalp Alopecia Areata: A Pilot Study.
Alopecia areata (AA) is an immune-mediated disease that targets anagen hair follicles. Despite various therapeutic options, there is no cure for AA. Prostaglandin analogues have been recognized as being capable of inducing hypertrichosis.
To compare the efficacy and safety of bimatoprost to those of corticosteroid in the treatment of scalp AA.
Thirty adult patients with patchy AA (S1) were included. Two AA patches were randomly assigned to treatment either by mometasone furoate 0.1% cream once daily (area A) or bimatoprost 0.03% solution twice daily (area B) for 3 months. Patients were assessed using the Severity of Alopecia Tool (SALT) scoring system for hair re-growth.
All responding AA patches showed significant reduction in their SALT score after therapy. Area B demonstrated significantly better results regarding rapidity of response in weeks, percentage of hair re-growth and side effects compared to area A.
Bimatoprost solution represents a therapeutic option for scalp AA.
Whether you’ve just noticed a thinning hairline or you’re constantly wearing a baseball hat to hide your bald spot, there’s a good chance you’ve tried at least one product to keep your hair. And while there are myriad products designed to fight hair loss, it can sometimes be hard to tell which methods to trust and which to toss.
One hard truth: Hair loss is mostly out of your control. “Baldness comes down to your genes,” says Frederick Joyce, M.D., founder of Rejuvenate! Med Spa and a member of the International Society for Hair Restoration Surgery. “If you have the baldness gene, there are some natural remedies that may make your hair stronger and healthier to slow your hair loss slightly—but they won’t prevent you from going bald. Still, maintaining hair health by eating well and using the right products—combined with medical-grade treatments—can really work all together to help you have a fuller, thicker head of hair.”
There are some solutions that address the problem (using adult stem cells to regrow hair is promising) but many are still years away from becoming available as a hair loss treatment. So here’s the lowdown on which baldness solutions available now are truly effective—and which hair-loss fighters are merely snake oil.
While diet alone won’t save your hair, there may be some truth to the old adage that you are what you eat. “You’re not going to have the healthiest hair if you’re living off doughnuts, because being nutrient-deficient weakens strands and makes them more prone to breakage,” says Denise Kernan, owner of DK Hair Techs, Inc., a member of the International Society for Hair Restoration Surgery, and a hair transplant technician who has worked on everyone from senators to sports stars to actors to mafia guys (she won’t name names to protect the privacy of her clients).
“While nutritious eating isn’t going to bring your hair back by any means, eating plenty of protein-rich foods and healthy fats can make the hair that you still have look thicker and shinier.” Skimping on the B vitamins in particular can interfere with the formation of hair cells and, therefore, hair growth. The best sources of Bs are protein-packed foods like chicken, fish, eggs, and pork, as well as leafy greens such as spinach. (These foods are also good for melting belly fat, so it’s a win win).
You’ve no doubt heard of Nioxin, a brand of hair care products aimed at fighting thinning hair. But can a shampoo or spray reverse baldness? “Nioxin is negligible in terms of helping with hair loss,” says Dr. Joyce. “There’s no shampoo out there that will actually stop hair loss.”
While you won’t find a miracle shampoo on the market, nioxin and some other products can help keep your scalp in tip-top shape to improve the look of any hairs you do have left on your head. In fact, feeding your hair with the proper nutrients both inside and out can make it appear healthier, so you might consider using products with natural herbs, such as rosemary and mint.
Compared to your typical shampoos, those made with these types of ingredients may help stimulate your scalp naturally to boost blood circulation and better nourish hair follicles. One to try: Bio Follicle’s Rosemary & Mint shampoo, conditioner, and scalp-stimulating spray made with organic essential oils such as peppermint and spearmint.
Bonus: The formula has no harsh chemicals, such as sulfates or parabens.
In-office laser light treatments or at-home handheld devices, such as the HairMax LaserComb, supposedly grow new hair by stimulating blood flow to the area (think: an amped-up version of a scalp-stimulating shampoo). Just don’t expect the device to make your noggin go from looking like George Costanza’s to Jerry Seinfeld’s. “These lasers won’t grow any new hair. If anything, they may just help you hang on to some of the hair that you already have a bit longer,” says Dr. Joyce.
Laser light therapy is not a baldness solution, and the HairMax takes a time commitment: You have to use the product for 15 minutes a day, three days a week and you have to keep using it indefinitely to get results. Still, laser light therapy has no major side effects, and may be best for men who have noticed some increased shedding and want to maintain more of the hair they have on their head.
The best fix by far for replacing lost hair is a transplant. Back in the day, docs used plugs that resembled cornrows (definitely not natural looking). Today, guys have more options. You can go for “the strip method” where a doctor surgically removes a strip of hair from the back of your head, dissects every hair graft under a microscope, and then plants the individual grafts onto hair-thin areas of your scalp with tiny incisions.
“If you don’t want a scar because you like to wear your hair short, you might opt for a “scarless” hair transplant,” says Dr. Joyce. Also known as follicular unit extraction (FUE), grafts are harvested one at a time with tiny punches that heal virtually undetected so you can still buzz your head. “If you’ve gone so bald that you don’t have a lot of donor hair on your head, we can do FUE extractions with body hair such as on your chest, stomach, back, and sometimes even the pubic area,” says Dr. Joyce.
Regrowth rates with FUE is almost as high as with the strip method, and there is less downtime—three to five days to heal compared to 10 days for the strip method. It’s a good idea to make sure your doc is a member of the International Society for Hair Restoration Surgery.
Also known as Finasteride, it’s the only other FDA-approved medicine to treat hair loss. The drug was originally created to help prevent prostate cancer, and works by blocking production of a male hormone in the scalp known as androgen dihydrotestosterone (DHT) that shuts down follicles to cause male pattern baldness.
“Propecia acts as a sort of fertilizer for the monixidal, helping it to regrow hair more effectively,” says Kernan. “You have to know it’s a lifetime commitment. Once you stop using Propecia, any hair loss that you would have had if you weren’t taking the medication will happen within three to eight months.”
You might want to note that some guys experience sexual side effects, like impotency or lack of desire.
The brand name of this topical treatment for sprouting new hair is Rogaine, and it’s only one of two FDA-approved drugs for the condition.
“Minoxidil will help slow the hair loss process and is the best solution for now to help you hang on to your hair,” says Kernan. “It may even help you grow a little bit of peach fuzz, and the biggest area you’ll see regrowth is on the crown rather than the front of your hairline.” However, you’ll pretty much lose that hair you were trying to save if you ever stop using the med. Though uncommon, some side effects may include itchiness and chest pain (minoxidil also comes in a pill to treat high blood pressure).