Unraveling the Mystery of Hair Loss: Causes, Myths, and Solutions

For many, the concern about hair loss begins in early adulthood. The questions arise: How long will my hair last? What can I do to keep it?

Let's explore the truths, debunk the myths, and discover what you can do to maintain your hair.

The Statistics of Hair Loss

Hair loss can begin as early as your teens. Statistics show:

20% of men experience some balding by age 20.
30% of men experience hair loss by age 30.
40% of men experience hair loss by age 40.
50% of men experience hair loss by age 50.

Types of Hair Loss

There are three primary ways people lose hair:

Receding hairline: Hair gradually recedes from the temples, forming an 'M' shape.
Bald patch: A circular bald spot develops on the crown of the head.
Thinning: Hair thins out across the top of the head.

Genetics play a significant role in determining the type and pattern of hair loss.

Receding Hairline

Bitemporal recession, or a receding hairline, often starts at the temples, creating the 'M' shape. This can begin in the teens, but don't panic; it doesn't always progress rapidly. Less than 5% of men maintain their original hairline from boyhood.

Bald Patch

A bald patch on the crown of the head expands in all directions, sometimes leaving a hoof-shaped area of hair at the bottom.

Thinning Hair

Hair thinning is common among both men and women. Women may notice a less full ponytail, while men may see an actual bald patch due to shorter hair.

The Hair Growth Cycle

Understanding the hair growth cycle is crucial to understanding hair loss. Hair consists of the follicle and the shaft.

Follicle: Contains the dermal papilla (blood and nutrient supply) and the bulb (where cells divide to grow new hair).
Shaft: Made from cells pushed out of the follicle, resulting in new hair growth.

The hair growth cycle has three phases:

Anagen (Growth Phase): Lasts 2-6 years. The longer this phase, the more hair is produced and the longer it grows.
Catagen (Regression Phase): Lasts up to 2 weeks. Hair detaches from the blood supply, and growth ends. A bulb of keratin forms, creating a 'club hair.'
Telogen (Resting Phase): Lasts about 3 months. The follicle is dormant, and the hair doesn't grow. The hair falls out during the 'Exogen' sub-phase, and the cycle restarts.

On average, adults lose about 100 hairs per day. Significant increases in hair loss may indicate Androgenetic Alopecia, or pattern baldness.

Androgenetic Alopecia (Pattern Baldness)

This occurs when hair follicles shrink, the growth phase shortens, and the resting phase lengthens. Smaller follicles produce thinner hair, which is less anchored and falls out more easily. Eventually, the growth phase becomes so short that hair doesn't even emerge from the skin.

The Role of Testosterone and DHT

It's a common myth that excessive sex or testosterone causes baldness. The real culprit is a sensitivity to testosterone, which is converted into dihydrotestosterone (DHT). DHT causes follicular downsizing.

DHT helps develop male characteristics, but high levels can lead to hair loss. The enzyme 5-alpha-reductase (5-AR) converts testosterone into DHT in the sebaceous glands under the scalp. Increased 5-AR levels lead to more DHT, stimulating sebum production and hair loss.

Genetics and Family History

Family history is a key indicator of DHT levels. If your father is bald, you're more likely to have higher DHT levels. The University of Edinburgh conducted a study in 2017, identifying 287 genetic signals linked to hair loss. 40 of these signals were linked to the X chromosome, inherited from the mother.

Lifestyle Factors and Hair Loss

Hair Styling Products

Many worry that hair styling products cause baldness by blocking follicles. However, hair is made of dead cells, and as long as products are applied to the hair and not the scalp, they generally don't cause damage. Avoid applying products to the scalp to prevent irritation and inflammation.

Towel Drying

Towel drying can damage hair, but not in the way you might think. Wet hair is vulnerable because the cuticles (protective outer layer) are open. Vigorous towel rubbing can erode the cuticles, leading to breakage. This doesn't cause permanent hair loss, but it damages the hair shaft. Use conditioner to protect and close the cuticles. Blow-drying on a medium to low setting, held about 6 inches away from the hair, is a preferable method.

Stress

Stress doesn't cause Androgenetic Alopecia, but it can trigger Alopecia Areata, an autoimmune disease causing unpredictable hair loss. Severe stress may be a trigger, but hormones, viruses, allergies, and toxins also play a role.

Telogen Effluvium, another stress-related condition, disrupts the hair cycle, pushing a large percentage of hairs into the resting phase. This leads to thinning about 3 months later. This type of hair loss is usually temporary, with hair regrowing within 3-5 months.

Solutions and Treatments

The hair regrowth industry is worth billions, so what actually works?

Promising Discoveries

In 2018, Dr. Nathan Hawkshaw discovered that Cyclosporine A, a drug used for organ transplants, enhanced hair growth by affecting a protein called SFRP1. An existing osteoporosis drug targeting this protein also showed promise in promoting follicle regrowth.

Hair Transplants

Hair transplants are now more accessible due to scientific advances. Up to 4,500 grafts can be transplanted in a single session, covering the top of a completely bald head. However, this option can be expensive.

Finasteride (Propecia)

Finasteride is a pharmaceutical drug that stops the progression of hair loss in many men. It reduces DHT levels and should only be used after a certain age due to potential sexual side effects. Consult a doctor before using Finasteride.

Hair Boosting Shampoos

Shampoos claiming to reduce hair loss often lack sufficient evidence. Trichologists suggest that shampoos and conditioners cannot stop or slow hair loss, help with a receding hairline, or thicken thinning hair.

Lifestyle Habits for Healthy Hair

Wash your hair daily with a sensitive shampoo (or every other day if you have dry hair), massaging the shampoo into your scalp.
Gently dry your hair with a hair dryer or by patting it dry with a towel.
Use water-based styling products and rinse them out daily.
Manage stress through meditation and mindfulness techniques.
Eat a healthy diet rich in iron, vitamin D, B vitamins, biotin, and protein.

Conclusion

Hair loss is a common concern influenced by genetics, hormones, and lifestyle factors. While there's no guaranteed cure, understanding the causes and adopting healthy habits can help maintain your hair. If you're experiencing hair loss, consult with a dermatologist or trichologist to explore the best treatment options for you.