The June 2018 FACE event (Facial Aesthetic Conference and Exhibition) in London's Kensington featured an interesting talk by London-based hormone specialist, Dr. Martin Galy MB BCh BAO LRCP&SI.
Body Identical Hormone Replacement Treatments (BHRT) are medicines which are artificially produced to mimic the same chemical or molecular structure as naturally-occurring hormones found in the body. They are also known as Bio Identical, or Bio Equivalent HRT and examples include Thyroxine, Estradiol, Progesterone and Testosterone.
Dr. Galy explained his experiences of how these can benefit patients with a range of symptoms, including hair loss
, particularly in women.
Myriad factors involved in hair loss
It was Dr. Galy's assertion that certain BHRT, particularly in relation to Estradiol, Thyroxine and Vitamin D, could be prescribed to help hairloss issues. As stated in his FACE abstract notes
, "evidence supporting the use of these hormones specifically for hair restoration is lacking,[but] there are a few studies that support the anecdotal positive outcomes most prescribed see when optimising these three hormones in men and women with hair problems".
Whilst there have indeed been many studies investigating the effects of certain hormones
and vitamins on hair loss conditions, anecdotal evidence in this area is often difficult to rely on. The reason is that hair loss is often the result of an extremely complex reaction to what is often a chain of events with many influencing factors - some which the person affected may not even be aware of.
In addition to a person's DNA and whether they have an inherited predisposition towards genetic hair loss, there are many more elements involved. These range from health, diet and lifestyle to gender and even the environment, and can influence aspects such as when shedding starts and how fast a person loses their hair.
Whilst men's hair loss tends to largely centre around the genetic form, Male Pattern Baldness, women are more susceptible to a greater range of hair loss conditions
than men. Though Female Pattern Hair Loss
- which affects the top of the scalp only - may top the 'most common' list, there are a number of other conditions to which women are prone, especially those which cause hormone-related hair thinning. These include Telogen Effluvium
, its more persistent form Diffuse Thinning
, the shedding which occurs after having a baby, Postpartum Alopecia
and hair loss associated with the menopause
Areas of the scalp affected by specific women's hair loss conditions
Women's hair loss can also be linked to health issues more prevalent in females, such as thyroid problems
, chronic fatigue syndrome, stress
or the side effects of hormone-based medication such as the contraceptive pill
or HRT. In these non-genetic cases, the hair tends to shed fairly evenly from the entire scalp, with as much as a three month delay occurring between the trigger incident and thinning hair
Dr. Galy noted that, in the case of over-active and under-active thyroid-related hair loss, "Human hair follicles are direct targets of thyroid hormones
. Both T4 (Thyroxine) and/or T3 (Liothyronine) modulate multiple hair biology parameters, ranging from hair follicle cycling (growing and resting phases) to pigmentation (colour)."
He further asserted that "oestrogen has been hypothesized to have a protective role against hair loss on the basis of the observation that patients with lower oestrogen levels during menopause, postpartum, or treatment with aromatase inhibitors or selective estrogen receptor modulators are more likely to develop Female Pattern Hair Loss."
As such thyroxine BHRT may benefit those with hypothyroidism or hypothyroidism, whilst oestrogen BHRT may be helpful to women experiencing genetic or hormonal hair loss, though - as before - this is as yet unproven.
Treating women's hair loss
The first step in assessing how to treat any form of unusually prolonged, excessive or sudden hair fall is to properly diagnose the condition(s) present, including investigating any possible underlying causes or issues which may be exacerbating the problem.
In some cases it may be that the trigger issue needs to be resolved - such as having an underlying illness
diagnosed and treated, or to avoid certain hairstyles
- in order for the hairloss to clear up naturally. In others, a tailored course of hair loss treatment
can help to stabilise shedding and promote accelerated hair growth.
A hair specialist can provide the necessary diagnosis, advice and personalised treatment recommendations based on each individual's unique pattern and level of shedding, as well as their medical and lifestyle needs. So, regardless of the next step, the information is there ready to help those in need make an informed choice before making such a highly personal decision as how to treat hair loss.