Hair Loss After Drastic Weight Loss and Calorie Controlled Diet'

Name: Solomon

Question: Hi I am 18 years old and around 4 weeks ago I noticed a massive increase in hair shedding. Around 2015 I crash dieted and lost 4 stone in about 4 months. After I just lost 4 stone my hair, out of nothing, started shedding so much and so much of my scalp on top became visible when I showered. I researched the reasons for this and all I saw was MPB which I thought I had. This lead me to depression however I recovered and about 7 months later my hair regrew and re-thickened without me noticing until I looked in the mirror and realised.

Now to 2017; after maintaining my weight for about a year I decided to diet again and lost another stone in 3 weeks. Since then till now I eat less than 500 calories on a Monday and the rest of the days in the week I starve the whole day and only eat dinner. A couple of weeks ago I noticed my hair falling out way more than normal, also on my pillow. In the space of a couple of weeks I went from thick head of hair to thinning. I got a haircut as I had enough of seeing my hair everywhere and noticed just behind my hairline has become very thin, My hairline is unchanged and my crown, however my hair has become thinner and especially just behind the hairline.

Please help me I do have relatives who have gone through MPB all on my mum's side. And I'm afraid I'm going through it. Nobody notices my thinning only me especially when I shower, my scalp is visible when it was thicker a couple of weeks ago. Also just before I cut my hair I done a slight test, I combed the top of my head and a lot of hairs came out and combed the back of my head which is normally unaffected by MPB and a lot hairs also came out. My hairs are 90% long strands with a White bulb in them. What is happening to me? Please help.

Answer: Hi, Solomon. Although we would need to examine you to give a confirmed diagnosis, from what you say here there two issues potentially at play which could be causing your hair loss. One is genetic and one is related to your extreme weight loss and restrictive eating practices, though both are connected.

The first is Telogen Effluvium and this is a temporary form of hair loss which presents as hair fall from all over the scalp. It can lead to a drop in hair density of around 50 per cent in some cases, though there are reports of this figure being as high as 70 per cent. Your crash dieting and weight loss maintenance eating plans are likely to be, if not the sole cause, then an important factor in triggering this condition.

The body needs a balanced approach to nutrition, with food eaten regularly that contains a wide range of vitamins and minerals essential to support its normal functioning - including the running of the hair growth cycle. If you want to top up on the nutrients needed for healthy hair growth then a dedicated food supplement can be taken. Links between nutritional deficiencies and hair loss are well known, as are the risks of shedding associated with rapid weight loss. Starving yourself - whether you are consuming no food or severely restricting your calorie intake - can push the body into 'fight or flight' mode. Not only does this cause fat stores to be hoarded, but it can also lead to production of the stress hormones adrenaline and cortisol - this, in turn, may result in thinning hair across the entire scalp.

You mention suffering from depression and this, along with other forms of stress and lifestyle habits such as excessive exercise and a lack of sleep, can also contribute to causing this condition.

Telogen Effluvium may seem sudden when the hair falls out, but this shedding does not tend to happen until around three months after the hair loss condition has been triggered. Whilst normal hair regrowth should resume naturally, it can take up to six months. A specialist hair loss clinic will be able to assess you and, if necessary, provide you with suitable treatment to help speed this process along. It is advisable, in order to prevent recurrences of this condition, that you identify and rectify the issues that are most likely to have caused the hair loss.

A key piece of information regarding Telogen Effluvium - and its more intense form, Chronic Telogen Effluvium, also known as Diffuse Thinning - is the relationship to hereditary hair loss. If you have a genetic predisposition, inherited from either side of your family, to Male Pattern Baldness, then it is possible for Telogen Effluvium to effect this. In cases where there are not yet signs of male pattern hair loss, Telogen Effluvium may bring about the early onset of this condition. Alternatively, where male pattern baldness is already an issue, Telogen Effluvium may speed up the rate of hair loss, intensifying the shedding in the areas affected by hereditary hair loss, namely the top of the scalp and the hairline.

It is possible to experience both Telogen Effluvium or Chronic Telogen Effluvium hair loss at the same time as having Male Pattern Baldness. It can also be possible to treat these conditions, either separately or simultaneously, through the use of a customised hair loss treatment programme devised by a specialist to fit your precise needs. These courses tend to feature clinically-proven components, including finasteride 1mg and minoxidil - the only two MHRA-licensed and FDA-approved male hair loss treatments - alongside additional hair growth booster products.

As you have a history of depression, finasteride 1mg would not be recommended to you and a high strength minoxidil-only course, with appropriate hair growth supporting products if desired, may be the better route, however we recommend speaking with a specialist who can talk you through the most suitable options after a further examination of your situation.

As before, we cannot diagnose you simply from the information provided here - you may have one, both, or even neither of these conditions. As you mention no-one else can notice your hair thinning the chances are that any hair loss you are experiencing is minimal and nothing to worry too much about. Even if you have are affected by any of these issues, there is help, support and treatment available should you need it. So, if you would like a personalised diagnosis and recommendations from an experienced hair loss specialists, we would recommend having a consultation to, at the very least, put your mind at rest.