Locks And Queries: Exploring The Top 5 Hair Loss Questions Of 2023

Written by Rali Bozhinova, Superintendent Trichologist, The Belgravia Centre

In the ever-evolving landscape of beauty and wellness, the quest for luscious locks and a vibrant mane remains timeless. Amidst the intricacies of modern life, an increasing number of individuals, much like yourself, are on the lookout for guidance and effective solutions to stronger and healthier hair. At the forefront of this pursuit are our dedicated hair loss specialists and treatment advisors, who empower individuals like you to reclaim the strength and vitality of their hair every single day. We reached out to our team of experts to compile a comprehensive list of the 5 most frequently asked questions of 2023. These questions encapsulate the shared curiosity and concerns of individuals navigating the intricate world of hair care, seeking not only answers but practical solutions for achieving stronger and healthier hair. Keep reading to find out more.

Question 1: Does Rosemary Oil Work For Hair Loss?

Rosemary oil has been a trending topic throughout 2023. The buzz around this aromatic herb isn't just about its culinary prowess; it's transcended into the realm of hair loss solutions, sparking a surge in inquiries. The question on everyone's mind: Can Rosemary Oil truly treat hair loss and pave the way for stronger, healthier locks?

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With compounds like camphor and rosmarinic acid, rosemary oil holds anti-inflammatory and antioxidative properties, making it a common ingredient in hair products and a remedy for various skin conditions. In addition, when applied to the scalp, rosemary oil increases blood circulation, bringing more oxygenated blood to the hair follicles. This is how it has gained its reputation as a hair loss remedy, and has been regularly compared to the effects of a well-known and licensed medication for hair loss – minoxidil.

A study in 2013 suggested that rosemary leaf extract may inhibit the 5-alpha reductase enzyme and reduce the binding of dihydrotestosterone hormone to androgen receptors. This mechanism of action is relevant to the most common type of hair loss – androgenic alopecia, also known as male pattern hair loss in men, and female pattern hair loss in women. This type of hair loss is genetic and causes the hair to thin around the front hairline, top and crown of the scalp. This leads to gradual hair loss in the affected areas, the scalp being easily visible through the hair on the top, and in some cases, this can lead to baldness on the top of the head. Dihydrotestosterone is the responsible hormone for this, making the affected hair follicles smaller and shallower over time, a process known as follicle miniaturisation. Unfortunately, there is not enough evidence that rosemary leaf extract can stop this process.

A study in 2015 compared the effects of topical rosemary oil to topical minoxidil 2% on men with male pattern hair loss. Although the study suggested that both exhibit similar effects and promote hair growth, this was a very short-lived study and without a control group to compare the results to the natural fluctuations of hair growth throughout the hair cycle.

Overall, it seems that rosemary oil has some benefits for the skin and hair. It can help relieve itching, redness, and other symptoms of scalp dermatitis. After all, a healthy scalp is important for healthy hair growth. It can even have a mild effect on blood circulation and hair growth. However, there is simply not enough evidence that the use of rosemary oil alone can treat any type of hair loss, or maintain hair density in the long term. There are no long-term studies and it is not a medically proven treatment for any hair loss condition. It is also important to note that just because a remedy is natural, or plant-derived, this does not automatically make it safe. It is still possible to experience skin irritations and allergies in rare cases.


Question 2: Can Hard Water Cause Hair Loss?

We frequently receive inquiries from patients who come from regions with softer water, wondering if hair washing with hard water in London could be a factor contributing to their hair loss. While this is highly improbable, it has remained a frequently posed question throughout the year 2023.

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Hard water contains high concentrations of calcium and magnesium ions, and the tap water in London is therefore considered hard – it comes from rivers that run through chalky rocks, collecting calcium and magnesium minerals. Many patients ask ‘How about mineral water? Should I be washing my hair with mineral water?’ – mineral water contains substances such as sodium, potassium, calcium and magnesium, making it hard water, too. This can be a rather expensive and wasteful choice of hair washing routine without any added benefit.  

A study in 2017 was published suggesting that dermatology patients in Saudi Arabia often present with hair breakage and brittleness, and are concerned that the hard water in the area is the primary underlying reason. By using scanning electron microscopy, the researchers looked at the structure of hair treated with hard water. Although they found a higher deposition of magnesium salts in the hair treated with hard water, they did not find any significant difference in terms of hair shaft damage.

A study in 2018 looked at the changes in hair strength after treating it with hard water and deionised water. The study suggested that the ions dissolved in hard water may lead to oxidative damage to the hair, similar to that of hair dyeing. This meant that the hair had less tensile strength and was more likely to have breakage. However, the authors also clarify that this damage can be slowed down by the use of shampoos and hair conditioners as they would remove some of the metal ions from the water, and their slightly acidic nature would prevent the entry of the metal ions into the hair structure.

There is currently no evidence linking hard water to any hair loss conditions. The only suggested potential impact is increased hair brittleness, a claim that also requires further research for confirmation. A significant number of patients report localised hair loss, affecting specific areas like the hairline or crown rather than overall hair loss. Given that these individuals use hard water for their entire hair, it is unlikely for the hard water to selectively cause hair loss in specific areas. It is crucial to emphasise that the notion of hard water causing hair loss is a debunked myth.


Question 3: What Happens If I Stop Treatment?

The simple answer is – it depends on what type of hair loss you are treating.

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There are many reasons for hair loss – some are temporary hair cycle changes requiring only short-term treatment, and others are ongoing driving triggers for hair loss requiring long-term treatment. The best way to find out is to speak with your hair loss specialist.

For example, conditions like telogen effluvium can resolve within several months without the need for continuous treatment, although occasionally people may experience chronic telogen effluvium which requires longer treatment. Other conditions, such as alopecia areata, are autoimmune and therefore have an unpredictable nature. Treatment for alopecia areata can be stopped once the condition resolves, but the duration of the treatment cannot be predicted. There are also cases when the hair can regrow spontaneously without having a treatment in the first place.

However, the most prevalent form of hair loss we encounter is male and female pattern hair loss. This type of hair loss is influenced by genetic factors and tends to progress over time, making the hair thinner. Therefore, it is advisable to undergo ongoing treatment to maintain optimal hair health and thickness. In cases of this type of hair loss, the affected hair follicles consistently diminish with each hair cycle, resulting in progressively thinner and weaker hair until eventually the hair is lost. Early intervention is crucial for effective management, leading to more favourable outcomes. Sustained treatment ensures a continuous stimulation of the hair follicles, promoting as strong hair growth as possible. Discontinuing treatment usually leads to a gradual return to the natural rate of hair loss that would have occurred without intervention at this stage of your life.


Question 4: Can Shampooing Lead To Hair Loss?

This is a question that we hear daily and we notice many of you reducing the shampoo frequency in an effort to make your hair healthier. You may have come across information suggesting that daily shampooing can damage your hair, strip off your hair from its natural oils, that your hair can clean itself, or that you lose more hair when you shampoo. We understand there is a prevalent misconception surrounding this issue.

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Shampooing is essential for maintaining a clean scalp, and it comes with additional benefits such as enhancing hair shine, providing volume, a pleasant fragrance, and an overall improved appearance. Moreover, shampoos can be effective in addressing specific scalp issues like dandruff or seborrhoeic dermatitis. The frequency of shampooing should be personalised based on factors such as your skin condition, hair care routine, lifestyle, and scalp oiliness.

Your scalp's sebaceous glands produce sebum, the natural oil of your scalp. While sebum offers numerous benefits for hair growth and a healthy scalp, an excessive build-up can lead to issues like an itchy and flaky scalp, and occasionally, acne. Combined with factors such as sweat and the accumulation of styling products, avoiding regular scalp washing can do more harm than good. Since everyone produces different amounts of sebum, some may find their scalp gets oily within a day, while others may not notice any issues for several days or even a week. Therefore, the recommended shampoo frequency varies from daily for some, to every few days or weekly for others.

In essence, there is no one-size-fits-all advice regarding shampoo frequency—it should be tailored to your specific situation. Shampooing is not detrimental to your hair and is unlikely to cause hair loss. In fact, neglecting regular shampooing can result in an unhealthy scalp and potentially contribute to further hair loss. Achieving positive results in addressing hair loss is more likely when you maintain a healthy scalp and adhere to a regular shampooing routine.


Question 5: Will Caffeine Shampoo Treat My Hair Loss?

Caffeine shampoos have become a popular shampoo choice for those with hair concerns. However, we often see people who have used such shampoos for months to no avail.

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Using caffeine on your scalp is of course not the same as drinking coffee. Caffeine has a very useful ability to absorb through the skin with the help of the hair follicles. This has led to the rising popularity of topical products containing caffeine, a chemical present not only in coffee beans but also in various plants like cocoa and tea. Additionally, caffeine is synthetically added to beverages, cosmetics, weight loss medications, and pain relief medications.

When used in moderation, caffeine offers several benefits. It serves as a rich source of antioxidants and is commonly included in anti-aging cosmetic products, playing a role in protecting cells from free radicals and safeguarding the skin against UV radiation-induced photoaging. Additionally, caffeine has been suggested to promote hair growth. A 2007 study in the International Journal of Dermatology investigated the impact of caffeine and testosterone on hair follicles using biopsied follicles from men with androgenic alopecia. While testosterone suppressed follicle growth, caffeine in concentrations of 0.001% and 0.005% not only counteracted this effect but also stimulated further growth in follicles exposed to caffeine alone.

A 2013 study conducted a double-blind randomized clinical trial with 60 patients diagnosed with androgenic alopecia, comparing the efficacy of topical caffeine + minoxidil solution 2.5% and topical minoxidil solution 2.5% alone. After 5 months, the researchers found that the combination of caffeine and minoxidil achieved significantly better results in hair count on the affected areas of the scalp compared to minoxidil alone.

A 2014 study in the British Journal of Dermatology investigated the effects of caffeine on human scalp hair follicles in a lab setting, finding that caffeine exposure resulted in longer hair shafts, extended duration of the anagen (growing) phase in the hair cycle, and stimulated cell growth while reducing cell death. Notably, female hair follicles exhibited higher sensitivity to caffeine than male hair follicles, with both showing growth-promoting effects.

While low concentrations of caffeine have been associated with positive effects on hair follicles and growth, higher concentrations can inhibit hair growth, according to a 2014 study, which observed reduced cell division and poor wound healing at elevated caffeine levels, emphasising the importance of maintaining a healthy scalp condition to support optimal hair growth.

While the combination of caffeine with other treatments like minoxidil shows promise in enhancing hair growth, there is currently no clinical evidence supporting the idea that caffeine alone can produce comparable results to established treatments such as minoxidil or finasteride. A caffeine shampoo is therefore not a treatment for hair loss.


Should You Have More Questions…

There are many reasons for hair loss and we understand that this may leave you with many more questions specific to your situation. If you have any burning questions, or if you have noticed any signs of hair thinning or hair loss, reach out to an expert as soon as possible. They will examine your hair, discuss your medical history, lifestyle, and hair care routine, and give you treatment recommendations tailored to your specific case. To help you get a head start, follow these steps:

If you just want to ask a question:

If you would like to book a free consultation at our Central London clinic:                                                                                            

  • Call us on 020 7730 6666 and ask to book an appointment or
  • Request a clinic appointment by contacting us online
  • You can collect your medication on the day of your appointment, or we can post it to you
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If you would like to have an online consultation:

  • Complete an online consultation form – this will take you 5-10 minutes
  • We will get in touch with you on the same or next day and help you book a Zoom consultation with a hair loss specialist
  • We can post your medication to most parts of the world

The Belgravia Centre’s pharmacy is dedicated to preparing bespoke treatment formulations tailored to our patients. Medications are prepared in oral or topical forms of various strengths and with various additives to maximise their effectiveness. This helps us choose a treatment plan that suits your type and severity of hair loss, your medical history, and your lifestyle. Additionally, our qualified hair loss specialists are available 7 days a week to support you with advice and answer your questions.

Take a look through our hair regrowth photo gallery – which is the largest gallery of its kind in the world and contains over 1,000 sets of hair growth photos and verified reviews from patients of The Belgravia Centre. You can filter the photos by pattern and severity of hair loss so you can find similar cases to your own.

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The Belgravia Centre

The Belgravia Centre is a world-renowned group of a hair loss clinic in Central London, UK. If you are worried about hair loss you can arrange a free consultation with a hair loss expert or complete our Online Consultation from anywhere in the world for home-use treatment.

View our Hair Loss Success Stories, which includes the world's largest gallery of hair growth photos and demonstrates the level of success that so many of Belgravia's patients achieve.