Understanding And Combating Hair Loss This August. It’s Hair Loss Awareness Month!

Written by Rali Bozhinova, Superintendent Trichologist, The Belgravia Centre

Welcome to August, the month dedicated to raising awareness about a topic that is still taboo for many – hair loss. Hair loss is a prevalent issue that can lead to emotional distress and a decrease in self-confidence. It can be temporary, or long-term, it can occur due to various reasons, ranging from genetics and hormonal imbalances to lifestyle choices and medical conditions. In this article, we will delve into the most common triggers for hair loss and explore essential insights to help you understand and combat hair loss effectively.

Genetic Predisposition

The most common type of hair loss is androgenic alopecia, also known as male pattern hair loss in men, and female pattern hair loss in women. Although this type of hair loss is hereditary, there are many other factors in your environment that can influence the severity of it, such as hormonal changes, diet, and your wellbeing.

This type of hair loss can start at a very young age – just after puberty. This is when your hormones naturally change, and your androgens (your male sex hormones) peak. Signs of androgenic alopecia include:

 

 

• Receding hairline
• Thinner crown
• Thinner hair on top of the scalp, whilst the hair at the back remains dense and strong
• Widening of the top parting
• Seeing your scalp more easily through your hair at the front and top of your head
• Thinner hair strands
• Hair growing slower in the affected areas

Dihydrotestosterone (DHT) is the androgenic hormone primarily responsible for this. DHT is a metabolite of testosterone, the main circulating androgen in the blood. Testosterone converts into DHT in the presence of 5-alpha reductase enzyme, found in your scalp. The genetically predisposed hair follicles also have androgen receptors. As a result, more DHT will be converted in the scalp and this will then attach itself to the androgen receptors in the hair follicles.

This leads to many changes in your hair follicles including smaller and weaker follicles that produce thinner and shorter hair over time, a process also known as follicle miniaturisation. The hair cycle of the affected follicles becomes shorter, too. As a result, the hair falls out quicker and the follicles remain without hair for longer.

When your follicles are still strong and healthy, they are capable of holding multiple hair strands in each follicle. However, when they shrink, they often hold a single hair strand, gradually reducing your hair density. In the long term, these follicles can sometimes disappear, leaving areas with permanent hair loss. For this reason, it is always best to treat male and female pattern hair loss early.

Thyroid Function Changes

Your thyroid gland is vital for your entire metabolism and regulates numerous bodily functions. Its hormones influence the metabolism of almost every cell in your body, controlling the rate at which cells use oxygen and produce energy. Both under- and over-active thyroid can lead to multiple health complications if left untreated, and also lead to changes in your hair texture and hair growth cycle.

Underactive thyroid is a condition that occurs when the thyroid gland doesn't produce enough thyroid hormones to meet the body's needs. This often leads to:

 

 

• Rough, dry and scaly skin
• Dry, brittle, coarse hair
• Thin eyebrows or partial loss of eyebrows
• Slow-growing, patchy or diffuse hair loss
• Slow-growing brittle nails
• Tiredness, weight gain and low mood
• Changes in menstrual cycle

Overactive thyroid is a condition that occurs when the thyroid gland produces an excessive amount of thyroid hormones. This often leads to:

 

 

• Hair loss that can be diffuse or patchy
• Excessive hair shedding
• Hives and itchiness
• Tremors and palpitations
• Tiredness, weight loss, and anxiety
• Swelling in the neck due to an enlarged thyroid gland, also called goitre
• Bulging eyes or problems with vision

Hair loss caused by thyroid problems can often aggravate pre-existing hair loss conditions such as male pattern hair loss and female pattern hair loss. In addition, sometimes your immune system can be responsible for changes in your thyroid function. Autoimmune thyroid problems have also been associated with other autoimmune skin and hair conditions such as psoriasis and alopecia areata.

Alopecia areata (AA) is an autoimmune type of hair loss. Your white blood cells which normally protect you from foreign bodies like bacteria and viruses, are attacking cells in your hair follicles in error. As a result, you may notice patchy hair loss and little stubbles of broken hair, called exclamation mark hairs. It can affect any hair on your body but is most commonly found on the scalp. Signs of alopecia areata include:

 

• Sudden patchy hair loss
• Sudden increased hair shedding
• Some people lose the back hairline in a band-like pattern – this is called alopecia areata ophiasis
• Some people may lose all hair on their head – alopecia areata totalis
• In rare cases all hair can be lost from the head and body – alopecia areata universalis
• Small broken stubble-like hairs called exclamation mark hairs
• The new hair growth may be white
• You may notice your nails pitting and breaking

When the follicles lose their hair, they may remain empty for a while. Although this type of hair loss can be difficult to treat and completely unpredictable, the affected follicles have the potential to regrow their hair. In some cases, alopecia areata recovers spontaneously, but sometimes treatment is required and can be very beneficial.

Hormonal Changes In Women

There are many other hormonal changes that can influence the appearance of your skin and the behaviour of your hair. Women go through multiple hormonal changes in their lifetime. Pregnancies, menopause, and changes in the menstrual cycle can all influence your hair.

Polycystic Ovarian Syndrome

Polycystic Ovarian Syndrome (PCOS) is common and affects around 5%-20% of women in reproductive age, although many women remain undiagnosed. PCOS has been associated with:

• Irregular menstrual cycle, skipping your periods or having long heavy periods and iron deficiency due to the heavy menstrual bleeding
• Polycystic ovaries and problems with fertility
• Excess production of androgens – this means that your male sex hormones, such as testosterone, may be elevated
• Increased hair growth on your face and body
• Weight gain
• Oily skin and acne
• Hair loss around the top of your scalp
• Higher risk of developing insulin resistance, type II diabetes and high blood pressure

Female pattern hair loss is very common among women with PCOS and in fact, this is more than twice as likely in women with PCOS compared to women without PCOS. The increased production of androgens often aggravates hair loss further leading to thinning of the hair on top of the scalp and widening of the top middle parting.

Pregnancy

During pregnancy a woman’s metabolism changes entirely to prioritise the baby’s growth. The increased oestrogen and progesterone support the baby’s growth and development, increase the blood flow to the womb, support the function of the placenta, and prepare the body for labour. This shift in hormones often results in thick, long, luscious hair during pregnancy with barely any shedding. However, once the baby is born and your hormones return to pre-pregnancy levels, your hair cycle changes and triggers the start of excessive shedding, also known as postpartum alopecia. Signs of postpartum alopecia include:

 

 

• Excessive hair shedding from all over the scalp
• Quick loss of hair density and volume
• Smaller ponytail
• Hairline feeling thinner with visible scalp through the hair
• Constantly finding loose hairs on the floor, brush and on your clothes
• New short baby hairs all over the scalp 3-6 months later

Thankfully, postpartum alopecia is only a temporary condition and tends to recover within 3-6 months unless there are other reasons that trigger further hair problems. Try not to worry if you see increased shedding after you give birth as this is likely to slow down on its own. If the hair doesn’t recover, a hair loss specialist can help you find a solution.

Menopause

Menopause is a completely natural process and you cannot prevent it. Hormonal changes can start several years before the actual menopause, and this can also result in changes in your hair. For many women, this is the time when they first notice hair loss. For others, this is the time when their pre-existing hair loss condition may get worse.

The drop in oestrogen during menopause changes the ratio between male and female sex hormones in the follicles. It becomes easier for the male hormones to influence the hair follicles, depending on where they are in the body. For example, you may notice more hair growth on your face and more hair loss on your scalp.

While going through peri-menopause, the years leading up to menopause, the drastic fluctuations in the hormones may cause some changes in the hair growth cycle. As a result, you may notice increased hair shedding and loss of hair density across your scalp.

In addition to the excessive shedding, many women develop female pattern hair loss, making the hair around the front and top of the scalp thinner. As a result, the scalp becomes visible through their hair, and they lose a significant amount of volume.

The decline in oestrogen can also lead to dry scalp and frizzy hair. The scalp produces less sebum and hyaluronic acid, which can lead to dryness and itching. The process of wound healing slows down, making it more difficult for scratch marks to heal. Unfortunately, this maintains the itch-scratch cycle, and sometimes the constant friction from scratching combined with an unhealthy scalp can aggravate hair loss and hair breakage further.

Hair Styling

Your hair care routine is vital for healthy hair growth and sometimes less is more – the less styling you do, the healthier your hair will be.

We all like to style our hair occasionally but there are certain habits that can do more damage than good. For example, prolonged use of hair extensions and tight hair styles often lead to a condition called traction alopecia. It can develop gradually over a long period of time and often makes the hairline lose its hair in a band-like pattern. Other patterns of traction alopecia are also possible, depending on the hair styling practices.

Traction alopecia is hair loss caused by continuous repetitive physical trauma to the hair, usually due to the tension applied to the hair roots when the hair is styled. Common practices that can cause traction alopecia over time include tight ponytails, tight hair clips, tight wigs constantly rubbing against the hairline, tight braids and cornrows, hair extensions and weaves, glued-on hair pieces, excessive pulling of the hair during blow-drying. When combined with further trauma to the hair such as bleaching, relaxing, perming, and using hair straighteners, you may notice severe hair breakage and hair loss, and you may also struggle to grow your hair in length. Signs of traction alopecia include:

 

• Hair loss and breakage around the hairline, often in a band-like pattern
• It may affect the hairline above your ears and above your neck
• You may have hair loss in the places where your extensions are attached
• Your hair may be growing thinner and shorted from the affected areas
• You may notice some areas looking perfectly smooth without any hair

Some helpful tips that can help your hair include:

• Try using a wide tooth comb or a brush that doesn’t tangle in your hair each time you brush it
• Start brushing from the ends, gently working your way up to the roots
• Avoid tight hair styles that apply significant tension to the hair roots
• If you need your hair to be up or away from your face, why not try a low ponytail, loose plaits or twists
• Avoid tight rollers and vigorous brushing and pulling during blow drying
• Avoid strong heat such as regular use of hair straighteners or blow drying your hair on high heat setting
• Avoid chemical trauma to your hair such as that caused by bleach, perms and relaxers
• Embrace your natural locks! If you want to change your hair style on occasion, just try to reduce the amount of trauma applied to your hair and don’t make it a habit.

Diet Changes

A change in diet can often be a good thing, especially if the change is a healthier and balanced diet combined with exercise.  It's no secret that what you eat affects your overall wellbeing, and your hair is no exception. Your hair, like the rest of your body, requires a variety of nutrients to thrive. Proteins, vitamins, minerals, and fats all play a vital role in maintaining strong, shiny hair. When you undergo significant diet changes, you may inadvertently alter your intake of these crucial nutrients without realising, leading to potential hair issues.

Hair is primarily composed of a protein called keratin. A diet lacking sufficient protein can weaken hair follicles, resulting in brittle and thinning hair. Ensuring an adequate intake of lean meats, poultry, fish, eggs, beans, lentils, nuts can help prevent this.

Deficiencies in iron and vitamin D are common which can lead to thin dull hair, and excessive shedding. Crash dieting and rapid weight loss often result in multiple vitamin and mineral deficiencies, as well as lack of energy. In response, your body might divert resources away from non-essential functions like hair growth, leading to hair shedding, also known as telogen effluvium (TE). Telogen effluvium happens when many actively growing hair follicles are pushed prematurely to the end of their cycle, losing their hair quickly. If you have telogen effluvium, you may notice a significant loss of hair density. Signs of TE include:

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• Increased hair shedding from all over your scalp
• Quickly losing hair density
• You may feel like your hair doesn’t grow in length
• Many short tapered hairs across the entire scalp – these are newly growing hairs and can be confused with broken hair

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Fortunately, this type of hair loss has the potential to recover on its own within 3-6 months as long as the trigger event has been eliminated. For example, if a vitamin or mineral deficiency is the only reason for TE, then the hair should recover once your health improves. However, chronic cases of TE that last for more than six months may require further treatment as there may be other factors keeping the TE going.

First Hair Loss Signs? Be Proactive

There are many factors that can influence your hair growth cycle and often your hair loss may be caused by a combination of triggers such as genetic predisposition, your health, your nutrient intake, and hair care routine.

If you have noticed any hair thinning, or hair loss, the first thing you should do is contact a specialist. They will go through your medical history, examine your scalp, and discuss a suitable treatment plan for your specific case. The Belgravia Centre advises that you bring a recent blood test to your consultation. This will help you determine whether there are any nutritional factors that could be contributing to your hair loss.

If your blood test shows that you have iron deficiency or a thyroid problem, you should certainly address this. However, this may not be the sole reason for your hair loss and this is where a hair loss specialist can be of huge help. Not only they will discuss a treatment plan for you, but they will also monitor you regularly and be ready to answer any questions that you may have 7 days a week.

Addressing any health concerns with your doctor and having varied nutrients in your diet are vital for your wellbeing and hair health. Alongside your healthy balanced diet, taking a daily food supplement, such as Hair Vitalics, can help you obtain important vitamins, minerals, amino acids and botanical extracts that support healthy hair growth. They are available in Hair Vitalics for Men and Hair Vitalics for Women formulations in order to be as highly-targeted as possible.

If you notice any signs of chronic telogen effluvium, mild to moderate patchy alopecia areata on your scalp, male pattern hair loss, or female pattern hair loss, contact The Belgravia Centre where the team of hair loss specialists will be more than happy to help you. The Belgravia Centre’s pharmacy prepares special formulations of minoxidil at different strengths, and with various additives to maximise effectiveness, whilst finasteride can be used orally or topically by those with male pattern hair loss.  We also offer other natural and technological solutions that are combined to provide the optimum solution to prevent hair loss, and an exceptional level of expertise. One of our 20 qualified hair loss specialists will be available to help you any time at our Central London clinic or through a Zoom consultation if you live outside of London.

If you are worried about hair loss you can arrange a free consultation with a hair loss expert or complete our Online Consultation Form from anywhere in the world. 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.