What causes hair loss?
According to the Department of Health Victoria, losing around 100 hairs a day is normal. However, if you are experiencing excessive hair loss, consult a doctor to determine if a medical condition is the cause. Your doctor can then create a treatment plan to address the issue accordingly.
Hair loss, temporary or permanent, can occur anywhere on the body and at any age. Although hair thinning is more common in men, it also affects many women.
The presence of bald spots or patchiness on the scalp can sometimes predict further hair loss in areas such as the beard or eyebrows. Causes of hair loss can include conditions such as alopecia areata or fungal infections (usually affecting children).
To determine the root cause, a consultation with a doctor is necessary. In some cases, additional lab work may also be required, including blood tests to check hormone function, iron levels, and other possible deficiencies.
Hair loss is most commonly caused by:
Hereditary Hair Loss
Androgenetic alopecia, the most common type of hair loss in men, is genetic and results in gradual hair thinning to eventual baldness. Unfortunately, hereditary factors account for 99% of male hair loss. A family history of hair loss (telogen effluvium) often leads to a receding hairline or general hair thinning that can result in baldness on the crown and throughout the scalp.
Hormonal changes can result in hair loss or hair growth for both men and women. Women may experience hair loss when pregnant, after childbirth, and throughout menopause. Up to 50% of women will experience thinning when estrogen is no longer available to support the hair. A common early sign of hair loss is a wider part or less thick, glossy hair.
Birth control pills and antidepressants, which affect hormone levels, are the most common causes of hair loss in young women.
There are several disorders that can induce hair loss. Autoimmune diseases can lead to an immune system response that will eliminate hair follicles. Before undergoing hair transplant surgery, conditions such as frontal fibrosing alopecia, lichen planopilaris, and other scarring alopecias must be diagnosed as they can render transplanted hair follicles non-viable for regrowth.
Endocrine conditions can also lead to hormonal imbalances causing hair loss. In women, polycystic ovary syndrome (PCOS) can often mean thinning hair due to elevated androgen levels.
Insufficient intake of protein, vitamin D, and iron, paired with anemia or fast weight loss, can also contribute to hair loss. Lastly, by not providing the necessary nutrients, healthy hair growth can be inhibited.
Telogen effluvium is a temporary hair loss condition where hair follicles can remain in their resting phase for an extended period of time. This illness can be caused by stress, fever, or other medical incidents. Telogen effluvium is most prevalent in women and can result in patches of hair falling out even from just a gentle pull. It may also cause thinning broadly instead of precise bald spots. Hair regrowth typically starts within 6 months after recovering from the trigger event.
It is also possible to develop bald patches as a result of a similar hair-pulling disorder called trichotillomania.
Traction alopecia can be caused by tightly tying hair in styles such as ponytails, braids, cornrows, or turbans. Hair transplant surgery can effectively treat traction alopecia, but only if the reasons for hair loss are resolved.
Hair loss can result from skin and hair conditions that cause itching. Excessive scratching can result in permanent hair loss and the development of folliculitis, an infection requiring medical attention. Folliculitis can completely destroy hair follicles, creating bald spots.
Children also have a higher chance of developing fungal infections such as ringworm or piedra, which causes clumps of hair loss known as tinea capitis.
Injuries and Burns
Chemical scalp burns are possible complications that can arise from hair straightening or inadequate hair dye preparation. The extent of the injury to the scalp will determine if regrowth is possible. If there is significant scarring or the follicles have been damaged beyond repair, hair regrowth will likely not occur.
Medication & Treatment Side Effects
Medicines used to treat ailments such as arthritis, depression, gout, or high blood pressure can cause hair loss as a side effect. To mitigate these risks, talk to your doctor about alternative medication options.
Cancer treatments like radiation and chemotherapy can also result in hair loss as they disrupt the anagen phase of hair growth, preventing new hair from growing all over the body. Though hair does grow back after finishing treatment, the texture and colour may differ from your original hair.
Hair loss during chemotherapy may be minimised with the use of a cold cap device. This scalp cooling technology reduces the flow of chemo medication to the hair for those with breast or lung cancer.
As people age, hair thinning and balding can occur, especially in those over 80 years old with a common condition known as senile alopecia.
What are the best ways to treat hair loss?
Once your doctor confirms that your hair thinning is not due to a treatable medical condition, consider exploring these hair restoration options.
Hair Transplant Surgery
Hair transplantation is a surgical procedure where hair follicles are extracted from areas of the scalp with thicker hair, typically the back and sides, and transplanted to areas with thinning or balding.
The hair follicles can be collected via two different methods: follicular unit transplantation (FUT) or follicular unit extraction (FUE). In FUT, a strip of skin with hair is taken from the back of the scalp and the follicles are removed. After the incision heals, a straight line scar may remain, but your new hair will conceal it.
In an FUE transplant, individual hair follicles are extracted using a punch tool and then inserted into the recipient area. This process results in small, dot-like scars, but these are usually not noticeable once the new hair begins to grow.
New hair growth roughly begins 3 to 4 months after the procedure and will continue permanently. After a year, you should be able to see your full new head of hair.
NeoGraft devices are TGA-approved tools used in FUE hair transplant surgeries. The handheld machine extracts each individual hair follicle for implantation.
Some doctors caution that using NeoGraft can result in the delegation of the procedure to less experienced casual practitioners. To ensure that your procedure is performed by a dedicated hair transplant professional, make sure to explicitly ask during consultation.
An FUE transplant performed using a NeoGraft device can still take anywhere from 4 to 6 hours, possibly longer, depending on the number of grafts required.
ARTAS Robotic Hair Transplant
The ARTAS robotic hair transplant system is an automated harvesting process for follicular unit extraction. The machine selects hair follicles with the highest strand count and extracts them in a manner that preserves the appearance of the donor area. The follicles are then carefully implanted, either by the robot or manually, into the desired areas.
The advantage of using the ARTAS system is that it reduces the reliance on surgeons compared with manual FUE techniques. The system is generally regarded as being able to deliver more consistent results versus conventional techniques performed by surgeons with varying skill levels.
Regardless, the ARTAS system still requires oversight by an experienced hair transplant specialist in order to achieve the best results.
PRP (platelet-rich plasma) treatment
PRP (platelet-rich plasma) therapy involves taking a sample of a patient's blood, processing it through a centrifuge to separate the platelets, and then injecting it back into the scalp. The growth factors found in the platelets are thought to improve blood flow to the hair follicles and extend the active phase of hair growth.
Studies have shown that PRP is an effective treatment for age-related hair loss and alopecia areata. It is also safe, cost-effective, and less invasive when compared to a hair transplant. However, results are not as consistent as alternative treatments.
PRP can help to prevent further hairline recession by reducing the pace of hair loss. The treatment works by improving the health of existing hair, and if the dormant follicles are not too far gone, it can even prompt new growth. PRP is a highly rated option that can enhance the appearance of your head of hair.
Usually, it takes 3 to 4 treatments spaced a month apart to see results from PRP therapy.
Over-the-counter hair loss treatments
Hair growth supplements and medication can also help reduce thinning and stimulate hair growth.
Minoxidil, the active ingredient in Rogaine or Regaine in Australia, is a topical treatment for hereditary male and female pattern baldness (androgenic alopecia). This product is available over-the-counter as a liquid or foam and is TGA-approved as a safe, DIY treatment. Minoxidil works by expanding the size of hair follicles and extending the growth phase of hair, resulting in greater scalp coverage. It is considered most beneficial for patients under 40 who have recently begun losing hair.
In some cases, doctors may prescribe oral versions of minoxidil, a potentially more effective treatment for male-pattern baldness.
Propecia, also known as Finasteride, is a prescription medication that reduces the levels of dihydrotestosterone (DHT) in the body, a hormone responsible for shrinking hair follicles. Clinical trials demonstrated its efficacy, with 88% of men seeing a decrease in hair loss and 66% experiencing regrowth, though it may take up to a year to notice results.
Propecia is deemed safe for women after menopause, however, its use is discouraged in premenopausal women as it can cause pregnancy complications and birth defects.
Capillus Hair Growth Laser Cap
Capillus manufactures a cap equipped with lasers that emit low-level light that stimulate hair follicles. This device is worn daily for a few minutes to improve regrowth, the appearance of thinning and reduce hair loss. The FDA-cleared cap is considered a safe at-home treatment. The manufacturer of Capillus also provides a range of styling products and supplements that can enhance hair volume and growth.
Vitamins & Supplements
Using vitamins and supplements from Swisse, Nature’s Way and SugarBearHair gummies for hair regrowth is quite widespread. Although there is limited evidence to support their effectiveness in regrowing hair or preventing hair loss, they may help reduce hair thinning.
How to reduce hair loss without medication
Medical intervention is the only way to reverse most forms of male and female pattern baldness, but you can still take better care of your scalp to help maintain your existing hair.
Several factors such as stress, unhealthy diet, poor blood circulation, pregnancy, medication, illnesses, and thyroid problems can worsen balding. While some of these cannot be avoided, adopting a healthy lifestyle and managing stress can improve the health of your hair.
The following tips can help you reduce hair loss.
- Reduce tension and strain on the scalp and hair follicles by avoiding tight hairstyles. Styles such as braids or ponytails are not recommended as they pull the hair. Also, steer clear of wearing tight hats and headbands.
- Make sure to hold your hair gently when washing, brushing, or styling. Use a wide-tooth comb instead of a brush that may pull the hair. Reducing exposure to the high heat found in hair curlers and straighteners may also help.
- If possible, avoid taking medications and supplements that can cause hair loss.
- Quit smoking. Studies have connected smoking to hair loss, as well as other severe health problems.
Studies & Sources
Ablon, G & Kogan, S 2018, ‘A Six-Month, Randomized, Double-Blind, Placebo-Controlled Study Evaluating the Safety and Efficacy of a Nutraceutical Supplement for Promoting Hair Growth in Women With Self-Perceived Thinning Hair’, Journal of drugs in dermatology: JDD, vol. 17, no. 5, pp. 558–565, viewed 2 February 2023, <https://pubmed.ncbi.nlm.nih.gov/29742189/>.
Gentile, P, Garcovich, S, Bielli, A, Scioli, MG, Orlandi, A & Cervelli, V 2015, ‘The Effect of Platelet-Rich Plasma in Hair Regrowth: A Randomized Placebo-Controlled Trial’, Stem Cells Translational Medicine, vol. 4, no. 11, pp. 1317–1323, viewed 2 February 2023, <https://academic.oup.com/stcltm/article/4/11/1317/6387852>.
Trüeb, RM 2003, ‘Association between Smoking and Hair Loss: Another Opportunity for Health Education against Smoking?’, Dermatology, vol. 206, no. 3, pp. 189–191, viewed 2 February 2023, <https://www.karger.com/Article/Abstract/68894>.