How Hair Thinning Affects Your Health and Self-Confidence

The thinning of hair can be devastating to the sufferer. However, we are all unique and react in different ways to hair thinning; some people are not bothered by it while others can find it heavily impacts their lives. The good news is that with common cases of hair thinning, the hair is replaced and will thicken again once the excessive rate of hair loss is slowed. 

There are two main types of hair thinning; the first where you thin in the top and/or front areas of the scalp, and the second where excessive hair loss occurs all over the scalp.  

The first type of thinning is known as genetic hair loss or male pattern/female pattern hair loss. The second type of hair loss is termed diffuse hair loss or telogen effluvium. Effluvium means to fall out and telogen refers to the “resting” phase of the hair cycle. If the hair falls normally or excessively, it is usually in the telogen stage. 

From the health point of view, diffuse hair loss is more significant as it can be a sign of a nutritional or medical problem. From the psychological health point of view, male/female pattern hair loss can have greater effect because, if left untreated, the thinning of hair can become noticeable. 

MALE PATTERN AND FEMALE PATTERN HAIR LOSS (GENETIC HAIR LOSS) 

There are four factors involved with genetic hair loss: 

1. Genetics
2. The influence of male sex hormones on the hair follicle
3. Inflammation around the hair follicles, and
4. Oxidative stress.

With genetics, it used to be thought that male pattern hair loss was a dominant trait (could be inherited from Dad or Mum) and female pattern hair loss was a recessive trait (had to be inherited from both parents). However, it seems life is not so easy. Just because one or both of your parents are showing genetic hair loss does not mean you will exhibit it. Similarly, just because both parents do not show any signs of genetic hair loss does not mean you won’t be affected by this issue. What we can say with certainty is that genetics certainly play a part. And that we can’t change them! 

Most men and women who exhibit genetic hair loss have normal levels of male hormones (androgens) and female hormones (estrogens). What is increased is the level of dihydrotestosterone (DHT), a strong male sex hormone that is produced from testosterone, that triggers the thinning of hair.  

DHT binds to androgen receptors on the surface of affected cells, which leads to the affected hair follicles slowly becoming smaller and finer with each hair cycle. This is termed miniaturisation. This means the hair is still replaced but the replacement hair is finer than it previously was.  

Hair follicles at the back and sides of your scalp do not have receptors for androgens and so will never be affected by genetic hair loss. That is why you never thin out in these areas. Furthermore, the fact that females have much lower levels of androgens than men explains why women do not go bald whereas men can. 

A rule of thumb is that estrogens are good for the hair whereas androgens are bad for the hair.  So, with men, the increase in androgen levels at puberty sometimes triggers the start of genetic hair loss. With women, the decline of estrogens at the time of menopause can trigger female pattern hair loss. This also explains why some birth control pills that have an overall androgenic influence on the body, can trigger female pattern hair loss.  

About 90% of men and women who show genetic hair loss have inflammation around the hair follicles. This cannot be seen with the naked eye but requires magnification of about 50 to see it easily. The inflammation is caused by white blood cells attacking the stem cells in the “bulge” region of the hair follicle. Stem cells are essential to the growth of hair so it is important to reduce this inflammation.  

Contributing to this inflammation is what is termed oxidative stress, which is a result of an excess of free radicals over antioxidants. These free radicals can damage hair follicle cells and also lead to the production of a chemical known as transforming growth factor ß1 or TGF ß1 which reduces hair growth. So, it is important to take antioxidants, such as vitamins A, C, D or E, to neutralise the free radicals.  

Therapies for genetic hair loss include measures to reduce the inflammation, supplements of antioxidants, therapies to reduce the influence of DHT on the hair follicle, and measures that increase the growth of hair. Natural therapies include the herb, saw palmetto, pumpkin seeds, green tea and such topical treatments as rosemary oil. 

DIFFUSE HAIR LOSS 

Diffuse hair loss refers to excessive hair loss from all over the scalp. 

There are two general classes of diffuse hair loss (DHL): temporary self-correcting DHL or acute DHL, and Permanent DHL or chronic DHL. With both types of DHL, the hair is replaced but, temporarily, the rate of hair loss is greater than the rate of replacement. 

TEMPORARY SELF-CORRECTING DIFFUSE HAIR LOSS 

The following are common causes of temporary diffuse hair loss: 

• Cessation of pregnancy 

• Operations 

• High fevers 

• Dieting or a change in diet 

• Medications that the body adjusts to, the cessation of medications and stopping oral contraceptives. 

Two important points to note with this type of hair loss are: 

1. The hair loss will begin two or three months AFTER the event causing the hair loss 

1. No treatment is required to stop the hair loss. It will stop after two or three months and the hair will return to normal after about six months. 

Remember, hair is very sensitive to any body imbalance due to its fast rate of growth, so hair loss can follow the slightest body imbalance. Also, what causes diffuse hair loss in one person may not cause it in another person. It is also worthwhile noting that temporary diffuse hair loss may continue for more than three months if the patient has experienced two causes at different times. For example, they might have had a baby in January, followed by a high fever in April, which could lead to a total of six months of diffuse hair loss. 

PERMANENT DIFFUSE HAIR LOSS UNTIL CORRECTION OF THE CAUSE 

The most common causes of this type of diffuse hair loss are mineral deficiencies, anaemia and hormonal imbalances.  

The number one cause of this type of hair loss in women is low ferritin (iron storage) levels with or without low iron levels (anaemia). Fortunately, this problem is easy to correct – usually by taking an iron supplement every second day. 

With DHL as a result of hormonal imbalances, the excessive hair loss slows about three months after the hormonal imbalance has been corrected. The hair then thickens up. 

DIET AND NUTRITION 

Obviously, diet is critical to everything. Hair and most things in the body are proteins so it is important to eat protein with every meal. On top of this, fibre is essential to maintaining the correct balance of microbes in the gut. So, plenty of fruit and vegetables. The most important supplements, if required, are Vitamin D, Iron and Zinc. Many types of hair loss are associated with a deficiency of Vitamin D – and many people are deficient in this vitamin as a result of spending too much time indoors. Some people are intolerant to certain foods (gluten, lactose etc.) so, if you are always bloated or experience stomach pain, find out why; the absorption of many nutrients might be affected. 

STRESS 

Stress affects the hair in many ways, causing different types of hair loss. The sympathetic nervous system (SNS) has a big influence on the hair in times of stress. The increase in noradrenaline at the hair bulge (from the SNS) can reduce or prevent hair growth and deplete the hair of pigment. The increase in corticosteroids from the adrenal cortex also has an adverse effect on hair from long-term stress. These are just a couple of examples of how stress affects the hair. 

HAIR CARE PRACTICES 

Protect your hair from the sun with appropriate cosmetics or, preferably, by wearing a hat. Never pull the hair tight for long periods of time. Try to shampoo with a shampoo of pH 5.5 at least every two days. Shampoo after exercise where you sweat. 

ROLE OF A TRICHOLOGIST 

Trichologists specialise in hair loss and scalp problems and pinpointing the cause of such problems. See https://www.iattrichology.com/trichologists-near-me/ for a list of qualified trichologists. They will examine your hair and scalp under magnification and will suggest blood tests to be run by your doctor, if appropriate. Trichologists will usually spend about 30 minutes with you which will include covering the history relevant to your problem.