Hair loss is such a common and distressing problem with estimates that up to 50% of women will be affected by noticeable hair loss at some stage during their life. The incidence of hair loss increases with age, and it can significantly impact on quality of life. At our clinic, whilst we do not specifically treat hair loss, we are often asked by female patients we are treating for other concerns, whether anything can be done about hair loss.
WHAT IS NORMAL HAIR LOSS?
Every day an adult women will lose 50-100 hairs which is called shedding. This is part of the normal hair cycle, and these hairs are replaced by new hair growth. It is only when more hairs fall out than are replaced by new hairs that hair loss occurs. As women age there can be hair loss because of hormonal changes. With menopause some women find hair starts to grow where it wasn’t before, such as on the face, whilst others find their hair thins and falls out more easily. This is because oestrogen and progesterone hormone levels fall, and the effect of androgen hormones are then increased.
Abnormal hair loss happens when something causes hairs in the growing phase (anagen) to fall out or because something causes more hairs to transition into the resting phase (telogen) which is where hairs normally fall out. The common signs of hair loss are finding more hair on your brush, pillow, or shower; seeing scalp through your hair, seeing hair break off or noticing the part on the top of your scalp is getting wider.
DO I NEED ANY TESTS FOR HAIR LOSS?
When a woman notices significant hair loss it is important to consider if there might be a medical cause for the hair loss. If you are taking medications these need to be reviewed as drugs used for many conditions can cause hair loss as a side effect in some people. Hair loss is associated with certain skin diseases and with several medical conditions including Diabetes, Thyroid disease, Lupus, and nutritional deficiencies such as Iron or Vitamin D.
The key features that suggest investigating your hair loss is warranted are:
- Generalized and rapid onset of hair loss
- Well defined bald patches
- Symptoms of itchiness, burning and pain
- Features of excess androgen such as acne, hirsutism, menstrual irregularity
- Onset of hair loss at a young age
- Loss of hair/thinning on outer eyebrows or sides of scalp
- Other systemic symptoms such as weight change (loss or gain) fevers, joint/muscle aches, skin sensitivity, fatigue
WHAT IS FPHL?
For most women who have thinning and loss of hair it is due to what is called Female Pattern Hair Loss (FPHL). In FPHL hairs become shorter and thinner (called follicle miniaturization) which is believed to be triggered by a combination of genetics and androgen hormones. It can’t be prevented, and the incidence of this condition increases with age, and it is estimated it will affect around a third of Australian women to varying degrees.
The pattern of hair loss typically starts with scalp hairs becoming progressively less dense and thinning on the top of the head where the hair parts. This is sometimes referred to as a ‘Christmas tree pattern’. The scalp is normal and there is typically normal hair density at back of scalp and the front hairline is preserved. If you are diagnosed as having FPHL it is important to check your blood pressure, blood sugar and be assessed for heart disease as FPHL is associated with an increased risk of hypertension, cardiovascular disease, and higher sugar levels.
CAN FPHL BE TREATED?
There is no treatment that can cure FPHL but there are some strategies to reduce damage to thinning hairs and camouflage areas of hair loss. There are also several treatments that can be tried to slow the rate of hair loss.
- HAIR CARE:
Hairstyling can help. Shorter hairstyles can generate greater volume and lift, light curls can add lift and zigzagging of central part can help cover. Haircare is important such as using toothed combs and brushes to minimise breakage of thin hairs, friction free towels to dry hair and non-drying hairsprays to give volume. Camouflaging products, scalp spray thickeners and tinted pressed powders or creams can help cover thinning areas.
Smoking damages the microcirculation so is not good if you have hair loss. A healthy diet is important for healthy hair, and it is known deficiency of certain nutrients can contribute to hair loss, in particular Iron, Zinc, Vitamin D and Biotin. Treating Iron or Vitamin D deficiency is important for optimal hair health. Biotin is a B group vitamin and whilst deficiency of it is very uncommon, some recommend Biotin supplementation to improve hair quality and growth. A popular supplement for hair growth is VIVISCAL which contains Biotin, Zinc, Iron, and shark cartilage. Whilst some studies suggest certain supplements can help reduce hair loss, there is less evidence they can promote significant new hair growth.
The aim of any medical treatment is to slow further hair loss although some women do find they may have new hair growth. Treatments need to be daily and if discontinued any treatment benefits will be lost within several months. MINOXIDIL is a topical lotion that can arrest hair loss and produce some regrowth. It also can be prescribed as a tablet at low dose to control hair loss. Another medication ALDACTONE can also help with one study showing it can arrest progression in 90% of women and improve hair density in 30%. These medications need to be used with caution before menopause and can’t be used if you are pregnant or breast feeding.
In the USA low light laser treatments with Laser combs, caps and helmets have been approved by the FDA to treat FPHL. These include devices such as the HAIRMAX Laser comb and the THERADOME low light laser helmet. Other treatments that have also been used to encourage hair growth in women with hair loss include PRP (blood injections) and micro needling treatments both with and without the use of topical MINOXIDIL.
Hair loss is a common and distressing problem for many women and whilst FPHL is the main cause there are other medical conditions that can be responsible or coexist in someone with FPHL and make the hair loss worse. At the Collins Cosmetic Clinic as a medical based practice, we are happy to advise and refer patients as necessary even if we don’t specifically treat that condition. If you require any further information about hair loss and how to manage it feel free to contact us at the Collins Cosmetic Clinic by phone on 03 9654 5720 or email us firstname.lastname@example.org