What to look for
- in men, thinning hair on the scalp, a receding hairline.
- in women, thinning of hair in general, but mainly at the crown.
- in children or young adults, sudden loss of patches of hair; known as alopecia areata (this also can occur in adults).
- complete loss of all hair on the body; a rare disorder called alopecia universalis.
- children can deliberately rub or pull out hair, a disorder called trichotillomania.
- excessive shedding of hair, but not complete baldness, associated with various illnesses and drug treatments, rapid weight loss, anaemia, stress, or pregnancy.
The structure, colour and texture of human hair varies widely from person to person depending on a range of different factors such as sex, age, race and genes. However, when thinning of the hair or baldness appear, it is not normal and we need to look for a cause.
Hair is made up of a protein called keratin, produced in hair follicles in the outer layer of skin. As follicles produce new hair cells, old cells are being pushed out through the surface of the skin. The average adult head has about 100,000 hairs, and loses up to 100 of them a day; so finding a few stray hairs on your hairbrush is not necessarily a problem.
In men, a receding hairline and gradual disappearance of hair from the crown is called male pattern baldness. In women, female pattern baldness is typically a general thinning over the entire scalp, with the most extensive hair loss at the crown. This does not usually occur in women until later on in life, if at all.
Alopecia areata is a sudden loss of hair in patches usually occurring in children and young adults. This disorder may result in complete baldness, but in about 90 percent of cases the hair returns, usually within a few years.
With alopecia universalis, all body hair falls out and the likelihood of regrowth is slight, especially when it occurs in children.
Tearing out one’s own hair, a disorder known as trichotillomania, is seen most frequently in children.
Doctors do not know why certain hair follicles are programmed to have a shorter growth period than others. An individual’s genes, from both male and female parents, unquestionably influence that person’s predisposition to male or female pattern baldness.
Temporary hair loss can occur when you have suffered, a high fever, a severe illness, thyroid disorders, iron deficiency, general anaesthesia, drug treatments, hormonal imbalance, or extreme stress, and in women following childbirth. In these conditions, a large number of hair follicles suddenly go into a resting phase, causing hair to thin noticeably.
Drugs that can cause temporary hair loss include chemotherapeutic agents used in cancer treatment, anticoagulants, retinoids used to treat acne and skin problems, beta-adrenergic blockers used to control blood pressure, and oral contraceptives.
Hair loss can also be caused by burns, x-rays, scalp injuries, and exposure to certain chemicals (including those used to purify swimming pools, and to bleach, dye, and perm hair). Normal hair growth usually returns once the cause is eliminated.
The causes of alopecia areata, a disorder that often strikes children or teenagers, remain unexplained. In most cases the hair grows back, although it may be very fine and possibly white before normal coloration and thickness return. A stressful event may trigger this illness off and it is slightly more common with certain disorders such as diabetes and pernicious anaemia.
Although too-frequent washing, permanent waves, bleaching, and dyeing hair do not cause baldness, they can contribute to overall thinning by making hair weak and brittle. The hair usually grows back after the cause is stopped.
Most people turn to wigs, hairpieces, and hair-weaving to hide their baldness.
A drug is available which has been found to promote hair growth on previously bald areas. This drug appears to be successful and is called minoxidil. It’s retail name is Regaine and is available on prescription. It is available also as a lotion formulation to be applied onto the scalp.
It must however, be used every day to maintain the growth of hair. It is also very expensive. The effects are most promising in younger people who are just beginning to show signs of balding or who have small bald patches.
The medication is applied to balding spots twice a day and must be continued daily. More than 50 percent of users claim that it can thicken hair and slow hair loss, but it is not considered effective in men who already have extensive male pattern baldness.
Although most cases of alopecia areata are resolved naturally, some doctors try to speed recovery with corticosteroids applied topically or injected in the scalp. Cortisone taken orally may stimulate new hair growth, but the effect is likely to be temporary.
Hair transplantation is another option available to people with hair loss.
Despite claims to the contrary, no alternative therapies can reverse normal balding, although some may encourage reversal of temporary hair loss and improve damaged hair. Certain relaxation techniques are helpful in calming stressful people.
Chinese Medicine – In Chinese medicine, hair is thought to be nourished by the blood, which is influenced by the liver and kidneys. Chinese medicines for the hair are intended to help and nourish these organs and promote new hair growth; they include such herbs as polygonum (Polygonum multiflorum), lycium fruit (Lycium barbarum), Chinese foxglove root (Rehmannia glutinosa), Chinese yam (Dioscorea opposita), and cornus (Cornus officinalis).
Herbal Therapies – For temporary or partial hair loss from a known cause, herbalists recommend stimulating hair follicles and improving blood circulation in the scalp to encourage new hair growth. Try massaging your scalp with essential oil of rosemary (Rosmarinus officinalis) or rinsing your hair with tea made from sage (Salvia officinalis) or nettle tea. For temporary or partial hair loss from a known cause, herbalists recommend stimulating hair follicles and improving blood circulation in the scalp to encourage new hair growth. Try massaging your scalp with essential oil of rosemary (Rosmarinus officinalis) or rinsing your hair with tea made from sage (Salvia officinalis) or nettle tea.
Homoeopathy – Many homoeopathic remedies are thought to be effective for hair loss, particularly thinning caused by pregnancy, stress, or emotional trauma. Consult a homoeopathic professional for more advice. Many homoeopathic remedies are thought to be effective for hair loss, particularly thinning caused by pregnancy, stress, or emotional trauma. Consult a homoeopathic professional for more advice.
Massage- Massage improves circulation and helps supply more blood to the scalp, which in turn improves the health of your hair and scalp. Massage improves circulation and helps supply more blood to the scalp, which in turn improves the health of your hair and scalp.
A few drops of vitamin E oil massaged into the scalp is recommended to strengthen fragile hair and help prevent dry, flaky skin. Or use the oils mentioned above.
(Emotional or physical stress may be a factor in some cases of hair loss. Yoga and meditation may help in these cases).
Hair loss can result from a poor diet. It is advisable that you start back on a balanced diet and consult your doctor about supplemental vitamins A, B complex, and C, as well as iron and zinc. (Go to our Vitamins page).
Be careful with your hair and do not over wash or treat it. If your hair is very oily, you may want to wash it every day, but shampooing too often can strip your hair of its natural oil.
When to seek further professional advice
- you suspect that you or your child has alopecia areata, or that your child has trichotillomania; both conditions should be evaluated by a doctor.
- you suffer an unexplained loss of hair on any part of your body.