Just as the Bible calls the hair of a woman as her crowing glory, no woman jokes with her hair. Even those who have natural short hair like Dr. Oby Ezekwesili and Onyeka Onwenu, cherish it so much and give it utmost care. That is why for the average women seeing a lot of hair fall out can be frustrating and downright disheartening, especially if it’s sudden. In order to treat or even prevent hair loss, known in medicine as alopecia, it’s essential to understand why hair is falling out in the first place.
What is alopecia?
Alopecia is basically a fancy medical term for hair loss and like many conditions, no two types of alopecia are the same. “There are a number of different types of alopecia and they are generally characterized by thinning hair or complete loss of hair,” said Dr. Sejal Shah, a cosmetic dermatologist.
Although several types of hair loss exist, the two most common are androgenetic alopecia (female pattern hair loss) and telogen effluvium (excessive daily hair fall), according to Anabel Kingsley, a trichologist (a hair and scalp expert).
“Androgenetic alopecia is a slow and progressive reduction in hair volume,” Kingsley said. “It occurs when you have a genetic predisposition that causes hair follicles on your scalp to be sensitive to normal levels of circulating androgens (male hormones).”
In other words, your hair follicles gradually shrink and produce hairs that are slightly finer and shorter with each passing hair growth cycle. Even though this type of hair loss is mostly reliant on genes, Kingsley said that other factors can influence it as well. For instance, certain contraceptives and hormone-replacement therapies that effect hormone levels can aggravate the problem if there’s already a genetic predisposition to follicle sensitivity.
Telogen effluvium, on the other hand, is characterized by excessive daily hair fall with more hairs falling out when women shampoo or brush/style their hair. It can take 8-12 weeks for hair to fall out after a triggering event. “It is a reactive alopecia, triggered by an internal disruption,” Kingsley said. “As hair is non-essential tissue, it is very sensitive to fluctuations to general health.”
Certain vitamin deficiencies — like Vitamin D, iron and ferritin (stored iron), for instance — and other factors like crash dieting, thyroid issues and pregnancy (postpartum hair loss) can also trigger telogen effluvium.
Alopecia areata, another type of alopecia typically diagnosed by a dermatologist, is an autoimmune condition that affects as many as 6.8 million people (approximately 3.5 million women) in the U.S. Basically, the immune system mistakes the normal cells in the body as foreign invaders and attacks these cells.
To spot the condition, dermatologists will examine hairs that have fallen out and look to see if they resemble exclamation marks with their bulbs still attached, according to Gary Sherwood, director of communications for the National Alopecia Areata Foundation.
“They also examine the scalp to see whether there are white spots where the hair used to be,” Sherwood said. “Additionally, they will ask whether there is a history of autoimmune conditions in the family as that could (but not always) play a role.”
Is my hair loss normal?
Whether it’s from combing or shampooing (or just standing still, to be honest), every woman loses a bit of hair on a daily basis. “On average, women lose 100 hair strands per day; some people lose more and others less,” Shah said.
If a bit more hair is coming out for a few months after a stressful event — for instance, a death in the family or major surgery — it’s totally normal and usually corrects itself, according to Parks.
So, at what point does normal hair loss turn into a cause for concern? If you’re losing more than 100 hairs per day or finding bald patches on your scalp, you should probably consult your dermatologist.
“As a rule, you should always notify a doctor if you believe something is wrong with your body or your health in general. If you notice bald patches the size of small coins, you should notify your doctor or dermatologist,” Sherwood said.
If you’re genetically predisposed to hair loss, it’s not always preventable. But certain types of hair loss are avoidable; take traction alopecia, for instance.
“Traction alopecia, which is primarily due to a pulling force (for example, tight hairstyles that pull at the root), is potentially preventable if the hair is not subjected to this pulling force,” Shah said. That means you should try to keep your hair loose and avoid constricting styles like tight braids for long periods of time.
If you’re hoping to grow back healthy locks after experiencing hair loss due to a certain deficiency, vitamins can help. At the same time, vitamins aren’t a miracle cure for hair loss. “Nutritional supplements can be very beneficial if you are losing your hair due to a nutritional deficiency,” Kingsley said. “However, if your hair loss is unrelated to diet, nutritional supplements will not remedy it.”
Treatments for hair loss
When it comes to treating hair loss, there’s really no “one size fits all” treatment, but you do have some options.
“Treatments vary depending on cause but can include OTC Rogaine, intralesional steroid injections for certain types of inflammatory or autoimmune conditions, oral medications and treating underlying diseases,” Parks said.
For androgenetic alopecia, in particular, treatments include minoxidil, platelet-rich plasma and low-level laser therapy. Telogen effluvium, Shah said, has a whole different set of treatments.
“In the majority of cases, telogen effluvium resolves spontaneously, so treatment may not be necessary unless a treatable underlying cause is identified, such as thyroid disease or nutritional deficiency, then that would of course be treated,” she said.
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