Hair loss is a common problem affecting millions of people worldwide. Although it is often associated with ageing, it can be influenced by a number of factors and can affect anyone, regardless of age or gender. In this article we will explore the natural hair growth cycle, the main causes of hair loss and possible solutions to this problem.
The hair growth cycle
Hair does not grow continuously, but follows a specific cycle, which consists of three phases:
- Anagen (growth) phase. During this phase, which can last from 2 to 6 years, hair actively grows out of the follicle. In men, the anagen phase tends to be shorter, resulting in a faster growth cycle and earlier hair loss. In women, this phase can be significantly longer, allowing hair to grow longer. However, with advancing age, the anagen phase becomes shorter, thus limiting the maximum length that hair can reach.
- Catagen phase (transition). In this short phase, which lasts approximately 2-3 weeks, follicle activity stops and separation of the bulb, located at the root of the follicle and in charge of its regeneration during the hair growth cycle, occurs. As a result, the hair begins its journey towards the surface.
- Telogen (resting) phase. In this phase, which lasts approximately 3 months, the hair does not grow. At the end of this phase, the hair falls out naturally and is replaced by new hair.
Hair loss therefore occurs naturally when hair in the telogen phase falls out of the follicle at the end of its life cycle. However, several factors can interfere with the life cycle of the hair, causing it to fall out prematurely. Let us see what they are.
Factors influencing hair health
Factors that can influence the life cycle and health of hair include:
- Genetics. Genetic predisposition can shorten the anagen phase and thus accelerate the transition to telogen, leading to so-called androgenetic alopecia, which is typically male. In this case hair loss is associated with the effect of dihydrotestosterone (DHT), a hormone derived from testosterone, which affects hair follicles by shortening the hair growth phase.
- Hormones. Hormones have a significant impact on the hair cycle. For example, hormonal imbalances occurring during pregnancy, menopause, or due to conditions such as polycystic ovary syndrome, can alter this cycle and accelerate hair loss.
- Nutrition. A diet deficient in proteins, vitamins and essential minerals, such as iron, zinc, B vitamins and vitamins C and D, can weaken hair.
- Physical trauma. Invasive cosmetic practices, such as frequent use of straighteners, high-temperature hairdryers or hairstyles with very tight braids, can also lead to traction hair loss.
- Psychophysical stress. Prolonged periods of psychophysical stress, such as physical trauma, a serious illness, job loss or bereavement, can lead to an increase in cortisol production, which has a negative impact on the health of hair follicles. As a result, temporary hair loss known as telogen effluvium occurs.
- Environmental factors. Hair can be damaged as a result of exposure to:
- Pollutants. Chemical particles in the air, vehicle exhaust fumes or cigarette smoke can reduce circulation to the scalp, deteriorate hair follicles and increase the risk of skin inflammation and dermatitis, which in turn can accelerate hair loss.
- Sun radiation. Excessive exposure to the sun can damage the hair, making it dry, brittle and more prone to hair loss.
- Extreme climate. Intense cold or excessive heat can damage hair and alter its growth cycle.
- Hard water. Since it contains high concentrations of calcium and magnesium, it can dehydrate the hair and scalp. This dryness can increase the formation of knots and friction, causing damage and increasing the risk of breakage or tensile hair loss. In addition, a dry scalp can become itchy. The itching can in turn lead to frequent scratching, which can damage hair follicles and increase hair loss.
- Diseases. Certain thyroid diseases, or anaemia, may cause more hair to enter the telogen phase prematurely, leading to more massive and visible hair loss.
- Drug treatments. Certain drugs, such as certain antidepressants, beta-blockers, or drugs used for chemotherapy, may cause temporary hair loss.
How it manifests itself
Hair loss can manifest itself in different ways in men and women:
- Men: hair loss in men is often very visible and often starts at the top of the head, the forehead and the temples, creating the typical ‘clouding’ or receding hairline. With time, the baldness may extend to the top of the skull, leaving a crown of hair along the sides and back of the head. This pattern is influenced by the hormone dihydrotestosterone (DHT), which reduces the anagen phase and miniaturises hair follicles.
- Women: in women it generally manifests as diffuse thinning rather than complete baldness. Thinning tends to start at the top of the head, and a widening of the hair line is often noticeable. Women may experience more visible hair loss during hormonal changes, such as those occurring after pregnancy or during menopause. Progressive thinning of the hair can turn a once voluminous head of hair into a series of thin, brittle strands, often a prelude to more extensive loss.
Prevention
As some factors causing premature hair loss are modifiable, in order to keep our hair healthy we can take some measures to prevent this unpleasant situation:
- Use hair care products, such as specific shampoos, that protect the hair from the damaging action of UV rays, which damage the cuticle, the hair’s protective outer layer.
- Wear a hat during prolonged exposure to the sun or in extreme weather conditions.
- Wash your hair regularly to remove the accumulation of pollutants and residues.
- Use filters to soften hard water if necessary.
- Treat any scalp conditions, such as dermatitis or psoriasis, to minimise the impact on hair health.
- Try to contain stress. As stress is a trigger for hair loss, adopting practices such as meditation and muscle relaxation can help mitigate stress and thus reduce hair loss.
- Avoiding hairstyles that can create trauma to the hair is essential to prevent hair loss. If hairstyles, such as tight braids, ponytails or chignons, are done frequently, they can reduce blood circulation to the scalp, limiting the supply of essential nutrients to the hair follicles.
- If hair dyes or other chemicals are used, regularly moisturise and nourish the hair with specific products, such as nourishing hair masks, to prevent the hair and scalp from drying out.
- If dandruff is present, wash your hair regularly with non-aggressive products or anti-dandruff shampoos. Dandruff not only causes itching and discomfort, but, if left untreated, can also promote hair loss, as the accumulation of dead cells can clog hair follicles and interfere with hair growth.
- Healthy diet. As we have seen, a diet rich in proteins, vitamins and minerals is essential for healthy hair. It is therefore important to eat a varied diet and not to undergo overly restrictive diets such as drastic slimming diets.
Remedies and treatments
Hair loss is a frequently treated condition in dermatology and often requires evaluation by a specialist. The dermatologist may order specific tests and examinations to establish an accurate diagnosis and determine the most suitable treatment. The treatment of hair loss varies, depending on the underlying cause.
Commercially available topical products that improve the elasticity and general condition of the scalp and can therefore help combat hair loss, such as anti-hair loss gels or sprays, formulated with active ingredients such as:
- glycerine, which helps retain moisture;
- panthenol, a derivative of vitamin B5, which nourishes the hair, preventing weakening of the hair shaft;
- biotin, also known as vitamin B8, which stimulates the hair bulb by promoting regrowth.
Dietary supplements containing sulphur amino acids, trace minerals and essential vitamins such as:
- Iron and copper, which help maintain healthy hair and nails.
- Vitamin B5, which contributes to the general well-being of hair.
- Selenium and zinc, which improve hair’s resistance to external agents and protect cells against oxidative stress.
When over-the-counter products, supplements and lifestyle modifications are not enough, the doctor, after a thorough examination, might consider more incisive interventions. Low-intensity laser therapy, for instance, uses light to stimulate hair follicles and promote hair growth. On the other hand, in the case of advanced hair loss, when other therapies have been unsuccessful, the dermatologist may recommend hair transplantation to patients. This outpatient procedure allows hair follicles to be transferred from less affected areas to those affected by hair loss, and is suitable for those who still have a good amount of hair in the donor areas, typically in the back and sides of the scalp.
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