Lush hair is a symbol of health, happiness and success in our society. Hair loss is therefore combated by all means. Unfortunately, hair loss is a very complex problem for which neither a cause nor an effective treatment can always be found immediately.
Skin and hair are sometimes referred to as “mirrors of our body”. Hair loss can indeed be the result of a physical or mental illness, and conversely, problems with hair or hair growth can lead to serious mental health problems and even depression. It is therefore not surprising that this is one of the most popular areas where all types of quack sabers are active and for which the most fantastic remedies are recommended. At best, these miracle drugs have no effect at all, sometimes doing more harm than good.
There are many possible causes of hair loss (or alopecia) and also various types of hair loss. Determining the exact cause is a first step in treatment.
How do hair grow?
Hair is made from skin cells in the hair follicles or hair follicles. The number of hair follicles on the scalp varies by 100,000. The number of hair follicles is genetically determined. Blonde hair, for example, has more hair follicles than dark and red-haired hair.
With age, the number of hair follicles decreases slightly, and thus automatically the number of hairs.
Hair growth is a cyclical process with phases of growth (“anagenic phase”), transition (“catagenic phase”) and degradation (“telogene phase”). The growth phase of the skull hair takes about 3 years. At the end of this period, the cell division stops and the hair becomes thinner and thinner. During the transition phase, the hair gradually loosens out of the hair follicle and falls out during the degradation phase. This construction phase takes about 3 months. Unlike some animals, where hair is massive after winter, the hair cycle in humans is much more regular. Although there is a certain seasonal influence with a peak of hair loss around August-September.
In humans, 60 to 90% of hair is always in the growth phase and 10 to 20% in the rest or degradation phase. Assuming that 10,000 hairs are on one head and that a hair stays for 100 days (3 months), then an average of 100 hairs go out naturally in one day.
The speed at which the hair grows varies from person to person, but on average the hair swells per day by 0.5 mm longer. Women’s hair grows slightly faster than men’s, and the “peak age” is between 50 and 70 years.
Measure hair loss
If you have the impression that you are losing too many hairs, follow-up examinations can be carried out:
- During 24 hours, 4 days after washing (or if you wash the hair more often, 24 hours before the next wash) collect and count the hair loss;
— the pull test: Carefully pull on a hair bundle of about 100 hairs. If more than 20 hairs are discharged, further examinations are required;
— the trichogram or hair root status: In this method, about 50 hairs are cut off to 1 cm, which are then pulled with a quick jerk towards the hair growth. The hair roots are then examined under the microscope, which provides objective information about the growth phases and the abnormal forms of the hair roots.
The most common form of hair loss is androgenetic alopecia, which occurs under the influence of androgens, the male hormones. This type of hair loss occurs in both men and women, albeit to a lesser extent.
It is the typical hair loss that occurs from a certain age. In men, it usually begins with a shift of the hairline at the temples, later also on the forehead. At the same time, the crown can become bare. The final stage, in which only horseshoe-shaped hair remains, is only reached by 10 to 15% of men. In women, hair loss is more discreet and never develops into a real baldness.
This form of hair loss is hereditary. It is thought that there is a genetic predisposition that makes the hair root more sensitive to the male hormone in some people, even at normal concentrations, which causes the hair to end its hair cycle faster and therefore more hair to fail than are formed.
This form of hair loss cannot be “cured”, but there are a number of methods to stop the development or even cause new hair growth:
- A hair lotion with 2% minoxidil, a drug originally used for high blood pressure, can make hair grow back. However, the product must be used for life, otherwise the hair loss will start again.
— Recent studies also show that a lotion with an antibacterial and an antifungal active ingredient can also inhibit hair loss and the associated itching.
— In women, in about 50% of cases it is possible to inhibit hair loss with hormone preparations that block the action of the male hormone testosterone.
— Surgical methods such as hair transplantation and scalp reduction can provide very satisfactory results.
Alopecia areata, the most common form of hair loss after androgenetic alopecia, is characterized by one or more round to oval, completely bald spots, which are well defined and usually limited in size. However, these spots can merge and develop into a complete baldness.
The bald spots occur mainly on the scalp, but they can also affect the beard area, the eyebrows, the eyelashes or the pubis. The duration of this disease varies between 4 and 10 months. The healing process begins with the growth of small, white fluffy hairs, which gradually discolor.
The cause of this has not yet been clarified, but here too there could be a hereditary factor. It is also suspected that certain autoimmune diseases (i.e. diseases, caused by the production of antibodies against parts of the own body, in this case against the hair roots), a hereditary predisposition to the development of an allergy, thyroid problems, some infections of the mouth, nose, throat and ears (e.g. sinus itinerary, dental and oral cavitis, etc.) and psychological factors (such as stress) may play a role.
Since the cause and course of this type of hair loss is not known, there is also no causal treatment. Therapeutic options include general or local use of corticosteroids or PUVA therapy, which is a treatment with UVA rays of light that can temporarily cause hair growth. Due to the suspicion of a malfunction of the immune system, a substance has already been used, which triggers a contact allergy to the bald spots. The immune response directed against this contact allergen then suppresses the reaction directed against the hair root, so that the hair can regrow again.
Diffuse hair loss
This form of hair loss spreads throughout the scalp and rarely leads to complete baldness.
The most common form is telogenhair or telogeneffvium, which terminates the hair cycle prematurely and reaches the telogen or degradation phase faster. This form of hair loss can be a consequence of physical or psychological stress, such as high fever, infections, anemia, surgery, an accident, emotional problems, a strict diet, alcohol abuse and so on. Some medications (e.g. some blood thinning and antihypertensive drugs) can also trigger such hair loss.
Normally, hair loss occurs about 3 months after the triggering factor.
Hair loss, which often occurs about three months after childbirth, is also a form of telogen effluvium. The proportion of anaeous hair (hair in the growth phase) is 95% during pregnancy, so that the normal telogen hair loss is greatly reduced at this time. After childbirth, these hair follicles quickly pass into the telogen phase under the influence of the decrease in estrogen levels. The result is an increase in hair loss about 3 to 4 months later.
With the telogene Effluvium, there is little more to do than to tackle the cause and wait: in the next 6 to 12 months, the hair will spontaneously grow in. If necessary, supplements of cystine and methionine, the building blocks of our hair, can be given for a few months.
The same applies to hair loss in cancer patients treated with chemotherapy. Here, however, the hair roots are so badly damaged that the hair still fails in the growth phase and the hair loss can occur within the week after the start of therapy. This form of hair loss also recovers by itself after discontinuation of therapy.
This type of hair loss, scar alopecia, is a consequence of scarring of the skull skin, which causes the permanent loss of a number of hair follicles. This can be present from birth or may occur later in life due to burns, accidents or infection. It can also be the final stage of a fungal infection. To determine this, a specialist examination is required to remove a small piece of skin.
Recovery is not possible, but in the case of a fungal infection, for example, another catastrophe can be prevented.
Traumatic alopecia is caused by the stretching of the hair. A typical example is hair loss in women, who often make a ponytail. This sometimes leads to a dilution of the hair at the level of the forehead.
Another typical example is the so-called trichotill mania, the mania of constantly playing with hair bushes. This can lead to extensive bald spots.
A full recovery is possible if the hair is left alone.