While stories about hats choking off follicles or long hair pulling on the roots may be more folklore, repeat hair trauma like tightly woven hair pulled back and consistent friction can potentially worsen or cause localized hair loss in some individuals. Individuals who pull their hair tightly back in a rubber band can develop a localized hair loss at the front of the scalp.
George Cotserelis, MD, is director of the University of Pennsylvania's Hair and Scalp Clinic. He agrees that there's no evidence these alternative hair loss treatments have any effect. "If any of it did work," he says, "I'd be very worried about using that product. The fact that it’s working would mean it's doing something to the testosterone and could be having adverse effects."
Research is looking into connections between hair loss and other health issues. While there has been speculation about a connection between early-onset male pattern hair loss and heart disease, a review of articles from 1954 to 1999 found no conclusive connection between baldness and coronary artery disease. The dermatologists who conducted the review suggested further study was needed.
Less common causes of hair loss without inflammation or scarring include the pulling out of hair, certain medications including chemotherapy, HIV/AIDS, hypothyroidism, and malnutrition including iron deficiency. Causes of hair loss that occurs with scarring or inflammation include fungal infection, lupus erythematosus, radiation therapy, and sarcoidosis. Diagnosis of hair loss is partly based on the areas affected.
Low ferritin (the stored form of iron) is one of the most common causes of hair loss in women. Given low ferritin is also a common problem for hypothyroid people, it is important to have iron testing including ferritin especially if you are experiencing hair loss. It is not enough to be told by your doctor that your iron levels are ‘normal’. Ferritin levels are not always tested. Get a copy of your lab results and be sure ferritin has been specifically tested. Even if ferritin is within the ‘normal’ range that doesn’t make it ‘optimal’.
Hair transplant/surgery. A hair transplant or surgery is the quickest treatment for permanent cases of hair loss, although the most expensive. In pattern baldness, for example, where the top of the head is the most affected area, a hair transplant allows the surgeon to use existing hair to implant it into the bald sections of the head. It works by removing a graft or follicular sample in parts of the head that still have hair (usually this is the back of the head as this area is most resistant to hormonal changes), and placing this graft in the areas that are bald.
Last but not least, greasy hair is also one of the common hair problems that people should be aware of. The hair scalp contains one type of oil known as sebum, which is responsible for keeping the skin lubricated and generated by the sebaceous glands. However, sometimes, these glands work so hard that produce excess oil, resulting in the greasy hair. This type of common hair problems is a real trouble for many people who love the tidiness. To deal with this one, you should try washing your hair with a gentle shampoo in order to control the sebum production.
The pull test helps to evaluate diffuse scalp hair loss. Gentle traction is exerted on a group of hairs (about 40–60) on three different areas of the scalp. The number of extracted hairs is counted and examined under a microscope. Normally, fewer than three hairs per area should come out with each pull. If more than ten hairs are obtained, the pull test is considered positive.
Polycystic ovary syndrome (PCOS) is another imbalance in male and female sex hormones. An excess of androgens can lead to ovarian cysts, weight gain, a higher risk of diabetes, changes in your menstrual period, infertility, as well as hair thinning. Because male hormones are overrepresented in PCOS, women may also experience more hair on the face and body.
Treatments for alopecia areata include injecting small amounts of steroids like triamcinolone into affected patches to stimulate hair growth. Although localized injections may not be practical for large areas, often this is a very effective treatment in helping the hairs return sooner. Other treatments, such as oral steroids, other immunosuppressives, or ultraviolet light therapy, are available for more widespread or severe cases but may be impractical for most patients because of potential side effects or risks. In most mild cases, patients can easily cover up or comb over the affected areas. In more severe and chronic cases, some patients wear hairpieces; nowadays, some men shave their whole scalp now that this look has become fashionable. Recently, investigators have noted some beneficial results in small groups of patients with extensive alopecia areata or alopecia totalis with a JAK1/2 inhibitor, baricitinib (Olumiant). Long-term studies are under way.
The good news: Hair transplants don't look like dolls' hair anymore. The bad news: You won't be able to go anywhere to show off your new 'do because you'll be broke. The average recipient of a follicle transplant receives several thousand grafts -- strips of hair removed from bushier parts of the head -- at a cost of several thousand dollars. The cost continues to mount when patients come back for added thickness over the years.
That said, there are products that don’t have FDA approval or clearance, but may help prevent hair loss. For example, shampoos with ketoconazole, a chemical with anti-DHT properties, is widely used to treat fungal infections but has become popular among consumers as a hair loss treatment. It makes sense — research shows that ketoconazole actually has beneficial effects on hair growth (especially for those with seborrheic dermatitis).
My hair began to thin when I was 28 years old. Now I am 44 and the top of my head is bald. Recently, I considered using medicine to treat my hair loss and see if any hair would regrow. After reading the literature and talking to my doctor, I decided not to take medicine because it is unlikely to make a huge difference in my hair—and I don't want to take medicine forever!
Losing your hair can be distressing, but if it is caused by thyroid disease it is most likely reversible. In the meantime, try to stave off further hair loss by treating your hair gently. Avoid brushing it excessively, using harsh coloring products, and hairstyles that pull on the hair (such as a tight bun). If you feel self-conscious about having thin hair or bald patches, consider wearing a scarf or wig while your hair grows back.
Like a Ferrari production plant where luxury automobiles are painstakingly assembled from carefully crafted parts, hair growth depends on a number of carefully coordinated systems that work together. It’s no secret that supplements can have a positive effect on other parts of your body, such as your immune system and your heart. Can hair growth supplements have a similar effect on hair loss (androgenetic alopecia) to promote healthy hair growth naturally? Absolutely. In order to understand why, first it’s important to know how your hair grows.