Hair loss: causes, diagnosis, and treatments

What is hair loss?

Hair loss is the complete or partial loss of hair, and often occurs on the top of the head. Human hair goes through three stages during its life cycle: the growth stage, where hair grows and lengthens at a rate of 1 centimeter per month; The transition phase, which lasts 2 to 3 weeks and hair growth stops; And the finishing stage, which lasts from 1 to 3 months and the hair length remains constant. After these stages are over, the hair falls out automatically and a new cycle begins with the growth of a new hair from the same follicle.


Hair loss is the complete or partial loss of hair, and often occurs on the top of the head.

Hair stuck on a comb, hairbrush, or bathroom floor is part of normal shedding, with 50 to 100 scalp hairs falling out every day. Hair maintains its natural number in the scalp, as a number of hairs grow every day at the same rate of loss. About 90% of hair is in the growth phase at any given time, and this phase lasts from two to six years, while the remaining 10% is in the resting phase for a period ranging from two to three months. As you age, the rate of hair growth begins to slow down. When hair falls out, new hair grows from the follicles to begin a new growth cycle.

Causes of hair loss.

Hair loss may result from multiple reasons. In some cases, new hair can grow in place of the hair that has fallen out. In other cases, it may be possible to treat the loss phenomenon successfully by going to a dermatologist. Conditions for which there is no treatment to date are subject to ongoing research, and it is recommended to speak with the treating physician about the available treatment possibilities.

The most important causes of hair loss include:

1. Using harmful chemical products: such as hair dyes, color lightening agents, hair straightening and curling agents. Using these products in close proximity may weaken the hair and lead to breakage.

2. Androgenetic alopecia / Calvities: It is genetically transmitted and usually appears in the first decades of life.

3. Alopecia Areata: It is believed to be related to problems in the immune system, and is characterized by the appearance of small, rounded bald areas.

4. Telogen Effluvium: It occurs due to psychological or physical stress such as illness or surgeries, and it often stops spontaneously after a few months.

5. Ringworm of the head: It results from a fungal infection and causes hair breakage and redness of the skin.

6. Trichotillomania: It is characterized by a person pulling his hair, and it may be a reaction to stress or a psychological disorder.

7. Cicatricial alopecia: It causes the appearance of bald spots accompanied by itching and pain, and the formation of inflammation around the hair follicles.

Hair loss can happen to women, men, and children, and is considered a normal part of aging. Proper diagnosis and knowledge of the causes can lead to effective treatment for hair loss. Common causes of hair loss include hormonal disorders, psychological stress, medications, malnutrition, and certain skin diseases. Other factors include infections, autoimmune diseases, sudden weight loss, advanced age, and genetic factors.

Types of hair loss.

Types of hair loss include:
• Anagen hair loss: It occurs suddenly and rapidly, with complaints of short hair length and the appearance of empty pores.
• Telogen hair loss: It follows pregnancy or taking certain medications, and appears as hair thinning followed by loss, especially after childbirth or during breastfeeding.
• Hair loss associated with skin diseases: limited to areas affected by the skin disease.
• Scarring hair loss: occurs in areas where scars have formed.
• Hereditary hormonal baldness: It appears in men as a gradual loss that increases with age and starts from the frontal area of the scalp.
• Alopecia areata: hair loss in specific spots as a result of autoimmune diseases.
• Hair loss in children: It occurs for multiple reasons and may be accompanied by skin symptoms such as itching and redness.

What are the symptoms of excessive hair loss?

Symptoms of hair loss vary and include:
• Itching, pain and burning in the area of loss.
• Feeling uncomfortable in the area of hair loss.
• Flakes appear on the scalp, changing color to red and swelling.
• Thinness and thinning of hair in the frontal area.
• There are wide spaces between hair follicles.
• The appearance of bald spots in the shape of a circle, which may also affect the beard and body.
• Entire strands of hair fall out when combing or washing.
• Hair on the pillow after waking up.
• Complete loss of body hair.
Hair loss may be an indicator of conditions such as:
1. Thyroid problems.
2. Iron deficiency anemia.
3. Skin diseases.
4. Lupus.
5. Weight loss.
6. Excessive hair care.
7. Polycystic ovary syndrome.

Hair loss complications

Limited daily activities after the operation
A person can resume his daily routine activities while avoiding intense physical exertion or sports activities until the doctor allows it.

Other complications
Mild side effects, such as puffiness and bruising around the eyes, may appear for two to three days, and can be reduced by using ice compresses and sleeping in a semi-sitting position. There may also be a loss of sensation in the hair donor area or in the transplanted area, but this loss usually fades within a period not exceeding three months.

How is hair loss diagnosed?

Hair loss is diagnosed during a clinical examination in the doctor's office, where the doctor inquires about the patient's health history and carefully examines his scalp. The doctor is expected to perform a number of tests, including:
- Blood test for levels of hormones, minerals and vitamins.
- Scalp swab to examine the hair roots in case of suspected bacterial, viral or fungal infection.
- Pulling hair to determine how many hairs will fall out.
- Optical microscope to examine the shape and arrangement of cells and hair follicles.
- Immune tests if an immune disease is suspected that causes hair loss.
- In some rare cases, a biopsy of the hair follicle may be taken.
Genetic tests are usually not performed to rule out genetic causes, but studies are still ongoing in this area.

Hair loss treatment.

Hair loss treatment includes several options that vary between pharmaceutical and surgical treatments, and choosing the appropriate treatment depends on the extent of baldness and its form. Among the surgical treatments we mention:

Surgical Treatment	Description
Hair restoration surgery	It aims to restore hair and restore the areas where it has fallen out.
Hair transplantation	Hair is taken from the donor areas and transplanted into the bald area.
Shrinking scalp skin	Narrowing the area of bald spots and hiding them in some cases.
Scalp expansion	Two devices are implanted under the skin to tighten the skin that holds the hair.
Combination therapy	Treatment can be a combination of several medical procedures.

Pharmaceutical treatments include:

Drug Treatment	Description of Drug Treatment
Minoxidil	Used to treat some hair loss conditions, such as androgenetic alopecia and alopecia areata.
Finasteride	Used to treat baldness in men.
Corticosteroids	Cortisone is injected into the scalp to treat partial hair loss.
Anthralin	Used to stimulate new hair growth in cases of partial hair loss.

If drug treatments do not respond, surgical treatment can be resorted to, where pieces of skin are implanted in the bald areas. Hair extensions can also be used in cases where the patient does not wish to use medical or surgical treatment.

Natural hair loss treatment

Treating hair loss naturally can include the following methods:
1. Scalp massage: It helps improve hair density, especially when using a suitable oil such as coconut oil, and it can be done using green tea to stimulate hair growth and reduce cell death within the hair follicles.
2. Using Aloe Vera: Aloe Vera gel has therapeutic properties that reduce hair loss and strengthen hair follicles.
3. Applying onion juice to the hair: Onions contain sulfur, which helps in hair growth and has antibacterial properties that fight bacterial diseases of the scalp.
4. Using fenugreek seeds: They help strengthen hair, treat damaged follicles, and stimulate hair growth.
5. Using Indian gooseberry juice: It promotes the growth of dermal papillary cells in hair follicles.
Tips to prevent hair loss:
• Treat your hair gently and avoid using hot oils.
• Consult your doctor about medications and supplements that may cause hair loss.
• Protect your hair from ultraviolet heat and direct sunlight.
• Quit smoking because it negatively affects the hair.
• Use a cooling cap if you are undergoing chemotherapy.
Appropriate treatment depends on the type and cause of hair loss, and may include taking nutritional supplements or hormones in certain conditions such as polycystic ovary syndrome. As for hereditary baldness, it can be treated with minoxidil, finasteride, detasteride, mesotherapy, laser treatment, plasma injections, or hair transplantation.

Tips for living with hair loss

Guidelines for managing your life with hair loss: You can cope with hair loss through the following steps:
• Participate in support communities: Participating in online groups or forums can provide psychological support and help share experiences on how to deal with hair loss, especially in severe cases such as those resulting from medical treatments such as chemotherapy.
• Choose suitable hairstyles: Adopt a hairstyle that reduces the obvious effect of hair loss, or resort to using wigs as an alternative solution.
• A positive view of hair loss: Do not look at hair loss as a defect or deficiency, as it is a widespread matter that affects millions of people around the world, and can be lived with naturally.

How can hair loss be prevented?

To prevent hair loss, it is recommended that:
• Choose the right hair products.
• Avoid bathing with hot water because it may harm hair follicles.
• Massage the scalp to stimulate blood circulation.
• Ensure good nutrition that provides the proteins, minerals, salts, and vitamins necessary for hair growth.
• Care for your hair by letting it dry naturally after showering, and avoiding excessive use of a hair dryer.
• Avoid hairstyles that exhaust the hair and scalp.
• Stay away from permanent hair dyes that contain chemicals that may harm hair follicles.
• Use hair conditioner to reduce the chances of hair loss and improve its appearance and texture.

How do we stop hair loss?

To prevent hair loss, especially during chemotherapy, the following procedures can be followed:
• Scalp cooling caps: These are used to reduce the effect of chemotherapy on the hair by lowering the temperature of the scalp, which slows blood flow to the area and reduces the delivery of drugs to it.
• Minoxidil (Rogaine): It may help speed up hair growth after treatment, but it cannot prevent hair loss during chemotherapy.
Before treatment:
• Be gentle with your hair and avoid chemical treatments such as dyeing and perming.
• Cut your hair short to make it appear thicker and to ease the transition to hair loss.
• Plan to wear a head covering and consult your doctor about covering the costs through health insurance.
During treatment:
• Use a soft brush and gentle shampoo.
• Shaving the head may reduce potential irritation and embarrassment due to hair loss.
• Protect your scalp from the sun and cold.
post treatment:
• Continue to treat your hair gently and avoid chemical treatments until it grows stronger.
• Be patient, it may take time for the hair to return to normal.
Head covering:
• Choosing a head covering is a personal decision.
• Consult a doctor or social worker to find the best head covering.
• Look Good Feel Better provides support to women with cancer.
Radiation therapy:
• It only affects the treated area and may cause hair loss in that area.
• After treatment, hair can grow back, but results vary depending on the dose and type of radiation.
• Protect your skin and scalp from the sun and cold.

Hair loss treatment for men.

Hair loss treatment for men includes medical and natural methods:
Medical methods:
1. Medications: such as Minoxidil, which expands the hair follicle, and Finasteride, which increases hair growth on the head.
2. Hair transplantation: A surgical procedure that moves DHT-resistant hair from the back of the head to the front.
3. Laser treatment: stimulates hair follicles using intense laser beams.
Natural methods:
1. Natural oils: such as peppermint oil and coconut oil, which may help with hair growth.
2. Saw palmetto: It is used to treat prostate enlargement and may help treat hair loss.
3. Other treatments: such as onion juice and green tea, which need more research to confirm their effectiveness.
Lifestyle change:
• Ensure that there is no deficiency in nutrients.
• Limit drinking alcohol and quit smoking.
• Avoid styling hair while it is wet.
• Relax and avoid anxiety and stress.

Hair loss treatment for women.

Hair loss treatment for women includes several options ranging from home and medical treatments:
Home and natural remedies:
• Use oils such as castor oil and almond oil.
• Apply aloe vera extract to stimulate hair growth.
• Use garlic to stimulate hair follicles and combat dandruff.

Hair loss treatment for women.

Drug treatment:
• Use topical paints and solutions such as Rogaine.
• Taking drugs such as Aldactone to treat hair loss.
Laser treatment:
• It is used to stimulate hair follicles and relieve inflammation in the scalp.
Surgical treatment:
• Hair transplantation: It can be natural or artificial, and is performed in two ways:
1. Strip method: dividing hair strips and transplanting them into the damaged areas.
2. FUE method: extracting hair follicles and planting them in areas suffering from hair loss.
There is no 100% guaranteed treatment, as success depends on the cause of hair loss and the nature of the hair. Treatments vary in their effectiveness and costs, and some methods may take a long time to show results.

Hair regrowth for men.

To regrow hair for men, the following medical methods can be relied upon:
• Keratin supplements: They help enhance hair strength, and products containing 500 milligrams of keratin and vitamins are available.
• Topical ointments: such as melatonin ointment, which increases hair thickness, 5% minoxidil ointment, Propecia, and ketoconazole shampoo.

Natural methods:
• Fenugreek method: Soak and crush fenugreek seeds with coconut oil to prepare a paste that is applied to the hair and left for 60 minutes before washing with lukewarm water, and repeated twice a week.
• Garlic method: Use crushed garlic with olive, coconut or castor oil and apply it to the scalp and hair, then leave it for 15 minutes and wash with a mild shampoo. Repeat three times a week. Garlic contributes to improving blood flow to the scalp, strengthening hair, and getting rid of dandruff.

A final discussion on the topic of hair loss.

Case Question	Answer
What are the long-term psychological impacts of hair loss, and how can individuals cope with the emotional aspects of this condition?	This question addresses the psychological toll that hair loss can have on individuals, exploring the potential for issues such as depression or anxiety, and discussing coping mechanisms or support systems.
How do different hair loss treatments compare in terms of efficacy, side effects, and cost?	This question invites a comparison of various treatment options, looking at their success rates, potential adverse effects, and the financial investment required for each.
What advancements are being made in the field of hair loss research, and what potential future treatments are on the horizon?	This question explores the cutting-edge research in hair loss, including new drugs, gene therapy, or stem cell research, and what new treatments might become available.
How can lifestyle changes contribute to the prevention and management of hair loss?	This question considers the role of diet, exercise, stress management, and other lifestyle factors in preventing hair loss or managing its progression.
What role do genetics play in hair loss, and are there any predictive measures that can be taken?	This question delves into the hereditary aspects of hair loss, examining how much genetics contribute to the risk and whether genetic testing can help predict and manage the condition.