Major causes of hair loss - the bald truth

Outlines of major causes of hair loss & how each type of hair loss is unique to every person

Losing hair? You can blame it on the genes. Or, poor diet, lack of sleep, stress, trauma, hormonal changes, illnesses and medication. The list is endless. So, what is this hair loss exactly?

The most common hair loss is a natural daily phenomenon, in which re-growth is a given. But this type of hair shedding cannot be classified as a cause of hair loss. Every strand of hair on a human head is genetically programmed to a cycle that includes growth, stabilization, aging and shedding. On the average, a human head sheds about 50 – 125 (depending on gender) but most of them come back after the resting stage as the follicle itself is not destroyed. Trouble begins when the loss exceeds re-growth, or the re-growth is weak and unhealthy. Let’s explore the causes of hair loss plaguing every ‘head’ today.

Something in the “hair”

Most people believe they know everything there is to know about hair. After all, how much is there to know? When you pick up a hair from the sink you might give it a quick glance, but no further investigation. There is not much to look at. Is there?

Yes, there is! This little piece of hair is quite complex. A closer look at what a hair is made of and how it grows, surprises most people. Hair is a form of “appendage” to the outer layer of skin. It grows from very specialized cells, which produce hair even before we are born. A human head contains between 80,000 and 120,000 hairs. The number of hairs, the type and the color of each hair is genetically determined. The main purpose of hair is to isolate the tiny blood capillaries, which regulate the body temperature.

Each individual hair begins under the skin, in the root of the hair sac, which is called ‘dermal papilla’. The papilla contains cells that take in nutrition and amino acids necessary for the hair to grow. On top of the papilla is the matrix, where hair cells are produced in rather large portions. As these cells are being produced they get pushed upwards. During this process they “die” and form a very hard substance called keratin. The keratin is formed in long parallel strings within the cells and is kept together with binding compounds called disulphide. As the keratin cells are being pushed upwards, three layers are formed: the medulla, the cortex and the cuticle. The medulla is the core, or the central layer. It consists of ball shaped cells spun with air pockets. The exact purpose of this central core is still not clear.

The next layer, called the cortex, surrounds the medulla. It consists of dead cells filled with keratin. This layer determines the hair type and color.

The outer protecting layer is the cuticle, consisting of around seven overlapping layers of dead cells filled with hard and semitransparent keratin.

When the hair reaches the surface of the skin, all cells have run through the process - from living to dead cells - and filled with keratin. As this process goes on, the hair grows longer.

Why losing hair?

There are three main factors of hair loss : Age, genetics and hormones.

Age related hair loss

The Anagen (growing) phase of a young person can last up till seven years, while an older person has an Anagen phase of only 2-3 years. Getting bald is often a slow process, even though those experiencing it might not agree. As a measure, 30% of all men will experience balding at 30 years of age, 40% at 40 years and so on.

As we get older the diameter of each hair decreases. This is among other things a result of poor blood circulation to the hair. Massaging the scalp, for example with the fingers, regularly, improves circulation often to a noticeable degree. This is precisely what many undocumented hair loss products rely on. The buyer is asked to massage the scalp with cream or herbal oil, based on maybe a special formula, 2-3 times a day. This will often, after 6-12 months, reduce their hair loss.

What the buyer often is unaware of is that by massaging the scalp with the hair loss treatment product he/she stimulates blood circulation to the hair, thus increasing growth. Circulation is important for hair to get enough oxygen and nutrition to continue growing.

Genes and pattern baldness

There are men with increased levels of DHT in the body, and yet have a normal hair growth on the head. Somehow their hair roots are immune to the increased levels of DHT. This immunity is believed to be inherited through their genes. There are different theories, regarding the connection between inherited genes, DHT and hair loss.

Androgenic alopecia: It is a common form of hair loss in both males and females. In males, this condition is also commonly known as male pattern baldness. Hair is lost in a well-defined pattern, beginning above both temples. Over time, the hairline recedes to form a characteristic "M" shape. Hair also thins at the crown of the head. Often a rim of hair around the sides and rear of the head is left, or the condition may progress to complete baldness. The pattern of hair loss in women differs from male pattern baldness. In women, the hair becomes thinner all over the head, and the hairline does not recede. Androgenetic alopecia in women rarely leads to total baldness.

Cicatricial alopecia: It refers to a diverse group of rare disorders that destroy the hair follicle, replace it with scar tissue, and cause permanent hair loss. In some cases, hair loss is gradual, without symptoms, and is unnoticed for long periods.

Alopecia areata: It is a condition affecting humans, in which hair is lost from some or all areas of the body, usually from the scalp. Because it causes bald spots on the scalp, especially in the first stages, it is sometimes called spot baldness. In 1%–2% of cases, the condition can spread to the entire scalp (Alopecia totalis) or to the entire epidermis (Alopecia universalis). Conditions resembling AA, and having a similar cause, occur also in other species.

Telogen effluvium: It is a form of non-scarring alopecia characterized by diffuse hair shedding, often with an acute onset. A chronic form with a more insidious onset and a longer duration also exists. Telogen effluvium is a reactive process caused by a metabolic or hormonal stress or by medications. Generally, recovery is spontaneous and occurs within 6 months.

Traction alopecia: It is a form of alopecia, or gradual hair loss, caused primarily by pulling force being applied to the hair. This commonly results from the sufferer frequently wearing his/her hair in a particularly tight ponytail, pigtails, or braids. It is also seen occasionally in long-haired toy dogs whose owners use barrettes to keep hair out of the dogs' faces.

Hair loss and hormones

Hair loss is definitely connected to the male hormones. One of which is the well-known testosterone. Much more important is the hormone Dihydrotestosterone (DHT)–which exists in large amounts, in dying hair roots, in balding men. DHT is formed in the oil glands, and forces individual hair to become finer and shorter, becoming Vellus hair that remains. As mentioned earlier this is very fine and practically invisible hair. This Vellus hair, even in large amounts, is a poor substitute to real hair, as we know it. Ironically, DHT is responsible for the hair growth on other parts of out body, such as ears, nose and chest. Many bald men do have a lot of hair on their chest. This is the direct effect of the increased level of DHT. It causes hair on the head to stop growing, while helping it to grow elsewhere.

Women can also experience hair loss, during the period after childbirth. During pregnancy there is an immense increase in female hormones in the body. After birth these hormone levels are reduced to normal again. It is believed that this sudden change in hormone levels can cause temporary hair loss.

There’s more to hair loss...

There are a number of other reasons that might have an influence on hair loss, like:

• Stress: Long periods of hard physical and psychological strains might interrupt hair growth. This stress, might cause the hair to remain longer in the ‘rest’ phase, and slows down, or even stop, hair moving into the next ‘growing’ phase, and one begins to notice ‘thinning’ of hair. This hair loss is often temporary, as hair begins to grow again 3-4 months after the period of stress is over.
• Medicine: There are a number of medicines that have the unfortunate side effect of causing hair loss. Similar to stress, this is often only a period of temporary hair loss.
• Chemotherapy: Drugs used in chemotherapy can cause alopecia or hair loss, sometimes totally during the period of treatment.
• Nutrition: Insufficient amounts of proteins, vitamins etc. can in severe cases lead to hair loss. On the contrary, eating large amounts of vitamins, above the normal amount, does not increase hair growth.
• Tinea Capitis (fungal infection): It is a disease caused by superficial fungal infection of the skin of the scalp, eyebrows, and eyelashes, with a propensity for attacking hair shafts and follicles. The disease is considered to be a form of superficial mycosis or dermatophytosis.
• Trichotillomania (hair-pulling disorder): It is commonly known as an impulse control disorder or form of self-injury characterized by the repeated urge to pull out scalp hair, eyelashes, facial hair, nose hair, pubic hair, eyebrows or other body hair, sometimes resulting in noticeable bald patches.
• Hair treatments and styling: Hair dyes, perms, hair sprays, styling gels and holding crèmes can cause hair loss. If these products are used too frequently, if they are allowed to build up on the hair strands, or if they are used in excessive amounts they can weigh hair down, dry it out or weaken the strands. When this occurs hair strands can break, split and fall out. The result is premature thinning of the hair or hair loss.