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Hair loss (alopecia)

Hair loss (alopecia)

Hair loss, also referred to as alopecia, is a condition that can affect anybody. What causes and symptoms are associated with this condition? How do you treat it? Discover everything you need to know about how to fight this pathology.

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Summary

What is hair loss?

Although hair loss may appear trivial, it is a major motivation for people to seek consultation, with nearly 10 million French people being affected. Not one but in fact several different types of hair loss exist, each with different causes. Health professionals have classified them as follows:

Sudden onset occasional hair loss known as acute telogen effluvium
Gradual and prolonged hair loss known as chronic telogen effluvium
Hair loss associated with hormonal issues in relation to the genetic landscape, or androgenetic alopecia
And finally, with age, a loss of hair density and mass, known as age-induced or senescent alopecia.

All of these hair loss types are different because they are caused by different modifications in the hair cycle and, therefore, require different treatments. Daily hair loss may be seen as trivial, but it can cause great psychological distress in patients. As a result, it is a common reason for consulting a dermatologist. Objective: to find the cause, or causes, of the hair loss. That being said, identifying the source of an ailment is not always easy, and this despite the common factors...

A closer look at occasional hair loss

Also known as acute telogen effluvium, occasional hair loss is the most widespread form of diffuse hair loss. It is characterized by an increase in hair loss three to four months after a triggering factor. This is why it is more commonly referred to as “reactional hair loss”. Stress, an emotional shock, fatigue, an imbalanced diet, changes in season, or the postpartum period are examples of possible causes. The hair cycle is disrupted, triggering an abrupt, diffuse and simultaneous loss of hair. The proportion of hairs in the active growth phase (anagen phase) shifts to 70% (vs 85% in physiological condition), while the number of those in the elimination phase (telogen phase, less than 10%) increases by 30%. The result: hair loss may reach 300 hairs per day, compared to the regular rate of 25 to 60 hairs on a normal scalp. Hair loss that is associated with seasonal changes, the postpartum period or even a dietary deficiency is always sudden and lasts for less than 6 months.

The different types and causes of occasional hair loss

Seasonal hair loss. Just as the autumn leaves fall from the trees, temporary hair loss may occur at the start of spring or autumn.
Stress- or fatigue-induced hair loss. When faced with an emotional shock, intense stress or anxiety, the body responds in different ways. Hair loss can be one such reaction.
Hair loss associated with a dietary deficiency. When the body, including the scalp, lacks vitamins and minerals, hair becomes fragile and can easily fall out. This is the body’s way of sounding the alarm: it needs a healthy, balanced diet rich in vitamins, protein and minerals such as iron and zinc.
Postpartum hair loss. Hormones are a factor in the hair’s life span. As a result, many women notice an improvement in the quality and growth of their hair during pregnancy. What is behind this? Higher estrogen levels. After pregnancy, however, the drop in estrogen may trigger changes in the hair cycle and lead to hair loss. This is referred to as “postpartum” hair loss.
Hair loss associated with a medicinal treatment. Certain aggressive cancer treatments, mainly chemotherapy or radiation therapy, often cause hair loss. This loss is temporary, as the hair grows back at the end of the treatment.

A closer look at chronic hair loss

Also known as chronic telogen effluvium, chronic hair loss can appear at any age. Women are disproportionately affected compared to men.

Chronic hair loss may also begin following a high fever, a hemorrhage, a surgery, major stress, a thyroid hormone imbalance, or a low-calorie diet. Once the triggering factor has been identified and eliminated, chronic hair loss of course begins to show improvement. Approximately 6 months will pass before we begin to see any regrowth, and it could take between 12 and 18 months* for the hair to grow back completely.

A closer look at the symptoms of androgenetic alopecia

Androgenetic alopecia is a type of gradual, chronic hair loss (which lasts over 6 months). But what is alopecia exactly? What are its characteristics? It consists of hair loss episodes that gradually lead to hair miniaturization and a drop in hair density**. Beyond the symptoms of alopecia, it should be noted that 70% to 80% of men are affected at some point in their lifetime, usually between 30 and 40 years old.

The most common form of androgenetic alopecia is baldness, and the mechanism by which it manifests is hormonal and involves the androgen receptors found in the dermal papilla. These receptors are stimulated by dihydrotestosterone (DHT), an active metabolite of testosterone. This stimulation of the androgen receptors by DHT in the hair follicle causes its miniaturization and the appearance of short, thin hair. Alopecia is usually a gradual process. This type of alopecia affects 29% to 42% of women, mostly between the ages of 20 and 40 years***. Little is understood about the root cause of this condition. Daily loss is generally low (fewer than 100 hairs per day), but women are highly affected, complaining of a gradual thinning around the temples and of a reduction in hair mass.

A closer look at hair aging or age-induced alopecia

This type of alopecia is observed in patients over 60 and is characterized by a thinning of the hair as well as a loss of density and volume in people with no issues of hair loss in their history or in their family history.

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How to slow down hair loss known as alopecia

Managing hair loss remains a challenge for patients as well as health professionals. Few therapeutic alternatives are available. Chronic telogen effluvium can be treated, and occasional hair loss can be reversed; however, all we can do with androgenetic alopecia is slow down its progression. How? To date, two types of medicinal treatments are available: minoxidil and anti-androgen medications such as finasteride. In addition to these treatments, patients are advised to adapt some of their daily habits. So, what can you do for hair loss?

To start, do not hesitate to consult a dermatologist, skin and scalp specialist, or your primary care physician. Is it occasional hair loss, chronic hair loss, androgenetic alopecia, or age-induced alopecia? A healthcare professional will be able to provide the right diagnosis and advise you on the best treatment and care.
At home, swap your usual overly harsh hair care products for gentle solutions. From shampoo to conditioner, anti-hair loss lotion and more, the objective is to keep your scalp healthy.
Similarly, you must manage your hair with the utmost care. Avoid aggressive brushing and overly tight updos that pull the hair, causing it to break and fall out. If you feel your hair is becoming fragile, stop dyeing it for a while.
Treat yourself to a daily scalp massage. Two minutes is enough to stimulate blood flow to the hair, bringing with it all the nutrients it needs to grow.
Watch what you eat. Diet plays a crucial role in hair loss. To prevent loss, the hair needs a lot of vitamins and minerals.
During major seasonal changes, such as spring and autumn, begin taking dietary supplements. Those containing vitamins and minerals can be a good complementary therapeutic option thanks to their key role in the hair’s physiology.

* Source: Vañó-Galván S1 et al 2019 Skin appendage Disorder** Source: Blume-Peytavi U et al 2018 JEADV
*** Source: Blume-Peytavi et al., 2011; Norwood, 1975