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Why is my hair falling out?

Hair loss | August 24, 2016 | Author: Naturopath

men, woman

Why is my hair falling out?

Hair loss is seen as an inevitable sign of aging, but it frequently occurs in younger people and it's not always permanent... or inevitable. Like many conditions that affect our appearance, hair loss can cause great distress, a loss of identity, and even depression. But natural medicine can help.

For any treatment to be effective, it needs to target the cause. There's no point throwing all of your energy and money into a treatment that isn't right for you. Trying to figure out exactly why your hair is falling out can be frustrating, and treating any condition when you don't know the cause can feel like taking punches in the dark and never knowing if they hit.

There is good news, though

Understanding hair loss isn't as difficult as it seems. Once you get what's going on in the scalp, the hair follicle, and the hair fibre, then you can easily select the natural medicine that could help slow or even reverse your hair loss.

Understanding Hair Loss

To understand the mechanisms involved in hair loss, first we have to understand the process of normal hair growth. Each hair follicle moves through three phases:

Understanding Hair LossAnagen phase (active growth): The hair fibre grows at a rate of around half an inch per month. This phase lasts for 3-5 years on average, before the follicle moves into the transition phase.

Catagen phase (transition phase): During this 10 day period, the hair follicle moves from active growth into the resting phase.

Telogen phase (resting phase): In a healthy scalp, 10 – 15% of the hair follicles are in their telogen phase at any given time. During this phase, the hair is released from the follicle to make way for new active growth. In short: the hair falls out.

Around 80 hairs per day are lost from a healthy head of hair

What can go wrong in this hair growth cycle

A trigger disrupts the normal movement through these phases, and causes a shortening of the anagen phase and early onset of the catagen phase. Active growth is cut short (please excuse the pun) and hair loss is increased. This results in more hair follicles existing in their telogen phase at a given time – more than the average 80 hairs will be shed per day, resulting in thinning hair and/or bald patches.

5 ways the hair growth cycle can be disrupted

Nutritional Deficiencies

Iron deficiency anaemia is a common condition, particularly in women, and often presents with hair loss. But hair requires a lot more than iron, including adequate protein, vitamin C, zinc, essential fatty acids, selenium and vitamin D. An insufficient supply of any of these nutrients can result in thinning hair and hair loss.

Ageing

As we move into our 50s and 60s, it's natural to experience hair loss and thinning. The scientific community doesn't quite know why it occurs, but it probably has something to do with the interplay of genes getting “switched on”, and natural hormone changes that occur in this phase of life. “It's your age” sounds like an inevitable process, but there's still plenty you can do. Adequate nutrition may protect against premature “switching on” of these genes, while herbal medicine can support hormonal changes to slow down age-related hair loss.

Stress

Acute stress such as surgery, severe illness, or a traumatic event can cause temporary hair loss. It's as though the body sends a shock signal to the hair follicle, instructing it to end growth and immediately move into the dormant phase of the hair cycle. The result of this is usually seen as hair loss around 3 – 6 months after the acute stress occurred. The follicle resumes its natural cycle as the body recovers, and new growth should be evident within a year.

Hormone Dysregulation

The mechanism isn't completely understood, but an excess of androgen hormones such as dihydrotestosterone (DHT) prevents the hair follicle moving from the telogen (resting) phase back into the anagen (growing) phase. 

shutterstock_96884107This is referred to as androgenic alopecia and commonly known as male pattern baldness although it is present in all genders.

DHT is created from testosterone by an enzyme called 5a-reductase. The effect of the DHT on the hair follicles is also dependant on the sensitivity of the follicles themselves – and this comes down to genetics. The sensitivity of each follicle is determined by genetics.

Medical intervention for androgenic alopecia includes drugs that inhibit the 5a-reductase enzyme, thereby reducing the amount of DHT in the system. Changing or coming off the oral contraceptive pill can also trigger the hair follicles to enter the telogen phase, as can dramatic weight loss, but this is temporary hair loss is usually reversed
as hormone levels balance out.

Medical Conditions & Medications

Hair loss can be a flag that something serious is going wrong behind the scenes. Thyroid dysfunction (either over-active or under-active) can present with hair loss from the scalp or brittle hair that snaps off before the root; celiac disease can trigger autoimmune alopecia; and lupus can also present with balding. Pregnancy, PCOS, diabetes and any other medical conditions that affects hormones levels will of course have an effect on hair health, and many medications including antidepressants and chemotherapy may cause hair loss as a side effect. Consult your doctor about any excessive, sudden, or unexplained hair loss to rule out any serious underlying causes.

Natural Hair Loss Solutions

What if you are managing your stress, eating a nutritionally replete diet, and your hormone levels are in the “healthy” range, but your hair is still falling out? There's more you can do. Key herbal medicines and nutritional supplements have been shown to slow balding, increase hair growth, and delay the onset of age-related hair loss.

The Basics

Think about the physiology of hair growth. What does every cell need in order to grow and function? Energy and resources. Our hair follicles require oxygen for energy production, and nutrients for cellular respiration, creation of collagen, pigment, and proteins – that is, the hair itself. Blood carries our nutrients and oxygen, so for adequate delivery of the resources required for strong hair production, we also need adequate circulation. There are ways to promote blood flow to the head, including scalp massage, aerobic exercise, and yoga asanas where the head is lower than the heart. Circulatory stimulants like chilli, cayenne pepper, garlic and cinnamon can be eaten or taken as in supplement form, but not applied directly to the scalp as they may cause irritation and worsen any existing inflammation. Essential oils or herbal extracts can be included in scalp massage oil or hair care products to increase circulation to the scalp.

Herbal Medicine

Rosemary

Rosemary is a traditional hair tonic and circulatory stimulant in western herbal medicine. Topical application of the oil should be done combined with olive oil, as direct application can cause irritation.

Evidence suggests that rosemary has some promise in treating androgen-related hair loss, but only when used long term. A 2015 study showed that over 6 months, rosemary oil increased hair growth and performed as well as minoxidil (a drug that promotes hair growth by increasing circulation to the scalp). Notably, the rosemary oil reduced scalp itchiness whereas minoxidil worsened it. 

Rosemary oil may also be effective in treating other causes of hair loss.

Saw Palmetto

Saw palmetto is traditionally used to treat enlarged prostate. High levels of DHT are linked to benign prostatic hyperplasia and – guess what else? Androgenic alopecia. Saw palmetto works by inhibits the conversion of testosterone to DHT by blocking the 5a-reductase enzyme. A 2016 study showed that four weeks of topical treatment with saw palmetto extract increased hair count and quality, and produced no significant side effects. A small but notable randomised, double-blind study in 2002 showed that saw palmetto improved hair growth in 60% of subjects compared to a placebo group where 33% noted worsening hair loss.

Horsetail

The herbal extract of Equisetum arvense L. is used in western herbal medicine to strengthen and lengthen the hair. It contains ample nutrients such as silica and silicic acids which are required in the production of collagen, the protein that gives hair its strength and shine. It also contains potassium, selenium and manganese which are required for healthy, strong hair and cellular function. So while saw palmetto and rosemary can support scalp health and follicle function, horsetail provides the nutrients required for the hair itself. However, its use in treating hair loss has not been deeply explored by the scientific community, and peer reviewed studies are lacking to support its traditional use.

Nutrition

Supplementation with L-carnitine has been shown to stimulate hair growth in vitro and may assist in preventing or reducing hair loss. However, nutritional supplementation and herbal medicine will have little impact if there is a shortage of nutrients to support the hair follicle and create a strong hair fibre.

The key nutrients for hair growth include

Protein. The main constituent of the hair fibre is protein. Adults require around 0.8g of protein per 1 kg of body weight per day; without it, the follicle won't have the building blocks to produce hair fibre.

Vitamin C is required for collagen and keratin synthesis and gives hair its strength.

Zinc. A deficiency of zinc is known to lead to brittle hair and patches of thinning. It is needed to balance the immune system, and to regulate 5a-reductase.

Iron is needed to carry oxygen to the scalp, and as a cofactor in keratin production.

Selenium contributes to the pigmentation of hair.

Silica is required for collagen production and hair strength.

Vitamin D helps to maintain proper immune function, protects the follicle, and regulates gene expression.

By using a targeted approach, hair loss can often be reversed by using a combination of herbal and nutritional medicine, along with stress reduction and an excellent diet. If hair loss is causing you distress, or you still don't know where to start, see a naturopath or nutritionist for an assessment.

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References

Atanaskova Mesinkovska, N. & Bergfeld, W. F. (2014) Hair: what is new in diagnosis and management? Female pattern hair loss update: diagnosis and treatment. Dermatol Clin, 31:1, 119 – 127. http://www.ncbi.nlm.nih.gov/pubmed/23159181

Panahi, Y., Taghizaden, M., Marazony, E. T. & Sahebkar, A. (2015) Rosemary oil vs minoxidil 2% for the treatment of androgenetic alopecia: a randomized comparative trial. Skimmed, 3:1, 15 – 21. http://www.ncbi.nlm.nih.gov/pubmed/25842469

Ozmen, I., et al. (2015) Efficacy of aromatherapy in the treatment of localized alopecia areata: A double-blind placebo controlled study. Gulhane Medical Journal, 57:3, 233 – 236. http://www.scopemed.org/?jft=7&ft=7-1369234683

Wessagowit, V., et al. (2016) Treatment of male androgenetic alopecia with topical products containing Serenoa repens extract. Australiasian Journal of Dematology, 57:3, 76 – 82. http://www.ncbi.nlm.nih.gov/pubmed/26010505

Prager, N., Bickett, K., French, N. & Marcovici, G. (2002) A Randomized, Double-Blind, Placebo-Controlled Trial to Determine the Effectiveness of Botanically Derived Inhibitors of 5-a-Reductase in the Treatment of Androgenetic Alopecia. Journal of

Alternative and Complementary Medicine, 8:2, 143 – 152. http://www.ncbi.nlm.nih.gov/pubmed/12006122

Foitzik, K., et al. (2007) L-Carnitine–L-tartrate promotes human hair growth in vitro. Exp Dermatol., 16:11, 936 – 945. http://www.ncbi.nlm.nih.gov/pubmed/17927577

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