If you’re experiencing hair loss, it can be frustrating every time someone laments the thickness of their locks and how unbearably hot it is—well because, at least they’re not balding!
Given how shockingly common it is (approximately one in three women experience hair loss at some point), talking about the loss of our tresses can be hard. While it is inevitable and a part of our ageing process, there are plenty of potential triggers—from reactive to genetic—that result in an early or accelerated onset of a widening part. Whether it’s pregnancy, a stressful season in life or genetics at play, trying to figure out the root of hair loss can be tricky, let alone the solutions or options available.
Though we’re living in the age of instant information, sometimes the internet tells you everything and nothing at all. We spoke to expert Dr Chris Tan, a dermatologist from National University Hospital about the common reasons behind hair loss in women: answering your ‘why’s’ and most importantly, what you can do about it.
Meet the expert:
Dr Chris Tan, a consultant dermatologist at the Division of Dermatology at National University Hospital. He runs a fortnightly clinic in NUH that sees patients with hair loss issues.
Pregnancy and Childbirth
The nine-month journey is not without it struggles—the morning sickness, the body aches and the slew of insecurities that may come with having to watch your body change and grow in unfamiliar ways. Besides the extra weight and spidery stretch (or as we like to call it, beauty) marks, losing your tresses may feel like the last straw.
The reason
The hairs on our scalp go through a normal cycle of growth, rest and then shedding. During pregnancy and childbirth, this cycle is disrupted and more hairs are shunted into the shedding phase, resulting in increased hair loss. This process is called Telogen Effluvium (TE).
Is this type of hair loss reversible?
This period of increased hair shedding is temporary and usually resolves within a few months.
What can be done?
Both moms and expecting moms who experience increased hair fall can consider using a topical hair growth solution such as Minoxidil, which remains the only FDA-approved topical product currently for women with hair loss. They should avoid styling their hair into a tight ponytail as the traction applied on the frontal scalp can cause hair loss.
Additionally, they should also check for associated biochemical abnormalities such as iron deficiency anaemia, which is occasionally seen in pregnant women. Iron deficiency can contribute to increased hair loss, thus if this is discovered, then the mothers should take iron supplements to reduce hair loss.
Hormonal Changes
From postpartum, menopause to contraceptive pills, there are many life events in which a woman will experience an imbalance of hormones that may ultimately contribute to hair loss.
The reason
In general, the female hormone oestrogen is protective against hair loss, while the male hormone testosterone contributes to hair loss. Female hormones increase the amount of time hair is spent in the growth phase, while male hormones shorten it. Hence, when there is an increase in male hormones, reduction of female hormones, or disruption to this fine balance in a woman, it can lead to increased hair loss. Examples of this include, menopause, following the reduction in female hormones and consumption of contraceptive pills or certain medical conditions (hyperandrogenism), where there is an increase in male hormones in the woman.
Is this type of hair loss reversible?
It depends on the cause of hair loss. If the hair loss was due to consuming a new contraceptive pill, it should resolve upon discontinuation. If there is another medical condition discovered causing increased in male hormones in the body, treatment should be targeted to deal with it.
What can be done?
The patient experiencing hair loss should first be assessed by a healthcare professional trained to manage hair loss. As mentioned, if the hair loss was a result of consuming a new contraceptive pill, it should resolve upon discontinuation. If there is another medical condition discovered causing increased in male hormones in the body, treatment should be targeted to deal with it. At the same time, oral medications such as Spironolactone can be used to counter the effects of the increase in male hormones. Hormonal treatments for menopause are usually indicated to relieve the other symptoms of menopause such as hot flushes. In all the scenarios mentioned above, the patient can start using hair growth solutions such as Minoxidil.
Stress
The reason
Similar to pregnancy and childbirth, stress disrupts the normal hair cycle and more hairs are shunted into the shedding phase (TE), resulting in increased hair loss. Stress may not always only refer to emotional and mental stress—it can also be in the form of a major illness, surgery, or drastic weight loss.
Is this type of hair loss reversible?
This type of hair loss is temporary and resolves after the stressful event is over.
What can be done?
One should learn to manage their stress as best as possible. Successful techniques to de-stress differ between individuals so someone who is stressed should engage in activities that relax them most. The same hair growth solutions (i.e. Minoxidil) can be used continuously, but if the stressful event persists or worsens, the hair loss problem can also worsen despite using them.
Stressed out? You are not alone. Get immediate support from your GP or call the Samaritans of Singapore (SOS) if you are experiencing poor mental health, SOS provides confidential emotional support to individuals facing a crisis, thinking about suicide or are affected by suicide: Its hotline SOS 24/7 hotline: 1800 221 4444., operates 24/7.
Nutrition
Watching what goes on your plate may be the secret to healthier hair, as certain dietary efforts may lead to unfavourable results when it concerns your tresses.
The reason
Diets that contribute to hair loss probably reflects certain deficiencies in the individual as a result of their diet. For example, strict vegetarians may be at risk of iron deficiency and this can cause hair loss. Once the relevant deficiency is corrected, the hair loss should resolve. Extreme diets leading to drastic weight loss in a short period of time can also lead to hair loss, in addition to any specific nutritional deficiencies. As mentioned previously, drastic short term weight loss disrupts the normal hair cycle and shunts more hair into the shedding phase (TE), thereby causing hair loss.
Is this type of hair loss reversible?
This is reversible once the weight stabilizes and nutritional deficiencies corrected.
What are some important nutrients for healthy hair?
Some of the nutrients important for healthy hair growth include iron, zinc and vitamin D. Consuming such supplements in excessive quantities if one is not deficient would not lead to increased hair growth. They are meant to correct hair loss in people whose hair loss are attributed to these nutritional deficiencies.
Genetics
Those experiencing genetic hair loss may often feel very discouraged like you’re fighting a losing battle. It’s important to remember that you’re not alone in this and that there’s nothing to be embarrassed about.
The reason
Hair loss is generally more common as we age. A big factor that determines the age of onset and severity of hair loss is related to our genes. Patients suffering from hair loss should be assessed thoroughly and investigated for all possible causes of hair loss specific to them. Treatment options can then be tailored to the specific cause where identified.
Is this type of hair loss reversible?
Genetics is something we cannot change and hence irreversible.
What can be done?
Individuals with severe hair loss and/or hair loss from an early age may require active intervention. The current FDA approved treatment for men include topical Minoxidil solution and oral Finasteride tablets. For women, the only treatment is topical Minoxidil solution. Currently, many other touted treatments lack large-scale scientific evidence to be accepted as recommended treatments.
Patients need to understand that treatments, if successful, also need time before they can observe “visible results”, as hair needs time to regrow. Ultimately, hair loss treatments should be as “personalised” as possible to address the unique issues pertaining to the individual patient. It should address, first and foremost, the most likely cause(s) of the hair loss, and secondly, be sustainable in the long-run in terms of efficacy, safety, compliance and cost.
What is considered ‘normal’ hair loss and when should we seek medical attention?
Sustained periods of diffuse hair fall exceeding 100 strands a day is considered abnormal and should warrant medical help. Hair loss in patches, and/or associated with changes in the appearance of the underlying scalp should also prompt you to seek medical help.
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