It is estimated that nearly half of all Canadians will experience some form of hair loss, or alopecia, by age 50. Hair loss can affect anyone, can be sudden or gradual, temporary or permanent, and can affect your scalp and body to varying degrees. There are a number of different types of hair loss, and even more causes of hair loss. The Medical Station explores this pervasive health issue.
Why Is Hair So Important?
The average adult scalp has between 100,000 and 150,000 hairs – and that’s just on our heads. Hair grows almost everywhere on human skin, the only exceptions being our lips, palms, and soles of our feet. Hair, which is characteristic of mammals, serves a number of functional purposes – these include protection and regulation of body temperature.
In addition to these practical functions, hair is quite important socially and cosmetically in many societies. While this may seem flippant or shallow to some, it is important not to underestimate the social importance of hair – especially as perceived by those who may be suffering from hair loss.
The Physiology of Hair Growth
Our scalp is covered in hair follicles, which are responsible for the production of hair. Hair production and growth is cyclical – there is a growth stage, anagen, which can last between 2 and 6 years, followed by catagen, a transitional hair growth phase, and then a resting stage, telogen, which lasts up to 2 months. As follicles produce new hair cells, old cells are pushed out through the surface resulting in a string of dead keratin cells, commonly known as hair!
Understanding Hair Loss
At a given point in time 80-90% of your hair follicles are in the anagen phase. Hair loss, or alopecia, occurs when the cycle of hair growth and shedding is disrupted, or when hair follicles get destroyed, either temporarily or permanently.
The average person loses 100 hairs per day. Hair loss, however, refers to a more substantial, widespread, or rapid rate of hair loss.
Types of Hair Loss
There are a number of different types of hair loss, some of the main ones include:
- Involutional Alopecia – this refers to the natural hair thinning and loss that is associated with aging, as more follicles enter the telogen phase
- Androgenetic Alopecia (AGA Alopecia) – also known as male or female pattern baldness, this is the most common type of hair loss – affecting up to 80% of men by age 70 and 40% of women by age 50. It is a hereditary genetic condition. For men it typically manifests as a receding hairline, whereas for women it results in hair thinning over the entire scalp.
- Alopecia Areata (AA) – a poorly understood autoimmune disease where your immune system attacks your hair follicles, typically resulting in round bald patches. AA affects 1-2% of the population, arises unpredictably, and is temporary (a few years) for most individuals.
- Telogen Effluviums – a poorly understood type of hair loss which results from a significant increase in the number of follicles in the telogen stage and the subsequent loss of these hairs. It is usually temporary and typically the result of a shock to your body – often stress or diet related.
- Scarring Alopecia – typically the result of another medical condition, refers to potentially irreversible destruction of hair follicles and their replacement with scar tissue – disrupting the ability for hair growth and regeneration
- Trichotillomania – this refers to a self-inflicted type of hair loss, which is the result of a psychological disorder where an individual compulsively pulls out their own hair.
Causes of Hair Loss
The causes of hair loss are plentiful and diverse. Some of the more common causes are as follows:
- Genes – this can affect our predisposition for hair loss, as well as the age, rate, and extent of hair loss
- Hormones – typically tied with androgen levels. This is especially apparent for women during pregnancy, childbirth and menopause
- Illness – thyroid problems, autoimmune disease, eating disorders, lupus, diabetes
- Infection – ringworm
- Medications – chemotherapy drugs, blood thinners, blood pressure medications, birth control
- Hair Care – cosmetic over-processing, certain hair styles
- Stress – emotional and physical shock
- Diet – protein, zinc, or iron deficient diets
Treatment & Management Options
The treatment and management options will vary based on the type and cause of hair loss an individual is experiencing. Some of the common treatments include:
- Treating the underlying condition or cause of hair loss – if hair loss is a symptom of an underlying disease, illness, or infection, it is important to treat the root cause. This can often restore hair growth
- Medication – there are topical as well as oral medications available for hair loss
- Surgery - hair transplantation or restoration
- Hair Replacement – this includes wigs and/or hair pieces
- Psychosocial support for addressing the negative psychological effects you may experience