Do you love your hair the way it is? Many of us wish our hair were different–curlier, straighter, darker or lighter. But what people worry about most with their hair is when it starts to fall out. Can you keep your hair from falling out? Why does hair loss affect some people, including women as well as men? Why do others seem relatively unaffected?
While there is some familial component to male pattern baldness (despite the name, it affects women too), the exact genetics are unclear. Other causes of hair loss include autoimmune disease such as alopecia areata or hormone imbalance such as thyroid disorders. Pregnancy is a common cause of hair loss after delivery. That's because the hair that has been in anagen phase (growing) shifts to telogen phase in which the hair follicle rests and the hair is no longer growing. Stress can also make hair fall out.
Treating the conditions that triggered hair loss can be helpful. That’s why the first test might be for thyroid function. Once that is corrected, the hair loss will generally improve. JAK (Janus kinase) inhibitors can be surprisingly effective for autoimmune hair loss. Moreover, the drugs that men use for enlarged prostate glands, finasteride and dutasteride, can also stop hair loss. They do have some sexual side effects, however, and they are inappropriate for pregnant women. Minoxidil (Rogaine) works about as well for women as for men.
Ophthalmologists discovered some years ago that the bimatoprost eye drops they were prescribing to treat glaucoma could also make eyelashes grow thicker and fuller. The FDA subsequently approved this medication for eyelash growth under the brand name Latisse. The user applies it like eye liner and it works well for the lashes.
Certain medications may trigger hair loss, particularly in susceptible individuals. In most cases, the prescriber could find an alternative. For example, beta blockers such as metoprolol are known to cause this problem, but usually another medication could be used to control blood pressure or heart rhythm. In the case of chemotherapy, the benefit of overcoming cancer is usually considered to far outweigh the distress of losing hair. Nonetheless, there is a new tactic that may help counteract the hair loss due to chemo. It is a type of close-fitting cooling cap that constricts blood vessels so less of the medication gets to the hair follicles.
One thing to avoid: using oil with heat processing. This can actually damage and scar the follicle, preventing recovery.
Keeping your body and skin healthy with good nutrition, adequate sleep and stress control is also a good way to maintain a healthy head of hair. Crash diets or extreme calorie restriction can lead to hair loss. Essential fatty acids, including omega 3 fats found in fish oil, can be helpful. Zinc supplements may also be useful to keep hair from falling out. Reducing inflammation can be helpful to prevent hair from falling out. In general, prevention is more preferable to finding ways to rejuvenate growth. The supplements Dr. Adigun mentions as possibly helpful, although incompletely tested, are Viviscal and Nutrafol. They contain marine complexes and ashwagandha.
Chris G. Adigun, MD, FAAD, is a board-certified dermatologist who practices at the Dermatology and Laser Center of Chapel Hill, NC.
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