Hair loss

Man losing hair

Wednesday, February 9, 2022

Hair loss or alopecia is very common. In their lifetime, approximately 50% of men and 40% of women will experience temporary or permanent hair loss.  Don't panic, some solutions can reduce the problem!

During his recent appearance on Aventures du Pharmachien, dermatologist and founder of dermago, Marc-André Doré, discussed with Olivier Bernard the different options available in dermatology to reduce hair loss.

The causes of hair loss

First of all, it is perfectly normal to lose hair every day.  A person can lose between 100 and 200 hairs per day. An abnormal amount is defined when the amount of hair that falls out is greater than usual. 

 In our last hair loss tips post, we explained the two main types of hair loss:

Hair loss - scarring

Scarring alopecia is less common and is often due to a hair follicle disorder. This type of hair loss leads to permanent scarring of the scalp and must be managed in a dermatology clinic with cortisone injections to the scalp and sometimes even oral medication. 

Hair loss - non-scarring

Non-scarring alopecia is more common and includes mostly three conditions: telogen effluvium, androgenetic alopecia and alopecia areata.  In this case, the hair follicle is still present, but no longer produces hair.

man with alopecia Man with hair loss
Man with hair loss woman suffering from hair loss after pregnancy

Androgenetic alopecia

Androgenetic alopecia results in the appearance, on the top of the head, of thinner and often less pigmented hair, which becomes lighter. This baldness can affect the top of the head uniformly, or start by affecting the tip of the head or the temples.

Androgenetic alopecia results from two factors: a genetic predisposition and sensitivity to androgens.

Alopecia areata or "alopecia"

It is important to note that alopecia is not contagious, but rather an autoimmune disease that causes hair loss. This hair loss is usually localised. This type of alopecia can be isolated over time and resolve itself. However, the disease can also progress.  It then becomes important to treat the problem. 

Telogen effluvium

Telogen effluvium consists of post-stress hair loss and is signaled by a thinning impression of the hair that is accompanied by a large quantity of hair found on clothes, on the floor, in the shower or on the hairbrush. 

Telogen effluvium can have many causes. Hair loss occurs 2 to 3 months after a triggering factor such as a serious infection, a high fever, childbirth, an accident or even a psycho-affective shock. However, it is crucial to remember that this type of alopecia is generally temporary and reversible.

Myths related to hair loss

Is it normal to lose hair during pregnancy or postpartum?

Certain pathologies such as gestational diabetes can induce hair loss. On the one hand, if you have gestational diabetes, the regeneration process of hair follicles can be affected by fluctuating hormone levels. Similarly, high blood sugar levels also contribute to blood flow obstruction, leading to circulatory problems and follicle deterioration.

Hair loss can also be caused by the normal hormonal changes that are experienced as a result of pregnancy. Whenever the body makes a drastic hormonal change, the normal hair growth cycle can be affected and even stopped, causing irregularities and producing what is called telogen effluvium.

Does wearing hats or caps cause hair loss?

No! Wearing a hat every day will not cause baldness in a person who does not have this gene. The myth of hair loss from headgear originated from traction alopecia, a skin damage and scarring that prevents hair follicles from growing.

However, people who already have thin hair or who have the "hereditary baldness gene" would be more likely to have their caps amplify the phenomenon. 

Does over-shampooing cause hair loss?

NO, IT DOESN'T. It is important to understand that hair products may contain some irritants, but one shampoo a day will not cause hair loss.

Solutions and treatments

After having found the cause of the hair loss, it is possible to manage the alopecia. 

Among the most common treatments, there is Minoxidil, which is a vasodilator that will make blood vessels swell and stimulate hair growth.  It is a lotion or foam that must be applied every day in order to see the benefits. However, this type of treatment may not be recommended for people with heart problems, high blood pressure, pregnant or breastfeeding women.

Another treatment often prescribed is Finasteride, which can be taken alone or in addition to Minoxidil.  Finasteride is an "anti-testosterone" type tablet that prevents the conversion of testosterone in the scalp. 

In all cases, these treatments must be taken over a very long period of time.  In fact, the treatment works and stabilises hair loss while it is taken, but when it is stopped, there is a good chance that hair loss will resume in the case of androgenetic alopecia.

There are many products such as over-the-counter shampoos and natural supplements available, but the majority of over-the-counter products are not really proven to be effective.

Another solution to hair loss is of course hair transplants. In advanced cases of baldness, two types of transplants are possible: transplantation and extraction.  Depending on the need, the surgeon will plan the best treatment.  This is a fairly expensive procedure, but the most effective.  However, the genetic process of hair loss will continue.  It is therefore necessary to add certain treatments such as Minoxidil or Finasteride in order to control hair loss.

In any case, if you suffer from alopecia, it is recommended to consult a dermatologist in order to have a really effective treatment.

Information gathered from the episode of Les Aventures du Pharmachien, aired on January 14, 2022 on ICI (In French only)


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