Hair loss is rarely discovered by counting. It is noticed in a photo.
Perhaps the light in the bathroom revealed an expanded part or the hair at the temples had taken on a different shape. Perhaps the curl of the shower drain had taken on a more menacing appearance.
That’s when the biotin gummies start, the expensive shampoos, the rosemary oil and collagen powder. I understand the desire to do something. But it’s worth knowing what’s going on before throwing money at a mystery.
There is a difference between the types of hair loss
Is it normal hair loss?
Finding some hairs in the shower doesn’t mean you’re going bald. On average, people lose anywhere from 50 to 100 hairs per day.
Most of these are gone before you know it. A few get tangled in the hair you brush, but some remain, hidden among the rest until they are washed out.
This last fact is what causes people to wrongly believe they are losing hundreds of hairs at once. If you shampoo twice a week, the amount of hair that can accumulate over five days may well surprise you. It happens much more slowly than you expect.
Instead of studying the drain, study the reflection. Has your ponytail gotten thinner? Does your part look wider? Has your hairline moved? Can you see more scalp than before in the same picture? Take a photo once a month in the same room and you’ll have a more accurate idea of what’s happening than by staring into the bathroom mirror.
If thinning is following a pattern
Androgenetic alopecia is the medical term for male- or female-pattern baldness. It usually begins at the temples or the top of the head in men. Women tend to notice that their part is widening while the frontal hairline remains intact.
The follicles do not die suddenly. They simply shrink with each cycle, growing shorter, finer hairs until they are barely visible. This means that a single strand of hair may well have contributed to your fullness for many years. It may still contribute, just in a more modest way.
Genetics can play a role, but remember that baldness is inherited from both sides of the family. Your father may have a full head of hair while several of his relatives have a receding hairline.
Pattern baldness tends to be gradual, allowing plenty of time to do nothing. Unfortunately, the follicles that continue to produce fine hair are often easier to save than those that have stopped working entirely.
When suddenly there is hair everywhere
Sometimes it seems that all the hairs on your head have decided to quit at the same time. There may be no obvious pattern to it, unless the whole scalp counts as one.
This can happen after serious illness, surgery, childbirth, extreme stress, or drastic weight loss. In such cases, it is often telogen effluvium – a condition in which the hair enters the resting phase too early.
The trick is that this shedding manifests itself in a few months. If you were very sick in January, it doesn’t mean that you lost all the hair in February – it can be noticeable as late as April. Naturally, you will associate this loss with the events of the last month.
Telogen effluvium often recedes on its own after a few months, although it takes as long as it needs. New hair grows just as slowly as before. There’s nothing much that can be done about the pace, but a detailed guide to whether Ozempic is causing hair loss can help you understand what exactly is happening with your body.
When there are areas of complete baldness
Smooth, round patches can be a sign of alopecia areata, an autoimmune disease that causes the immune system to attack the follicles. This condition is unpredictable in its manifestations and often stops on its own.
The appearance of redness, flakes, broken hairs, or swelling around the patch suggests a fungal infection. Unsurprisingly, tight braids, extensions, and constant pulling can also lead to hair loss along the edges of the scalp.
Pain, burning, crusts, or shiny pink skin on the scalp require a more urgent visit to the dermatologist. These symptoms are often associated with scarring alopecia, another autoimmune disease that permanently damages the follicles.
Stress can definitely be a reason for baldness, but it should be recognized as such in a specific context. A stressful year for everyone doesn’t have the same impact on the body as a difficult period for one person.
What does the dermatologist do about it?
Unfortunately, there is no universal hair loss test.
The dermatologist reviews the history of the disease. Did it start suddenly or gradually, did it happen after a particular event, did you change medications recently, did you have surgery, a serious illness or significant weight loss. Are you losing hair roots or just strands of hair?
The next step is an examination under a microscope. This is necessary to see if there are differences in the thickness of the hair – an indicator of pattern baldness. In addition, the dermatologist looks at the scalp for signs of breakage, flaking, or irritation.
Blood tests are also possible if the dermatologist suspects an underlying condition. If you have missed your period, have severe acne, unwanted hair growth, or suspect hormonal problems, a blood test for hormones will be needed. The same applies to testing blood iron levels – if you have anemia or hair loss due to a deficiency.
It is not worth risking health by experimenting with hormone levels when the reason for the change is not even known for sure. High levels of iron are no less dangerous than low ones.
What can help?
The most proven topical treatment for pattern baldness is minoxidil. It is available in two forms – for women and men. In most cases, it reduces the rate of hair loss and improves existing hair. It is important to remember that three months is not enough time to notice a difference. Many people stop using minoxidil because they notice a lot of hair in the shower or on the comb at first. This is because minoxidil stimulates hair growth, and any existing hair will shed more actively to make way for new hair.
Minoxidil must be applied regularly to maintain results. Stopping the treatment leads to a slowdown in hair growth. For most people, it doesn’t matter which form of minoxidil they use – foam or liquid – as long as they tolerate it well. It all boils down to what is more comfortable for personal use.
Some dermatologists prescribe minoxidil tablets. This is not a stronger dose, but an alternative way of taking it. Finasteride 1mg is an FDA-approved medication for the treatment of male pattern baldness. It works by reducing the levels of DHT – the hormone that attacks the follicles during androgenetic alopecia.
Both minoxidil and finasteride can have side effects. In particular, minoxidil can cause swelling, dizziness, changes in blood pressure, and irregular heartbeat. Finasteride, in turn, suppresses the activity of sex hormones, and the possible side effects include decreased libido, erectile dysfunction, and reduction in testicle size. Before using Finasteride, you must discuss all the details of the treatment with the doctor. The same goes for minoxidil – a dermatologist will determine the dose and schedule that is most comfortable for the individual case. Remember that Finasteride is not recommended during pregnancy.
Is it worth spending money on biotin and other ” hair loss treatments “?
Biotin deficiency rarely occurs in isolation. If you lack biotin, it is an indicator of a more extensive problem. For this reason, high doses of biotin are not beneficial for hair growth in people who are not deficient in it.
At the same time, there is no reliable evidence that biotin, and other supplements, speed up hair growth in people with genetic baldness. On the contrary, biotin can inhibit some tests, for example, when determining levels of thyroid hormones.
A similar situation with hair loss vitamins: most of them contain protein, iron, zinc, calories, and other substances necessary for the work of the body. When these requirements are met, additional doses of these vitamins will not compensate for the lack of, say, protein in the diet.
When to see a doctor?
You should see a doctor if baldness occurs in patches or if baldness is associated with discomfort or irritation of the scalp. It is necessary to call an urgent visit if the process is developing rapidly. Diffuse hair loss is also a reason to consult a dermatologist, especially if it has been going on for more than six months.
The point is not to find the slickest treatment in the fastest way. It is important not to confuse every stray hair with a potential problem.
