What You Need to Know About Hair Loss

Hair loss – a horror for many women. Many charlatans take advantage of this anxiety and play off those affected with obscure drugs. What really helps?



Hair Loss – What is it actually?

Everybody runs out of hair every day – that is no reason to worry. A visit to a dermatologist is necessary if you lose more than 100 hairs a day.

In hereditary or androgenetic hair loss, the hair usually first becomes around the crown and then thinner. The scalp shines through more and more.

With circular hair loss (alopecia areata), inflammation of the hair roots interrupts hair production. Baldness suddenly occurs in one or more areas of the scalp. The areas become larger and in some cases can lead to complete hairlessness. The eyebrows and other body hair can also be affected. The nails can also change.

Diffuse hair loss causes the hair on the whole head to become thinner. Usually there is another disease or deficiency symptom behind it.



Who gets hair loss?

Hereditary hair loss is genetically determined. It mainly occurs during puberty and the menopause, i.e. in life phases in which the woman’s hormonal balance changes. Experts estimate that almost every tenth woman is affected, even every fifth after the menopause.

Circular hair loss often occurs in children and into adulthood and is probably a disorder of the immune system. The hair follicles – the small bags around the hair root from which the hair grows – inflame and repel the hair.

Diffuse hair loss can have many different causes. Possible causes include severe infectious diseases such as scarlet fever or high fever, deficiencies such as those caused by extreme diets, hormone fluctuations or shock. Drugs such as chemotherapy, psychotropic drugs, lipid reducers, beta blockers, blood thinners or hormone blockers can also cause hair to fall out.



What complaints should make me sit up and take notice?

When there is more hair on the pillow in the morning than usual, when combing or shampooing the hair, a lot of hair is lost and the hair looks lighter, it is time to go to the doctor.

How does the doctor determine if I am affected?
The doctor first examines the scalp and hair growth: Does the hair align evenly, only on the crown or are there individual bald spots? He tries out whether the hair is already going out by gentle plucking. If a reliable diagnosis is not possible in this way, he takes a small tissue sample of the scalp and examines the number and structure of the hair follicles under the microscope.



To determine how severe the hair loss is, a trichogram is often performed. The doctor removes a tuft of hair where the hair runs out. He plucks another tuft from a spot that is not affected. Under the microscope he compares the condition of the hair and hair roots. The modern TrichoScan method makes such an analysis possible without the hair having to be torn out.

How can hair loss be treated?

Hereditary hair loss cannot be cured, it can only be stopped. All remedies only work as long as they are applied. Hair loss continues after the end of the treatment.

Ointment with the active ingredient Minoxidil, applied to the scalp, prevents further progression and in some cases even makes the hair grow again. Success can be expected after three months at the earliest, the active ingredient can irritate the scalp and trigger allergic reactions. Tinctures containing the active ingredient 17-alpha-estradiol are also available over the counter. The active ingredient finasteride is only approved for men in Germany.

A pill with an anti-androgenic effect can also help women who are severely affected before the menopause. During the menopause, appropriate hormone treatment can slow down hair loss. In both cases, the male hormones are displaced from their contact points in the cells. A cosmetic solution to the problem is a hair transplant, which is however very expensive.

In the case of circular hair loss, the inflammation at the hair root can be treated with cortisone, a special light therapy and various stimulation therapies. In severe cases, immunotherapy with the active ingredient diphenylcyclopropenone (DCP) can be used. The doctor applies the aggressive tincture directly to the scalp and lures the immune cells away from the hair root. Circular hair loss often ends by itself after some time, but can recur over and over again.

Are there also gentle healing methods?

There are a variety of natural remedies to help against hair loss. However, their effectiveness is controversial in most cases. Keep your hands off overpriced, alleged miracle cures that are advertised on the Internet or in magazine ads – these usually only benefit the seller, not the patient!

In the case of congenital hair loss, the intake of zinc, biotin and vitamin B6 is worth a try – even if an influence on hair growth has not yet been proven in scientific studies. The same applies to hair lotions, which usually contain caffeine and are supposed to invigorate the scalp. Zinc is also often recommended for circular hair loss.

How can I protect myself?

One cannot protect oneself against congenital and circular hair loss. Diffuse hair loss, which is often caused by deficiency symptoms, can however be prevented by a balanced diet and the renunciation of extreme diets.

Incidentally, the assumption that regular hair cutting can prevent hair loss is wrong: Hair loss occurs directly at the hair root and is not influenced by hair length.