Dermatologists define "problematic" hair loss, or "alopecia," as the loss of 100 or more hairs per day . Below this limit it is considered normal, since each hair goes through a renewal phase in which it falls out and grows back later.
How to differentiate between hair loss or breakage?
It is important that you differentiate hair loss from hair breakage: in both cases you will find that you lose hair, but it is one thing for it to fall by the roots and another for hair to break because the fiber is weak and it breaks. Both problems will be seen as less hair volume, but the resolution is very different in both cases.1. Hair breakage
Hair breakage occurs when the fiber is altered and does not support the stresses to which it is subjected. You will see bits of hair on the pillow or brush, not full length hair. To start with, basic hair care will go through proper washing, brushing, and styling.
Hair should be washed as many times as necessary per week: there are those who have very oily scalps, so they cannot go without washing their hair for more than two days, while other people have normal hair and it may take three or four days without washing it, just brushing it. If you choose a suitable shampoo for your needs, and you wash your hair as often as the scalp asks for it, the myth of "dry shampoo" will only be that, a myth.
Another critical point is hairstyle and styling: tight hairstyles, daily ironing and excessive dyes weaken the hair fiber and favor its breakage, so if you start to notice hair breakage, reduce the number of times you use dyes, iron less the hair and comb it leaving it freer. In this way you will prevent the hair from breaking and you will maintain a vigorous head of hair.
2. Hair loss
Once it is established that it is a fall and not a break, it is necessary to look for the cause of the fall, since the reason for the fall will indicate the solution. There are two basic patterns: " diffuse alopecia ", which occurs when the hair falls evenly from the entire scalp, and " localized alopecia ", which leaves holes in our hair with a recognizable pattern.
Hair loss in "effluvium" or "diffuse alopecia "
Hair loss called " diffuse alopecia " occurs when you notice that you lose more hair than usual . Many people describe it as a fall “from the head in general”, “from all over”, without showing an area of greater clarity of hair. There are several causes:
- Lack of nutrients in the diet
- Certain medications
Hair loss due to lack of nutrients is not very frequent in our environment, but it happens when we eat badly for a long time or when we do a very intense weight loss diet.
What can I do if I suffer from "effluvium" or "diffuse alopecia?
This alopecia due to lack of nutrients in the diet is corrected as soon as the diet is supplemented by adding the necessary nutrients. The best known micronutrients related to hair loss are:
- The iron
We will see these micronutrients in many formulas to correct hair loss. The cystine , an amino acid also common in these supplements is added because it is one of the main components of hair protein. In case of protein deficiency, the hair is not a priority for the body, so it will direct the proteins to where they are most needed, neglecting the hair structure. Cystine supplementation ensures that there is enough material to synthesize hair with a healthy structure.
During postpartum women notice significant hair loss. This is due to hormonal reasons: during pregnancy, estrogens contributed to creating beautiful hair, but once the hormones change, hair falls back to normal, reaching a volume similar to that of prior to pregnancy. You do not need to worry about this fall , or use medications to stop it. A good diet will ensure that the hair grows strong and healthy, and the rate of loss will return to normal in no time.
Finally, some medications can cause hair loss . Among them we will find some medications for cholesterol, anticoagulants, some medications for blood pressure…. It is not very frequent that it happens, but it can happen that a medicine, when you start taking it, causes alopecia. The solution will vary depending on the medicine and the disease you are being treated: they can change the medicine, lower the dose, or recommend patience until the treatment is finished. In any case, it is a decision that you must make together with your doctor without stopping to medicate yourself, because the risk to your health can be significant.
All of these causes of hair loss are reversible. Once the poor diet is corrected, after the postpartum period, or the medication changed, your hair will return to its normal rhythm. This is not the case with the alopecia that we will see below, which can cause permanent baldness.
Hair loss in areas or "localized alopecia"
This type of hair loss occurs leaving areas of more or less normal hair, while others lose hair very quickly, leaving holes. There are two common types: alopecia areata and androgenetic alopecia.
The alopecia areata
It is produced in the form of a clap or coin, leaving an area without hair, due to an autoimmune problem that affects the scalp. It should be treated by a dermatologist, who depending on the state of the lesion can prescribe corticosteroids, minoxidil, hormones, or a magisterial formula that combines all these active ingredients. In this case, it is essential to see a dermatologist quickly, since the bulbs that give rise to the hair can atrophy and the clap would be irreversibly marked on the scalp.
The androgenetic alopecia
The best known is related to the action of androgens (male hormone) on the hair follicle, that is, on the origin of the hair. Androgens will cause a decrease in the size of the follicle until it is completely atrophied and is no longer functional. It is a very common process in men, but it can also occur in women.
The profile in both sexes changes: in men there are "recesses" and a bald crown, while in women hair is lost around the midline of the head, leaving a hairline on the forehead. This type of loss must be treated in time, since once the follicle has atrophied, it will not regain its ability to generate hair.
What can I do if I suffer from "localized alopecia"?
The most effective topical treatment for androgenetic alopecia is minoxidil . The mechanism of action of minoxidil is not known exactly.
A possible alteration of androgen metabolism in the scalp has been suggested, or also a vasodilator effect that can increase blood microcirculation around the hair follicle. It will not increase the number of hairs, but will stimulate the follicles that were losing their function to regain it.
This recovery will occur after 4 months or more of treatment , and the intensity varies from person to person. But if the treatment is suspended, the improvement stops, and the pre-treatment alopecia returns in 3-4 months. In men, minoxidil is used at 5% and in women at 2% (5% can be used but under medical recommendation). It can cause scalp irritation, dry skin, and even some dermatitis.
Other treatment options are oral 5-alpha-reductase inhibitors . This enzyme is responsible for the transformation to active form of androgens in skin and other organs, with which, by stopping their action, it is possible to stop the influence of androgens on hair loss.
Over-the-counter anti-hair loss tablets usually use extracts of sabal ( Serenoa repens ), pumpkin ( Curcubita pepo ) or some other plant capable of inhibiting 5-alpha-reductase. In the most severe cases , finasteride can be used , but due to its adverse effects, its use should be controlled by the doctor.
These options are valid when you have recently noticed alopecia. Remember that these treatments are "a long distance race", since you will not see results for 3 months. If you notice improvement you can continue, but if you do not notice it, do not wait long before going to the dermatologist.