Glorified as the crown on your head, the health and growth of your hair is often tied to our confidence and sense of self which is why hair loss can be distressing. Understanding why hair loss occurs is the first step in its treatment. It’s important to remember that losing hair is part of the body’s natural renewal process. We can lose up to 100 hairs a day as the hair follicle cycles through three phases: growth, an active growth phase, transition where the follicle shrinks and resting which precedes shedding allowing for a new cycle to begin. It is when this cycle is disrupted that you may notice hair loss.
What causes hair loss?
Genetics and hormones play a crucial role in hair health. Often it is our genes that determine how follicles develop and respond to hormonal signals. For example, androgenetic alopecia in men is the cause of a receding hairline and thinning. Or for instance changes in oestrogen levels during menopause can often drive hair loss in women. The problem is not always the hormone levels, however, but how genetically susceptible hair follicles respond to hormonal signals.
Stress and illness can trigger a condition known as telogen effluvium characterised by the falling of large bunches of hair often creating noticeable patches of bare scalp. This may occur following childbirth, periods of illness, weight loss or immense emotional distress. It may take some time to identify the cause of stress-induced hair loss as shedding can begin two to three months after the triggering event. Fortunately, this type of hair loss is often temporary and can be reversed.
Nutritional deficiencies are a common cause of many health ailments, and the hair is no exception. An adequate supply of proteins, vitamins and minerals ensures the hair follicles can function optimally. Therefore, periods of restrictive dieting as well as dealing with food allergies and intolerances may contribute to hair shedding. Although the focus is often on deficiencies, excessive consumption of certain nutrients like vitamin A and selenium can also cause hair loss.
Which hair loss treatments work?
Minoxidil remains the gold standard for being the most evidence-based treatment for hair loss. Minoxidil is the active ingredient in hair regrowth solutions and has been shown to be effective in clinical trials in both men and women when used at a concentration of 5% over a 48 week period. It’s important to note that it requires continuous use before improvements are noticeable and consistent use is usually necessary to maintain the results.
Bimatoprost and Dutasteride
Bimatoprost was originally developed for glaucoma, but researchers found that patients using it noticed longer and thicker eyelashes. Popular eyelash growth serums contain bimatoprost which works by prolonging the hair follicles active growth phase. It has also been used in improving eyebrow density with clinical evidence showing bimatoprost at 0.03% being significantly effective.
Dutasteride works differently to minoxidil and bimatoprost in its hormonal targeting approach by blocking the conversion of testosterone to DHT. DHT is a hormone that the body makes from testosterone and helps grow facial and body hair, but it can also cause hair loss on the head in some people. It is generally prescribed for hereditary hair loss and is not the best first choice treatment for everyone.
| Treatment | How it works | Best for | Drawbacks |
|---|---|---|---|
| Minoxidil | Prolongs hair follicles growth phase | Scalp and beard | Requires ongoing use |
| Bimatoprost | Encourages hair to grow thicker and darker | Eyelashes and eyebrows | May irritate skin around the eye |
| Dutasteride | Reduces DHT, hormone linked to hereditary hair loss | Male pattern baldness; selected cases in women | Unsafe during pregnancy; possible sexual side effects |
PRP (platelet-rich plasma injections)
PRP, platelet-rich plasma injections have attracted traction recently which involves taking a small sample of a patient’s blood, spinning it to concentrate the platelets and injecting it into the scalp encouraging tissue growth and repair. Treatment is often expensive, multiple sessions are required and there is less clinical evidence to support it.
Stress and Nutrition
Managing stress levels and ensuring an adequate amount of nutrients in your diet will help support hair growth. These vitamins and minerals include iron, zinc and biotin, which are essential to hair growth. As well as being more deliberate with food choices, prioritising nutrient dense foods that ideally pack in moderate to high amounts of each crucial component. Zinc and Iron are essential trace minerals but the word trace should not lead to the conclusion that because only small amounts are required that they do not matter. On the contrary, despite the human body requiring only small quantities, this is needed for the healthy functioning of the body. Zinc can be found in pumpkin seeds, beef, chickpeas, oysters and eggs. Iron can be found in lentils, red meat and tofu. Biotin can be found in liver, cooked egg yolks, salmon, almonds and mushrooms.
More on this topic: Hair loss treatments — what we prescribe for thinning hair, and how the consultation works.
Sources and further reading
- Lucky AW, Piacquadio DJ, Ditre CM, et al. A randomized, placebo-controlled trial of 5% and 2% topical minoxidil solutions in the treatment of female pattern hair loss. Journal of the American Academy of Dermatology. 2004;50(4):541–553. View source
- Olsen EA, Dunlap FE, Funicella T, et al. A randomized clinical trial of 5% topical minoxidil versus 2% topical minoxidil and placebo in the treatment of androgenetic alopecia in men. Journal of the American Academy of Dermatology. 2002;47(3):377–385. View source
- Zaky MS, Hashem OA, Mahfouz SM, Elsaie ML. Comparative study of the efficacy and safety of topical minoxidil 2% versus topical bimatoprost 0.01% versus topical bimatoprost 0.03% in treatment of eyebrow hypotrichosis: a randomized controlled trial. Archives of Dermatological Research. 2023;315(9):2635–2641. View source
This article is general information, not medical advice. If your hair loss is sudden, patchy or worrying you, speak to a pharmacist or doctor, as some causes need treating directly.
