What Really Helps with Hair Loss?

Hair loss, or alopecia, is a major problem, especially for women. What really helps when hair falls out?

Especially with over-the-counter hair loss remedies, their efficacy has not been proven under normal circumstances, warns Dr. Jana Präßler, physician at the Clinic for Dermatology and Dermatological Allergology of the Friedrich Schiller University of Jena. But what really helps? Dr. Jana Präßler says which therapies are suitable for the most common types of hair loss.

When do we talk about hair loss?

It is normal for hair to fall out. Those who lose up to 100 hairs a day do not need to worry. This corresponds to the normal hair cycle:

• 2 to 6 year growth phase
• 1 to 2 weeks transition stage
• Rest for 2 to 4 months, then failure

The hairs are all in a different phase within this hair cycle, which is why some of them always fall out. A visit to the dermatologist is only necessary if you lose more than 100 hairs a day.

Possible signs: In the morning there is more hair on the pillow than usual, when combing or washing the hair an extreme amount of hair is lost, the hair looks lighter overall.

“Before treatment, a doctor must always clarify why the hair is falling out,” says Dr. Jana Präßler. There are many different causes, which are treated differently.

The most common causes of hair loss

• Genetic predisposition: Androgenetic alopecia is the most common cause of hair loss. What hardly anyone suspects: around 80 to 90 percent of people are affected. Many people know nothing about it: “The severity and the course are very different. One is hardly affected, the other very severely. It’s like with acne,” says Jana Präßler. Incidentally, it affects men just as often as women. In men, however, hair loss sets in earlier and more often leads to complete hairlessness.
• Disorder of the immune system: The circular hair loss (alopecia areata) occurs frequently in children and into adulthood.
• Inflammation of the scalp, caused by a malfunction of the immune system (e.g. lichen planus or lupus erythematosus) or by bacteria or fungi.
• Severe infectious diseases such as typhoid and scarlet fever or high fever
• Drugs that affect cell division, for example during chemotherapy or as a side effect of other drugs such as psychotropic drugs, lipid-lowering drugs, beta blockers, blood thinners or hormone blockers
• Deficiency states, triggered by extreme diets or deficiencies in vitamins or minerals such as iron and zinc for other reasons
• Shock states: psychological (extreme stress) or physical (operations, accidents)
• Hormone fluctuations, triggered, for example, by malfunctioning of the thyroid gland or a hormone change, such as occur after the birth of a child or by a pill with a high progesterone content
• Mental illness in children who pull their own hair out (trichotillomania)
• External mechanical influences, for example through frequent strong pulls with tight hairstyles or constant wearing of headgear.

Which treatment helps with the different forms of hair loss?

The most common hair diseases are androgenetic/heritable and circular hair loss.

Androgenetic alopecia (hereditary)

With androgenetic (or congenital) hair loss in women, the hair usually first becomes thinner around the parting and then overall. The scalp shines through more and more.

Critical phases in androgenetic hair loss are puberty and menopause. During puberty, in addition to the female sex hormones, the male sex hormone DHEA (dihydroepiandrosterone) is also formed in the body. A sex hormone that shortens the hair growth phase. Normally, enzymes prevent these hormones from lingering too long on the hair follicles and thereby causing the failure.

But if the cells in the hair roots are particularly sensitive to androgens, i.e. male sex hormones, because the enzymes in them are not doing their job properly, hair loss can occur. Because: It is you who protect the hair roots. Since this protective effect is weakened, hair loss in women often increases during the menopause.

If women are severely affected before the menopause, a pill with an anti-androgenic effect can also help. Appropriate hormone treatment can slow down hair loss during menopause. In both cases, the male hormones are displaced from their contact points in the cells.

Circular hair loss (Alopecia areata) – what to do?

Suddenly, bald spots appear on one or more parts of the scalp. They enlarge and in some cases can lead to total hairlessness. The eyebrows and other body hair can also be affected. The nails can also change.

The exact cause of the circular hair loss has not yet been determined. At the beginning of the disease, immune cells are found on the hair roots that cause inflammation there. This interrupts hair production. Sometimes diseases of the immune system occur at the same time, for example thyroid disease, white spot disease (vitiligo) or diabetes mellitus, which must be treated independently of hair loss. The disease can also be inherited.

In many cases, circular hair loss heals after a while without treatment. However, hair loss can occur again and again.

There are various treatment options on the scalp itself, the effects of which are directed against the inflammation at the hair roots. These include cortisone, a special light therapy (psoralen UVA) and various stimulation therapies that lead to contact dermatitis. Which method is most effective depends on the patient.

Hair loss after pregnancy/ while breastfeeding

Clearly: the hormone carousel is to blame. Now there’s a lot going on in the body and hair loss affects almost every woman who is having or has had a child. No need to worry, because the hair grows back! Some women don’t notice the hair loss, others react worried when they find tufts of hair in their brush. Often, women notice that they have a light receding hairline, and the small hairs that grow back form a fuzz at the hairline. When the hormone balance has settled down again, the hair loss is also reduced.

Reaching for medication – the best help for hair loss?

The handle to the therapeutic should be well thought out, because many drugs have side effects and are therefore not a permanent solution. In general, the following applies:

• The doctor must clarify what the causes of hair loss are. Only then can one react to it and use medication and tinctures after consultation.
• The sooner treatment is carried out, the greater the success can be achieved. Once the scalp is bald, it is too late to react.
• If the remedy is discontinued again, it also loses its positive effect. Long-term treatments should be well-considered, because their side effects can have an organic effect.
• Not every remedy works for everyone. Minoxidil, for example, has been proven to work for about 10 to 20 out of every 100 people treated. Other manufacturers of hair loss drugs with active ingredients such as thiocyanate also point out that there are patients in whom the active ingredient does not work.

Thiocyanate – is cow spit the miracle weapon?

Responsible for the effect of cow spit on our hair should be a salt that the body produces itself: thiocyanate. As vegetarians, cows have particularly high levels of this in their saliva. Cancer research wanted to test the substance to strengthen the immune system, and in experiments with mice it was found as a side effect that their fur grew strongly through the administration of thiocyanate. The advantage: It should not have any side effects. Prerequisite is, of course, the timely application with beginning hair loss, if the scalp is already bald, even this active ingredient can not do much.

The classic: Active ingredient Minoxidil

If the doctor has determined that the hair loss is hormonal, he can prescribe preparations with minoxidil. It can be used if the hair loss is caused by an excess of male sex hormones. The oral form of minoxidil is a prescription drug.

The active ingredient was originally developed to treat high blood pressure. It was found that it also helps against hair loss by slowing down hair loss and stimulating hair growth. As a tincture / solution (available in pharmacies under the trade name Regaine), it does not require a prescription.

How does the active ingredient work? It dilates blood vessels and activates an enzyme that also dilates blood vessels. So the hair follicles can then probably enlarge again and start producing stronger hair.

Important: If the scalp itches, flakes, turns red or inflamed. Long-term use of minoxidil can cause heart and circulatory problems. which is particularly important in long-term treatment. If the drug lowers blood pressure and you experience chest pain, dizziness, weakness, or your heart beat faster, treatment should be stopped.

Nutrition and hair

The diet has an influence on skin and hair. Therefore, a healthy diet is a must.