Every day we all lose 100 hairs through natural causes. Each hair follicle goes through three cyclical phases lasting between three and five and a half years, and after the last (Telogen) phase a completely new hair is formed, forcing the old one out.

This natural hair loss is distinct from thinning hair and baldness which we will discuss later.

Male Pattern Hair Loss (Androgenic Alopecia)

By the time they are 50 most men will be suffering some form of noticeable hair loss. Male hair loss can be recognized by this basic pattern: Normally, a man in his late twenties or early thirties will notice a small recession of their hairline followed by a thinning of the hair on the crown and temples. It is not uncommon for these areas to meet forming a horseshoe shape known as the Ludwig pattern.

This type of hair loss is genetic and is caused by hereditarily over-sensitive hair follicles which can be passed down from either parent to children of either sex. These follicles react to androgens (male hormones) in the body, inhibiting the metabolism of hair cells resulting in thinner hair. The cyclical phases of the hair follicles will shorten, even on unaffected follicles, and any replacement hairs will be thinner. With time this thinning will result in baldness.

Female Pattern Hair loss (Androgenetic Alopecia)

Due to the fact that genetic hair loss is the result of a reaction to androgens, symptoms of female hair loss are regarded as rarer and less severe than its male equivalent. In general women's hair thins with age, and any hair they do lose tends to be from the crown of their head, and is more noticeable after the menopause.

If your hair loss does not follow this pattern it is best to contact your GP.

Alopecia Areata

Alopecia areata is an auto-immune disease where the immune system damages the hair follicles. This causes patches of baldness the size of large coins predominantly on the scalp, although they can appear anywhere on the body. In extreme cases this can result in total loss of all body hair (Alopecia universalis). People with alopecia areata are also more likely to develop other auto-immune diseases like diabetes.

Alopecia areata normally, but not exclusively, occurs in children or young adults and can be the result of anything from poor diet to anemia, although it does show a tendency to run in families. It affects about one in 100 people and in most cases there is a spontaneous resolution where hair grows back after a few months. Topical steroids can be used to encourage growth, although with mixed effects.

Treatments

Treatments such as minoxidil (sold as Regaine) are available over the counter at pharmacies and have been shown to stop the thinning of hair and even enhance hair growth when applied to the affected area. Although more effective in the early stages, minoxidil can work at any time in the treatment of hair loss. It is available in a 5% extra strength pack for men only, and a 2% solution suitable for everyone.

Minoxidil treatment can be affected by flaking of the scalp. Even a thin layer of dead skin cells can absorb the minoxidil, hugely reducing its effectiveness. The use of shampoos such as Pregaine can clean away this layer and add volume to thinning hair

Products such as Nourkrin Tablets and Solution stimulate blood flow to the scalp while also providing essential nutrients for hair follicles. Together these encourage the natural regrowth of hair. Those who would prefer a more holistic treatment should look at Absalom which uses a blend of herbs to stabilize and restart hair growth.

Other treatments are available on prescription from your GP. Propecia can be used to treat genetic hair loss, while anti-androgens such as Cyproterone have been used to treat women with Androgenetic alopecia. As mentioned above, alopecia areata can be treated with prescribable steroid creams and even injections as well as minoxidil, although none of these are 100% effective.

If you have any further questions please feel free to ask our pharmacist.

March 2007