Treating scalp hair loss – how difficult can it be?
Modern marketing stratagems seem to be ‘made’ for our society’s hedonistic ‘I want it now’ attitudes – and simplistic hair loss treatments are the perfect example.
We are reassured if we just use this shampoo or apply that lotion or take that generic vitamin supplement or prescription drug, our concerns will be over and hair density restored.
If restoring follicle scalp hair were that simple, every person would have healthy, dense locks of hair – and the hair loss treatment industry would cease to exist.
The reality is that treating scalp hair loss so that the client may at least gain ‘aesthetically pleasing’ results can be quite complex, multi-factorial and an investigative challenge as to cause.
Hair – particularly scalp hair in humans is considered a NON-essential skin appendage (in nutrient-metabolic-hormonal terms) – frequently the first tissue to have support for growth withdrawn when body balance is disturbed. Shedding/thinning of scalp hair density is often an initial primary symptom* of internal disturbance, deficiency or emerging disease process.
Body hair in modern humans is now also a lesser priority in terms of thermal regulation than it was for our cave-dwelling ancestors. As such our slow but continuing evolution has de-prioritised hair as a necessity for our survival.
In adult males the most common form of scalp hair thinning is male androgenic alopecia, as much a part of a post-pubertal male’s secondary sex characteristics as his whiskers, increased body hair, deeper voice and musculature. For females, scalp hair thinning is almost always an indication of internal disturbance or deficiency.
Optimal hair growth, quality & density is dependent on un-interrupted activity within the hair follicle, and therefore highly sensitive to any internal or external events that might disrupt follicle phasing.
A positive aspect to this is that a reduction in scalp hair density is a ‘signal’ from the body that all may not be well – a wise person listens to the body which they inhabit and best understand.
The body will ONLY commence to re-support follicle hair growth once internal disturbance is stabilised, and nutrient deficiency is corrected to the levels required to support ‘appendage growth’ (hair and nails) – then sustained for 3-4 months to allow for follicle phasing progression.
It then follows that attempting to treat scalp hair loss FIRST or in isolation to assessing and treating the underlying disturbances potentially causing scalp hair thinning will almost always result in a poor outcome because the body’s metabolic capacity determines scalp hair growth – not shampoos or topical lotions or even prescription drug ‘band-aids’.
Hair Loss is Hair Loss – true or false?
‘All hair loss is the same’ is a common myth perpetuated for commercial interests or an ignorance by some treatment practitioners as to the nuances of hair follicle regression. There are in fact many different forms of hair loss ranging from ‘temporary and self-correcting’ through to scalp (appendage) destruction and permanent hair loss; the causes of which are equally numerous and varied.
Most females experience ‘continuing until corrected’ thinning scalp hair – an expression of internal disturbance or deficiency.
Identifying ‘WHAT’ condition is established by:
- Time of onset i.e.: 1–3 months ‘rapid onset’ or 12-18months ‘slow’ thinning-out of scalp hair density.
- Is the hair shedding ‘diffusely’ i.e.: across the entire scalp or ‘patchy’ or ‘patterned’?
- Events preceding the onset of scalp hair loss: illness, surgical procedures involving blood loss, allergic reaction, significant stress or severe shock, ceasing or commencing certain such as contraception/hormonal therapy or anti-convulsant/mood stabilising medication, (rapid) weight loss programs or severe dieting.
- What other issues is the client reporting: tiredness, scalp sensitivity, sensitivity to cooler weather – felt especially hands, feet or tip of nose; unexplained weight gain and/or mood disturbance.
- What clinical signs are apparent to the treating practitioner: pale pallor, facial hirsuitism in a female, ocular signs (‘shiners’ indicating environmental sensitivity, allergies or inherited atopic state; ‘fat pads’ under the eyes suggesting Cortisol insufficiency), irregularities in the fingernails, mapping and cracking or discoloration on the tongue
- Pre-existing health or hormonal-metabolic issues: Insulin Resistance/Diabetes, Sex/Steroid hormone imbalance, Thyroid dysfunction, Adrenal/Chronic Fatigue, genetic cell mutations (termed: SNiP’s) to particular nutrients, disturbances in bio-chemical methylation metabolism pathways, gut dysbiosis or any other chronic health conditions will always reflect in a reduced scalp hair density.
- Mood disturbance/s: chronic anxiety, depression or psychotic illness such as Bipolar disorder or Schizophrenia may adversely affect follicle hair growth due to disturbance in body hormonal balance, or physiological stress of manic states etc. Mood stabilising medications often disturb the hair control cycle of follicle phasing.
- Pre-existing congenital or genetic issues: Haematology conditions such as Thalassaemia or Hemochromatosis will adversely influence hair cycle control (HCC). Thalassaemia suppresses bone marrow function resulting in a continuing low Haemoglobin (Hb).
- Client ethnicity: different races of people have greater susceptibility to certain conditions than others: Japanese for Alopecia areata or those of Greek/Mediterranean heritage to Thalassaemia.
- Gender: Post-pubescent females are at greater risk of deficiency in crucial nutrients (iron, Vitamin D, Iodine) and developing autoimmune conditions than are males.
- Specific pathology testing to assess above pre-existing or hitherto unrevealed issues will provide the treating practitioner with a clear pathology baseline of internal disturbance being reflected as scalp hair loss density. The two most important nutrients for scalp hair growth are:
- Adequate Vitamin D levels (minimum 100 nmol/L or 80 ng/L) are required to re-set the follicle growth phase (termed: Anagen).
- Optimised Zinc availability is crucial to the keratinisation process of hair and nails; keratin is the outer layer of the hair shaft structure and key to its integrity.
‘Local milieu’ – the X-factor of scalp hair growth:
Hair cycle control aka follicle phasing requires specific and complex local ‘signalling’ for the competent transformation of hair follicle development (Millar:2002; Oro + Higgins: 2003; Schmitt-Ullrich et al: 2004). This is inter-follicular and intra-epithelial signalling at a molecular level requiring specific growth factors, receptors and (neuro) trophins to progress follicle hair growth.
Some medication which contain hair cycle modulating properties can encourage or imitate some changes in the local milieu but (again) will have limited effect if other areas such as nutrient support is compromised.
Correcting any nutrient-metabolic disturbance can take some months to reflect in the hair, so approved topical treatments may also be used as adjunct hair regrowth ‘accelerators’ in a combination therapy approach.
Qualified treating practitioners can assist the Client with establishing the precise nature of their concern, what might be driving it and how they may correct it – but only the Client can actually allay the problem to their ‘aesthetic satisfaction’ through treatment diligence and patience; there are no short-cuts.
*Primary symptoms for NON-androgenic alopecia are:
- (Scalp) hair thinning or loss; sudden + excessive OR slow and imperceptible.
- Tiredness or general fatigue – both of the body and mind.
- Mood disturbance as anxiety, irritability, feeling ‘stressed’ or depressed mood
- (Sometimes) changes in weight.
Copyright Anthony Pearce 2019.