37 Popular questions and answers about Hair Loss
by an expert dermatologist
Dr Hiba Injibar was live in January 2021 with Fiona from the Harley Street Emporium talking about hair loss and answering some popular questions regarding this very hot topic. They chatted about hair and why it falls off. There are a lot of reasons why your hair might be falling. In this Live session, Dr Injibar discussed all the possible reasons and answered some popular questions regarding this subject.
Check out all the questions she addressed during the Live Instagram talk below.
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1) What are the different types of hair loss?
We classify hair loss into scarring and non-scarring varieties. Non-scarring hair loss is where the hair follicle is not destroyed, and the hair can grow back. Scarring alopecia leads to complete destruction of the hair follicle so they are permanent. Non-scarring alopecia includes male and female pattern hair loss, alopecia areata, and telogen effluvium. Scarring alopecia include diseases like lichen planus, lupus, certain bacterial infections of the scalp, and others.
2) As you comb your hair, it is normal to see some of your hair falling out. What is normal and when should you start to worry?
If you lose up to 100 hair strands per day this is considered normal. This is because your hair goes into cycles of growth and so losing some will often be replaced by others. So, you don’t need to worry if you aren’t seeing any bold patches or you aren’t seeing that your hair isn’t getting any thinner or broken. It is one the latter happens that we refer to the condition as hair loss.
3) Hair loss can be classified into two categories – scarring and non-scarring. What is the difference?
Non-scarring hair loss is where the hair follicle is not destroyed, and the hair can grow back. Scarring alopecia leads to complete destruction of the hair follicle so they are permanent
4) Under each category there are multiple diseases.
Non-scarring alopecia includes:
– Male and female pattern hair loss
– Alopecia areata
– Telogen effluvium.
Scarring alopecia includes diseases like:
– Lichen planus
-Certain bacterial infections of the scalp, and others
5) How can you diagnose hair loss?
We, dermatologists, are very well trained in distinguishing the different types of hair loss by a careful history and a physical exam and sometimes we need to do a scalp biopsy and some blood tests.
6) How can people know whether they have got scarring or non-scarring hair loss?
It might be difficult for people to know themselves but if the skin looks scarred i.e. red and shiny – then this is scarring alopecia . Also if their hair loss is permanent and patchy.
7) What are the more common non scarring alopecia that you see at the clinic and if they are caught early can they be treated effectively?
The most common scarring alopecia I see at the clinic include male baldness, female pattern hair loss, telogen effluvium (which follows strict diets, delivery, or a severe illness or surgery) and alopecia areata.
8) What is telogen effluvium hair loss? Can it be treated?
Telogen effluvium is when a big number of hair follicles synchronize their cycles and reach the telogen or falling stage of the cycle together. Patients will notice a significant shedding and thinning of the hair which is very alarming. Luckily this process is most often reversible on its own and we can also treat it with some supplements, PRP injections in the scalp, and some topical treatments.
9) What nutrients do you need for healthy hair?
For healthy hair, the most important nutrients are mostly iron, vitamin D, zinc, and folic acid.
10) We see a lot of supplements in the shops for hair growth. Are they any good? Is it worth taking them?
If your body is not lacking in a certain nutrient taking more of it will not make a difference].
11) If you have an iron deficiency, would you be expected to lose your hair? Why?
Not necessarily some people have iron deficiency and they don’t lose their hair so it is not a direct cause and effect relationship.
12) What is the best iron supplement? Would it be better if it has folic acid with it?
The pharmacist or your GP can suggest which is the best iron supplement as well as the right dose for you based on your blood iron level.
13) What can you do if your hair is breaking and getting shorter all the time? Is this a type of hair loss? What is it called? How is it treated?
That is not hair falling from the roots but breaking in the hair shaft. This might be due to dryness and other hair shaft diseases. Hairs need to be cut above the damaged parts and then taken care of by lots of moisturisers and avoiding extreme heat and styling.
14) Are tea gel shampoos effective to reduce hair loss?
15) Are Biotin a good supplement for stronger hair? Do they work?
Yes taking biotin supplements might help but not alone.
16) What is the difference between female pattern hair loss and male pattern hair loss? How do you treat each one of them?
Females don’t go bald but maintain their hairline – men can go bald. Treatment includes minoxidil which can be bought over the counter, finasteride which is an anti-androgen medication, PRP, and hair transplantation.
17) How can you know that you have androgenetic alopecia?
You will know that you have androgenetic alopecia as you will start noticing your hair getting thinner gradually from the front.
18) How long do you need to use minoxidil as a hair loss treatment to start seeing results?
About 4 months to start seeing results and in a year you will get the maximum results.
19) Can excessive exercise make hair loss worse? Why?
No exercise has nothing to do with hair loss.
20) The role of menopause and hair loss?
With menopause, there will be some hair thinning of course and this is more with those ladies who already have thinning hair before menopause, what we call female pattern hair loss.
21) Will taking testosterone to improve hair loss? Why?
No testosterone is not a hair loss treatment, and on the contrary, testosterone is the hormone responsible for balding in men and for hair thinning in women. The treatment we use blocks the effect of testosterone on the hair follicle.
22) Can Finasteride be prescribed to both men women? When would you prescribe it? What are their side effects?
Yes, it can be prescribed to men and post-menopausal women, side effects are sexual related and rarely include decreased libido which is usually reversible when they stop it.
23) Can you explain alopecia areata? Does it self-resolve? How can it be treated?
Alopecia areata is an autoimmune condition leading to hair loss in a localised circular area on the scalp. It can spread to include the whole scalp (alopecia totalis) or the whole body hair as well (Alopecia universalis) . It might self-resolve. We treat it with cortisone creams and injections, as well as multiple other treatments aimed at reducing the active immune response around the hair follicle.
24) Does brushing your hair stimulate hair growth?
No unless you have been prescribed a special laser comb.
25) Would PRP or micro-needling stimulate hair loss?
PRP is a very good treatment to stimulate hair regrowth, especially in cases of androgenetic alopecia and telogen effluvium.
26) Derma rolling on the scalp. Is it a good idea to stimulate your hair?
There aren’t a lot of peer-reviewed studies about its efficiency but yet it can be tried to stimulate hair growth in combination with PRP.
27) Which type of hair loss patient would benefit from PRP treatment?
Early stages of male and female hair loss, telogen effluvium, and post hair transplantation. It can also be tried in any kind of hair loss which is non scarring
28) Does it matter what you brush your hair with?
No unless you are breaking it up by using harsh combs or hot combs.
29) Are there any home remedies that can help with hair loss? Does almond oil, coconut oil or any other oil improve your hair growth?
Not really they just make your hair smoother and softer but won’t affect any hair loss from the roots.
30) Do Laser combs help with hair loss?
Yes they can help with stimulating hair regrowth in combination with other treatments.
31) What is alopecia neoplastica?
When patients have a tumour elsewhere in the body and it metastasizes to the scalp destroying the hair follicles and causing scarring hair loss in the area.
32) What is pressure alopecia?
When there is a lot of pressure on the scalp leading to destruction or trauma on the hair follicles and therefore slower hair regrowth.
33) What can cause permanent hair loss?
Scarring alopecia like lupus erythematosus, lichen planus , some severe hair follicle infections, alopecias neoplastica , etc.
34) What is frontal fibrosing alopecia? Is this permanent or can it be treated if caught early? What are the signs you might have?
It occurs mostly in women and leads to inflammation in the frontal hairline follicles and gradual receding of the hairline, and it can be permanent and scarring. Treatment is by prescription creams that aim to reduce the inflammation, if caught early some regrowth may occur but this condition leads to scarring of the hair follicle
35) Is there turning back with scarring hair loss? Would a hair transplant be effective?
It depends on what the transplant surgeon assesses but usually where there is a scar the graft won’t be viable and won’t take.
36) What kinds of hair loss also affect eyebrow hair loss?
Thyroid problems, alopecia areata.
37) What are the warning signs of hair loss that we need to come and get our hair checked out? What are the things we need to look for?
The first warning signs or fair loss are thinning of the hair, more shedding than normal, wider part width, hair everywhere clogging the shower drain and all over the pillow every morning.
You can also watch Instagram live to hear in detail all the unbiased melasma facts that were discussed in the Live.