Hair Loss Treatments

Our hair plays a significant part in our appearance as well as protecting us. Each strand is made from a tiny hair follicle located within the dermis layer of the skin. Our hair is constructed from various components which include:

• The Papilla supplies all the nutrients to the growing hair.

• Located deep within the epidermis is the Bulb, in which the hair follicles grow.

• The Root anchors the hair strands to the bulb.

• The Strand is the only visible part of the hair, growing in various colours, lengths, and sizes.

Hair plays an important part in our identity and self-image, so when there is a sign of hair loss, it can raise a cause for concern. Whether it's gradual thinning, a receding hairline, or bald patches, the loss of hair can be very distressing and also have an impact on our daily lives. There are many contributing factors to hair loss, which can include stress, underlying medical conditions, and even our genes.

An average person loses 30 - 150 hair strands per day through normal brushing and washing. This isn't noticed as the lost hair is replaced automatically through our body's hair growth cycle creating new follicles of hair each day.

What Are the Different Types of Hair Loss?

Hair loss is quite common and is often the result of genetic and lifestyle factors, however other causes of hair loss may be caused by illnesses or stress. There are various types of hair loss.

• The most common type of hair loss is Male-Pattern Baldness (Androgenic Alopecia). This is a genetic disorder affecting  50% of all men by the age of 50. Male pattern baldness is when the hairline starts to recede and the hair growth starts to thin at the crown and temples. Causing significant hair loss in up to 6.5 million men in the UK, male-pattern baldness can start in the teenage years and is usually apparent by the age of 40 in a large proportion of men. Hair loss and male-pattern baldness can cause emotional distress and even depression, especially when the onset of the condition starts at a younger age.

• Another common type of hair loss is known as Alopecia (Alopecia Areata). Alopecia is a disease that occurs when the immune system suddenly attacks the hair follicles resulting in hair fallout. This can happen on any part of the body, however, it mostly affects the head and face causing hair fallout in small patches. Alopecia cannot be cured and can occur at any stage of your life, even affecting healthy people with no other health conditions. However, there are various medical treatments available to tackle this disease and stimulate hair re-growth such as Propecia (Finasteride).

The less common but widely-known types of hair loss are:

• Telogen Effluvium & Anagen Effluvium. These two conditions may be confused as being the same but both occur differently and during separate cycles of hair growth. Telogen Effluvium is when the normal hair cycle is disturbed through changes in your body such as a traumatic event, excessive dieting for weight loss, or a side effect from new medications, causing sudden hair loss. Telogen Effluvium is not hereditary, affecting any person at any period of their lifetime. Anagen Effluvium occurs in the growing phase of the hair cycle, hence the name, and is caused due to autoimmune conditions, and cancer treatment (chemotherapy and radiation therapy).

• Traction Alopecia results from the constant hair-pulling of the roots. This type of hair loss occurs mainly in women who have their hair tight and is mainly common in the Afro-Caribbean background. Another cause is a hair-pulling disorder called Trich. This is when a person has the sudden urge to pull on their hair constantly and is most common in young adults and children. Traction alopecia can be a form of temporary hair loss and is preventable given the correct education and guidelines.

What Are the Symptoms?

Losing 50 - 150 strands of hair is normal for an average adult through the normal hair cycle. You should become concerned when the following symptoms arise, and  consult with a healthcare professional as soon as possible.

• Gradual Thinning on Top of the Head

• Circular or Patchy Bald Spots

• Sudden Hair Loosening

• Full-body Hair Loss

• Patches of Scaling that Spread over the Scalp

• Receding Hairline or Bald Spots in Men

• Hair Thinning on the Top of the Head for Women

• Rapid Hair Loss after a Shocking Event

• Brittle Hair Leading to Hair Loss

• Itchy or Painful Scalp Accompanied by Hair Loss

What Are the Main Causes of Hair Loss?

Losing your hair, both rapidly and gradually can be very alarming. Varying causes however determine whether the hair fall is permanent or temporary. Speaking with your GP or health adviser will aid you in understanding this, potentially allowing for early treatment to reverse hair loss and regrow hair. Various factors contribute to overall hair thinning and it can be incredibly empowering to understand the diagnosis.

Hair can be lost due to Genetic Factors; our entire scalp can be incredibly sensitive. Your family history can affect this. Androgenetic alopecia also known as male pattern hair loss and  female pattern hair loss, is caused by a sensitivity within the hormone DHT (dihydrotestosterone), leading the hair follicle to shrink and cease within the production of new hair. Whilst various exhibitions of hair shedding and thinning hair may occur during teenage years, symptoms may go unnoticed until entering your middle age years. Hereditary hair loss can however be treated.

Noticeable hair loss can be a result of Hormonal Changes. Significant factors include stress, menopause diet, pregnancy, the introduction of new medication, and unexplained weight loss. It is imperative to gain advice and direction from your General Practitioner or Dermatologist. Hormone levels play a critical part within the function of the body and maintaining this can be particularly challenging. Combatting hormonal changes to avoid losing hair can involve incorporating iron, essential C/B/D vitamins, and protein-rich diets - aiding in hair regrowth and maintaining healthy hair.

Medical conditions such as Thyroid Problems to Autoimmune Diseases are known to also affect hair loss. The thyroid gland is a small, butterfly-shaped gland within the neck and in front of the windpipe. A fundamental function of this gland involves the production of hormones that aid in maintaining the body and your overall health. Mild or short-lived thyroid problems are more likely to not attribute to thinning hair or permanent hair loss. Alongside a diverse range of symptoms, extensive hair loss is prominent for people experiencing hyperthyroidism and hypothyroidism. Alopecia areata, an autoimmune condition can result in the hair appearing sparse and patchy.

Theside effects of medications on our scalp can vary from person to person. Speaking with your GP can aid you in navigating this as the effects may be temporary or permanent. For many people, stopping or adjusting the intake of certain drugs and vitamins will ensure that sudden hair loss is temporary. Some medications or treatments which may cause hair loss in particular, consist of antifungal or acne medications, drugs that include high dosages of vitamin A, radiation treatments, birth control pills, and anti-clotting or cholesterol-lowering drugs. Chemotherapy drugs, in particular, target fast-growing cancer cells, in addition to destroying other cells which grow quickly - such as hair roots. Female pattern baldness may also be the outcome of the side effect of medications triggered by hormonal therapies.

Our daily lives and lifestyle factors such as physical and emotional stress, hair care, and diet attribute greatly to losing hair. Using harsh shampoos and chemicals within our hair strips the natural sebum produced, a necessary oil that maintains strong and healthy hair. Massaging your scalp gently on a weekly basis will enhance blood circulation, therefore strengthening the roots of the hair and encouraging hair growth. Allowing hair to naturally dry without the use the hair dryers, opting for gentle hairstyles which do not strain hair follicles, and limiting exposure to heated tools and appliances ensures few hairs are broken. Reducing salty, sugary, and fatty foods, instead maintaining a healthy diet and switching to yoghurts, spinach, fish, nuts, and eggs will assist in providing the key nutrients our entire body needs and prevent hair loss.

How Is Hair Loss Diagnosed?

Most of the time, male-pattern baldness (androgenic alopecia) is self-diagnosed without the need of consulting a doctor. As it is a genetic condition, it's likely that a family member (father, grandfather, or uncle) has also suffered hair loss and your condition will follow a similar pattern. The onset of the condition is usually slow and therefore difficult to notice straight away and will only be recognized when a significant amount of hair has been lost. If you are concerned about your hair loss, your GP should be able to perform a diagnosis by simply examining your scalp or using blood tests. This will help identify and confirm which type of hair loss you are suffering. If treatment is desired, then it should be started as early as possible to increase the likelihood of its effectiveness.

How Do You Stop Your Hair Loss?

Male-pattern baldness is usually only treated for cosmetic purposes as it doesn't pose any threats to your health. Although there are no cures for hair loss or baldness, there are treatments available that can help prevent further hair loss and also encourage new growth. The two most effective hair loss treatments which are available in the UK are Propecia (finasteride) and Regaine (minoxidil). Neither of these treatments is available through the NHS and will have to be purchased privately. The earlier you diagnose male-pattern baldness and start treating it, the better, as the treatments are more effective as a preventative measure. The two treatments available on  Quick Meds are DHT blockers known as Type II ‘5-alpha reductase inhibitors.

Finasteride (Propecia)

Finasteride (branded name, Propecia) is used to treat hair loss and you are required to take a 1mg tablet once a day. Your body normally converts the hormone Testosterone to Dihydrotestosterone which causes hair follicles to shrink. Finasteride (Propecia) blocks this conversion, allowing the hair follicles to remain their normal size. It is also said to actually increase the amount of hair growth, making the hair look fuller. Treatment is usually required for 6 months to reverse the hair loss and then continued to ensure this reversal. If the treatment is stopped, hair loss will likely resume within 6-12 months.

Minoxidil (Regaine)

Minoxidil is an over-the-counter topical foam that is applied to the scalp (roots of the hair) twice a day. The way minoxidil works is not fully understood, however, it increases blood flow to hair follicles which reduces hair loss and stimulates new growth, producing thicker and more visible hair. Treatment is usually required for a few months, but some consumers have experienced results in as soon as 8 weeks. It is important to remember that everyone's bodies are different and if results are not seen as soon as you'd hoped, you just need to remain patient. However, it is advised that you continue with the treatment for 6-12 months before deciding to stop or continue taking Minoxidil.

Apart from the two most popular treatments, there are other treatments available depending on the condition and recommendations from a healthcare professional.

Dutasteride (Avodart)

Avodart, also known as  Dutasteride in its generic form is another type of '5-alpha reductase inhibitor'. It is usually prescribed 'off label' when a healthcare professional believes the other treatments such as Finasteride and Minoxidil are not effective. According to research, Dutasteride has a 90% efficacy of blocking DHT compared to Finasteride which has an efficacy of 75%. Although Avodart may seem to be more effective, this can vary depending on individuals and the clinical decision of a healthcare provider will consider the best form of treatment for you.

Spironolactone (Aldactone)

Spironolactone is an anti-androgen. This type of medication is commonly prescribed to males and females to treat the build-up of fluid in the body such as heart failure, liver disease, and high levels of aldosterone. However, as this medication affects the hormones, it can usually be prescribed 'off label' to treat acne and hair growth in women. The anti-androgen also blocks DHT (Dihydrotestosterone) reducing the chances of hair loss in both men and women.

Corticosteroids

Corticosteroids also known as steroids are an anti-inflammatory medicine. This type of medicine can be prescribed for a variety of health conditions such as; asthma, allergic reactions, lupus, and multiple sclerosis. Alongside these conditions, steroids can be used to treat Alopecia areata. The medication helps fight autoimmune diseases leading to hair loss and is often prescribed to help regrow the lost hair.

Anthralin

Anthralin is a drug used to treat psoriasis but has also been found to be effective in the treatment of mild alopecia and patchy hair loss. The medicine irritates the scalp stimulating the immune system and encouraging new hair growth. Studies have shown an increase in hair growth within 2-3 months of using the medication.

All the medications above will need to be prescribed by a healthcare professional. It is important to use the correct medications for your condition to prevent any risk of harm or severe side effects. Although self-medication has become increasingly popular due to increased access to medication and the development of technology, it comes with its risks. Self-diagnosing can increase the chance of misdiagnosis, drug interactions, and excessive dosing. Seeking expert advice regarding medications should always be sought to ensure the right medication is used to treat your condition.

Are There Complications/Side Effects of Treatment?

As with all medicines, there are always risks of side effects. Not everyone is susceptible to this, however, doctors will advise the risks and benefits of the medication they are prescribing to you.

Hair loss treatments come with their risks of side effects too and it's important to have knowledge of them and how they can affect you.

Finasteride Precautions & Possible Side Effects:

• Swelling of the lips, face, tongue, and throat.

• Difficulty swallowing.

• Lumps under the skin (hives).

• Any breathing difficulties.

Uncommon side effects (affecting 1 in 100 people):

• Difficulty having an erection

• Low sex drive.

• Ejaculation problems and decreased semen during release.

• Mood swings and depression.

Finasteride cannot be used for the treatment of female pattern baldness. Women must not use this medication for the risks it brings during pregnancy. If finasteride is absorbed orally or through the skin by a woman, it may cause abnormalities in the child. Always speak to a doctor or health professional, if you have accidentally touched or taken a finasteride 1mg tablet.

Dutasteride Precautions & Possible Side Effects:

Dutasteride has similar functions and side effects as Finasteride 1mg. The medicine is for use by men only and should not be taken by women or children. If the medicine is accidentally touched, it can be absorbed by the skin and cause implications to women especially if they are pregnant or trying.

The medication should not be taken if you have severe liver disease. Any liver illnesses should be consulted with the doctor as there may be additional checks needed by them whilst taking Dutasteride.

Dutasteride (Avodart) affects PSA (Prostate-specific antigen) blood tests used to detect prostate cancer. Your doctor should be aware of this and allow you to take PSA tests more frequently to detect prostate cancer.

Dutasteride can interact with certain medications which can enhance the chances of side effects. These medications include:

• verapamil or diltiazem (for high blood pressure).

• ritonavir or indinavir (for HIV).

• itraconazole or ketoconazole (for fungal infections).

• nefazodone (an antidepressant).

• alpha-blockers (for enlarged prostate or high blood pressure).

A possible side effect is an allergic reaction. The signs of allergic reactions can include:

• Itchy skin rashes.

• Hives (bumpy and itchy rash).

• The swelling of the eyelids, face, lips, arms, or legs.

Common side effects affecting 1 in 10 men taking Dutasteride:

• Not achieving or maintaining an erection (impotence).

• Low sex drive (libido).

• Difficulty with ejaculation.

• Breast enlargement or tenderness (gynecomastia).

• Dizziness when taken with tamsulosin (medicine for enlarged prostate gland).

Spironolactone Precautions & Possible Side Effects:

Talk to your doctor or pharmacist before taking Spironolactone if you suffer from kidney disease especially children with hypertension or liver disease. Your doctor will routinely assess you particularly if:

• you are elderly.

• you have difficulty passing urine.

• you have a disease that can result in electrolyte balance disturbance in your blood such as potassium or sodium.

• you have severe heart failure.

• you are pregnant.

Spironolactone can interact with other medications. You should inform your doctor if you have recently or might be taking any other medications. Your doctor may adjust your dose if you are taking the following:

• Digoxin or carbenoxolone

• Medicines for high blood pressure including angiotensin-converting enzyme (ACE) inhibitors

• Non-steroidal anti-inflammatory drugs (NSAIDs) such as aspirin, indomethacin, mefenamic acid or ibuprofen

• Potassium supplements

• Heparin or low molecular weight heparin (medicines used to prevent blood clots)

• Antipyrine

• Medicines are known to cause hyperkalaemia (raised blood potassium levels)

• Trimethoprim and trimethoprim-sulfamethoxazole

• Spironolactone reduces your responsiveness to noradrenaline. If you are due an operation involving anaesthetic, tell the doctor in charge that you are taking Spironolactone.

List of side effects of Spironolactone:

• Raised potassium in the blood

• Confusion

• Dizziness

• Vomiting or feeling sick

• Itching of the skin

• Rash

• Muscle or leg cramps

• Kidney failure or abnormal function

• Breast enlargement in men

• Breast pain (in men)

• Feeling generally unwell

Speak to your doctor or pharmacist if any of the above symptoms occur.

Corticosteroids Precautions & Possible Side Effects:

Steroids tend to not cause significant side effects for a short time, however, there is a chance as with all medications that side effects will occur.

Some of the effects are increased appetite, mood changes, and difficulty sleeping. This is very common when taking tablets. Unless severe, it is not advised to stop the medication without speaking to your doctor. If necessary, a change of dosage may reduce or even stop them.

Other potential side effects include:

• acne

• muscle weakness

• diabetes (can worsen existing diabetes)

• stomach ulcers

• increased risk of glaucoma or cataracts

• mental health problems - depression, anxiety, or suicidal thoughts.

Doctors evaluate and provide the best option of Corticosteroids for you to reduce the chances of side effects, however, it is vital to reach out to healthcare professionals if you experience any side effects. Always read the patient information leaflet.

Anthralin Precautions & Possible Side Effects:

Anthralin may cause some skin irritation, such as redness, a burning sensation, and itching. Anthralin can stain the skin, hair, and clothing. The staining usually disappears after a few days of stopping the medication. These are very common but if it becomes severe, it is advised to stop using anthralin and ask your pharmacist for advice.

How Do You Prevent Hair Loss?

Sometimes it can seem like hair loss is out of your control, especially if it is due to genetic factors, which can be frustrating and distressing. The best approach is to start preventative measures and treatments as early as possible and take good care of your hair, scalp, and diet. We recommend:

• Reducing how much heat you expose your hair and scalp to, for example, intensive hair drying.

• Reducing how much hair dye you expose your hair to (try switching to semi-permanent hair dye).

• Reducing the amount of styling products and procedures you use on your hair.

• Washing your hair regularly using a mild shampoo.

• Avoiding brushing wet hair.

• Avoid vigorously drying and rubbing hair with a towel, instead use a soft cloth or a t-shirt to pat the hair and head dry.

• Wash your hair regularly using a mild shampoo and avoid brushing when the hair is wet.

• Avoiding stress where possible.

• Getting plenty of sleep and exercise.

• Considering stimulating the scalp with a weekly scalp massage.

• Top up on your vitamins. Vitamin B is essential for hair growth and immune health.

Identifying the cause of hair loss can also be brought forward by a dermatologist. They can detect early signs and causes of hair loss earlier than you can. It is important to book regular checkups with them to prevent or slow hair loss as they will provide the correct guidelines and treatments.

Complete baldness, hair growth slows and overall hair thinning can be stressful and exhausting. Discussions with family and friends may provide the necessary support and understanding required during this time. Joining support groups such as Alopecia UK is a great way of sharing stories and information also.

Are There Alternative Treatments?

Whilst there are medications that tackle hair loss, there are also natural approaches that promote hair growth and combat the loss of hair. Essential oils and natural remedies are a great way to nurture your hair back into great health. The possibility of combining both medicinal treatments alongside natural alternatives could even provide greater results. Here are some of the most effective natural remedies:

• Essential Oils have garnered huge popularity for their therapeutic properties. Some have even been known to promote hair growth. Rosemary oil, Lavender oil, and Peppermint oil all have similar properties. They stimulate blood circulation to your scalp, providing nutrients and promoting hair follicle health. They are also known to reduce stress levels which are known to be a factor in hair loss. Massage the oil into your head and leave it in for a few hours or overnight to see the best results, which can take 3-6 months. So be patient and consistent with your routine.

• Scalp massaging can be of great benefit to improve blood circulation providing essential nutrients to your hair follicles. It is very simple and doesn't require a lot of time. Mixing in oils can be a form of aromatherapy allowing the oils to seep into the scalp and provide further benefits.

• Egg Mask is great for nourishing the hair. Eggs are rich in protein, biotin, and essential vitamins promoting hair growth. Leave the egg mask on for at least 30 minutes before washing will allow all the proteins to soak into the scalp promoting the hair follicles to regrow stronger.

• Acupuncture is a treatment derived from ancient Chinese medicine. It consists of very fine needles inserted at certain positions of the body for therapeutic purposes. Acupuncture is often used to treat chronic pain in the body but studies have shown that the treatment also stimulates blood flow to the scalp promoting hair regrowth. Acupuncture can be sought privately or through a GP recommendation depending on availability.

• Supplements can also be taken as an alternative hair loss treatment. Natural supplements such as Saw Palmetto have been effective in combatting hair loss. It contains anti-androgen properties blocking DHT increasing the chances of hair growth. Other supplements and multivitamins are key to good health, such as Vitamin C. Vitamin C contains Iron, a very important mineral for healthy hair.

• Maintaining a healthy balanced diet is key to healthy hair growth. A balanced diet containing the right amount of protein, iron, vitamins, and zinc all play a crucial part in maintaining body function and hair. Choosing healthy options and avoiding "junk processed foods" that contain empty calories can impact a lot for hair health.

While  prescription medications have been proven to be effective for hair loss for some individuals, alternative methods have been proven to be effective also without potential side effects. Using essential oils, performing aromatherapy on the scalp, taking supplements, and eating a healthier diet together can lead to a head of healthy hair. However, as with prescription medication, everything takes time. Consistency and patience are needed as to see the effects can take 3-6 months to see results.

Always remember to consult with a healthcare professional before starting any alternative treatments as they will be able to evaluate if it may be the right for you. Any underlying medical conditions should also be brought to the attention of your healthcare professional as they will

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