Hair Thinning: The Causes and the Cures

Elisa Chistyukhina

Elisa Chistyukhina

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Diffuse hair loss is not a disease, but a symptom of a medical condition. About 10% of all hair diseases are cause diffuse hair loss. Hair thinning usually becomes visible when more than 100 hairs a day fall out all over the head.
Visible hair shedding can occur in people of all ages and sexes. However, it is ten times more common in women than in men.
There are many reasons for diffuse hair loss. It can be due to hormone levels, or it can be caused by improper care. Another common cause in older women is female pattern hair loss.
Even too much of certain nutrients can cause patients to lose hair.

Female pattern hair loss - androgenetic alopecia

Genetics are one of the most common causes of hair loss. Male pattern hair loss is usually seen with the development of a bald patch on the top of the head or a gradually receding hairline from the temples and forehead.

Genetic hair loss in women is less common than male pattern baldness but is still frequent, especially in older women. It is often less noticeable in its early stages because it results in excessive hair loss all over the scalp. The hair thins but there are no obvious bald patches like in men.

Androgenetic alopecia is not really preventable. It is linked to genetics and hormone levels. Male hormones are found to different extents in both men and women and some people’s hair follicles are oversensitive to them. The only permanent, long term solution is a hair transplant.

Diffuse alopecia, the symptoms, and its causes

Another word for hair loss is alopecia.
In diffuse alopecia – in which hair falls out all over the scalp – hair falls out but the follicles remain. Therefore, theoretically, the hair can continue to grow. But thanks to whatever the cause of the hair shedding is, too many hair follicles stay in the resting phase.
Therefore, when facing hair loss that happens over the whole head, it is important to do a holistic physical examination to find the cause. Once the cause is removed, the hair will start to grow again, unlike in androgenetic alopecia.
There is a distinction between two types of diffuse hair loss, telogen effluvium and anagen effluvium.

Telogen effluvium hair thinning

All hair follicles alternate between the resting phase and the growth phase. At the end of the resting phase, hairs fall out, and then the growth phase starts again.
In telogen effluvium, more hairs follicles than usual enter the resting phase. This can happen intermittently or in waves.
They do not grow back if the cause for the imbalance remains in place.
The cause is often difficult to find because hair loss does not start until two to three months later. So, many patients have already forgotten what happened at that time at which hair loss was triggered.

Anagen effluvium hair thinning

In anagen effluvium, keratin production is disrupted. The hair continues to grow normally, but its structure is brittle. In the worst case, the hairs break off at a length of one or two millimetres.
In this medical condition, hair loss occurs a few days after the damaging event. This can be the case, for example, with poisoning or with some – very aggressive – chemotherapies.

The causes of thinning hair

The causes of diffuse alopecia are extremely diverse. They can be divided into 4 categories:

• Local diseases of the scalp
• External damage to the scalp
• Effect of orally ingested substances (drugs, chemicals, toxins)
• General diseases or diseases of internal organs.

Examples of conditions causing diffuse hair loss include:

• Hormonal fluctuations (e.g., pregnancy)
Thyroid disease
• Stress
• Incorrect care
• Iron deficiency or zinc deficiency
• Vitamin A poisoning
• Heavy metal poisoning
• Chemotherapy
• Radiation therapy
• Unbalanced diet/ wrong nutrition
• Anorexia/bulimia
• Side effects of medication
• Eczema on the scalp
• Mechanical effects on the hair (for example overly tight braids)

It is important to clarify the causes of diffuse alopecia with a doctor to exclude possible diseases.
A much less common form of diffuse hair loss is alopecia areata. The hair falls out in patches over the body in this auto-immune condition. A special form of the disease occurs very rarely, diffuse alopecia areata, or diffuse constitutional hair loss.

Diagnosis of thinning hair

The acute variant of diffuse hair loss, anagen effluvium, can be cured most quickly. Since the hair falls out quickly and strongly after the causative event, the cause can usually be found quickly.
The chronic variant of diffuse hair loss, telogen effluvium, is more difficult to diagnose. Hairs fall out a while after the causative event and, what is more, they do not all fall out at once. Thus, it can very difficult to diagnose what the root problem is.
Diffuse hair loss can often be confused with the hair falling out in patches, such as in alopecia areata. It also needs to be separated hereditary hair loss, especially in women as female pattern baldness most closely resembles it.
Therefore, it is important to also examine the hair under the microscope so that the two diseases can be ruled out. This is because hormone treatments for genetic hair loss can be harmful to the follicles in if the cause lies elsewhere.

The treatment for thinning hair

The best way to cure diffuse hair loss due is to remove the cause.
If the diffuse hair loss is based on a nutrient deficiency, a doctor will prescribe nutritional supplements to replenish the follicles. When the cause of diffuse hair loss is the side effect of a medication, you should consult your doctor to see if other medications are available.
If the cause is a thyroid disease, a specialist should examine and treat it. Medication such as hormones may well be necessary to deal with the cause of illness.
If the cause of diffuse hair loss is dieting, then this should be stopped immediately. In any case, anorexia and bulimia need treating by medical professionals for considerably more reasons than just hair loss.
Only hair loss that results from a disease on the scalp, such as an infection, should be treated locally. For all other causes, the solution must be found elsewhere in the body.

How long does it take for hair to grow back?

The good news is, in most cases of diffuse hair loss, the hair will grow back. This is different from androgenetic alopecia, where hair loss is permanent. So, it takes about three to six months for the hair to grow back.
Of course, hair growth can be supported with lifestyle choices, for example with a healthy diet. A good exercise routine and good all-round health will also be beneficial.

Hair transplants for hair thinning

Diffuse hair loss that is not hereditary reverses when the trigger is recognised and removed. Healthy hair then grows back again.
If the hair does not grow back, a hair transplant may be the best option. Dr Acar and his team at Cosmedica Clinic will be happy to answer any questions you may have.