Hair is a huge part of our life and although we usually just think of it as a fashion statement, there are actually some practical reasons for keeping a head of hair! Nature has kept the hair on our head to protection from the sun, to keep our head warm, and also as a ‘sensory factor’ – that is to say, having hair allows us to feel tiny movements on our head. This can help us avoid damage and injury to the crowning jewel of our bodies – the head! After all those big geeky brains of ours need looking after! However in many conditions, and as part of the ageing process, we can suffer from hair loss. But why does this happen and how can we avoid it?

Alopecia is the general term for hair loss and it comes in many different forms. Alopecia areata is due to an immune system imbalance and another form of alopecia, ‘telogen effluvium’ is due to hormone imbalances such as during pregnancy, illness, stress or lack of dietary nutrients. The most common form of hair loss is androgen alopecia, the one associated with the ageing process, this can affect both males and females however there are significant differences between the two genders.

Male pattern baldness is what we call androgen alopecia in men. This is hereditary and depends on multiple genes, affecting a whopping 80% of men at some point in their lifetime, starting as early as your teens (eek!). Although it’s not harmful to your health, there are many cases associated with depression and anxiety – a big enough cause for concern to get some research done! Male hair loss presents itself as balding due to a gradual change in the hair life cycle resulting in less growth time, and sometimes the hair shaft also becomes finer.

The causes of hair loss in men is much better understood than in women so let’s start with that! The cause is down to the hormone testosterone which is needed for male development but is now also known to regulate hair growth. An enzyme called 5-alpha reductase converts testosterone to dihydrotestosterone (DHT). DHT binds androgen receptors in the hair follicles which will lead to different genes being turned on and off. As genes control everything that goes on in our body this pathway ends with a reduction in anagen (the growth stage of the hair follicle) and follicle miniaturization. Follicle miniaturization is as it sounds – the follicles get smaller as they are converted from large ‘terminal’ follicles into small ‘vellus’ follicles and smaller follicles means smaller hairs! In the process of balding, hairs eventually gets so short (due to reduced growth time) that they no longer reach the skin surface so they can’t be seen.

The parallel process to this in women is called female pattern hair loss – women don’t tend to go bald but their hair gradually thins and their overall head of hair becomes less dense. It affects around 50% of women usually after the menopause when the production of the female hormone oestrogen stops, as this is thought to promote hair growth. The mechanism of female pattern hair loss is much less well understood than that in men, however it is thought to be very similar and involve the action of androgens, just like in men (women also produce testosterone, just not in as high levels as in men). Again the miniaturization process occurs but different areas of the scalp are affected in woman and it is uncommon for women to go completely bald. A separate mechanism with no parallel in men is also thought to be involved although the details of this are elusive!

Topical Hair Loss Treatments
As a natural part of ageing and with no adverse physical health effects ‘treatment’ for hair loss is not usually given. However there are a few options for those of us rather attached to our tresses! Both men and women can use topical minoxidil-containing solutions, such as Rogaine (also known as Regaine), which comes in a foam form and is applied to the scalp. Minoxidil was originally developed to treat high blood pressure as it is a vasodilator, meaning it dilates blood vessels, but the studies looking at this soon found that it could help reduce hair loss! By dilating vessels you get increased blood flow to the follicles at the scalp, promoting healthy hair growth. There are other factors, including the hair cycle itself, which minoxidil may also alter (such as boosting the hair’s growth phase, anagen), but exactly how it does this is yet to be determined! It has been approved for males at a concentration of 5% and slightly less at 2% for females to try and increase the growth phase of the hair and potentially the diameter of the hair fibres. One down side is that the benefits can be delayed (it make take a little while of treatment to see results), and ongoing treatment is needed to maintain barnet benefit. It’s also associated with side effects like dandruff in some users.

An Oral Hair Loss Treatment
A second treatment option is finasteride, an orally taken drug which has only been approved for use in men and has not been found particularly successful in women. This a reductase inhibitor (the enzyme which makes the DHT) and by stopping the production of DHT you are therefore stopping the effects it has on anagen and the miniaturization of the follicles. However, careful consideration should be taken before considering this drug – it needs to be prescribed, so you can’t just go out and buy the stuff, and it does have side effects. If you are seriously considering such a treatment, then consultation with your GP (or a chat with a pharmacist) is a good place to start, and they can advise you further. Many nutritional supplements have also been associated with prevention of hair loss, but strong evidence here is lacking.

Wrapping up Hair Loss
So although not immediately bad for your health (although the self-consciousness and anxiety sometimes associated are certainly not to be ignored!), hair loss can be a somewhat stressful event. Whilst it’s a very common cosmetic concern, many men choose to simply take it in their stride. For those of us a little more attached to our hair, it’s good to know that there are some options out there, even if they’re not full proof. Whatever you choose to do – remember you’re not alone! And if you’ve got any favourite hair-boosting or volumizing products, we’d love to hear from you! Comment below, or give us a tweet at @BeautyByGeeks!
Hair density, hair diameter and the prevalence female pattern hair loss.
Hair through the female life cycle.
Minoxidil use in dermatology, side effects and recent patients.
Minoxidil may suppress androgen receptor-related functions
Female pattern alopecia: current perspectives.
Managing hair loss in midlife women.
Androgenic alopecia: pathogenesis and potential for therapy.
Image reference: