Hair Loss: Causes and Treatment

Strong and full hair is synonymous with youth and attractiveness – correspondingly great is the psychological burden for many when the hair falls out. In Germany, every second man and every tenth woman are affected – whether by hereditary or pathological hair loss. Hopes are often high that “miracle cures” and other therapies can stop the loss of hair. Hair transplantation is considered to be permanently effective. But there are also other at least temporarily effective means.

The hair structure

Our hair is made of keratin, so initially it is nothing more than horn threads with pigments – and yet it is the most beautiful natural ornament we possess. Between 100,000 and 150,000 hairs have the human being on the head, between 80 and 100 of them fall out daily and grow again.

Hair growth and hair loss

The hair on the head in humans does not stop growing at a certain length, but sprouts about one centimeter per month. Around seven years a hair can grow before it falls out and then grows back again. Unfortunately, this does not apply to everyone. Hair loss – alopecia – is a widespread problem. Anyone who loses more than 100 hairs a day over a long period of time suffers from this disorder. Basically, a distinction is made between two different forms, hereditary and pathological hair loss. Both occur in both men and women – albeit with different frequencies.

Genetically caused hair loss

Hormonal hereditary hair loss – so-called androgenetic alopecia – is the most common form of hair loss, which predominantly affects men. The cause is the “male genes”, which ensure that in many representatives of the male sex the hair follicles react more and more sensitively to the hormone dihydrotestosterone (DHT) with increasing age. This androgen is a male sex hormone that is often responsible not only for the thinning splendor on the head, but also for beard growth and the typical male growth on the chest and in the pubic region. The increasing sensitivity to DHT with age is genetically pre-programmed and leads to a reduction in the size of the hair follicle – the fact-like structure that surrounds the hair root. The hair follicle itself is surrounded by an outer and an inner hair root sheath. If the hair root sheath eventually dies, the hair will fall out and will not grow back.

Hair loss begins at the corners of the receding hairline

The changes regarding hair growth usually start in the 3rd decade of life. Normally, they begin insidiously at the “Geheimratsecken”. These grow backwards, and later the tonsure area of the back of the head is also affected. The loss continues for years until only a more or less sparse crown of hair remains. Typically, this form of hair loss occurs in men. However, women can also be affected, as they also produce DHT (although to a much lesser extent than men). Often, affected women show a more masculine type of hair overall. Hair loss in men ultimately leads to baldness, whereas in women the main hair only thins out. Different regions of the head have different sensitivities to DHT. For example, the hair in the hairline area at the back of the head is insensitive. Therefore, in hair transplants, hair is always taken from this area and transplanted to the top of the head.

Pathological hair loss

In circular hair loss (alopecia areata), round bald areas usually form on different parts of the head. The cause of circular hair loss is believed to be an autoimmune reaction of the body against the hair follicles. In Germany, about one million people are affected. At the beginning of the disease, the hair initially loses its pigment and turns gray. Circular or oval-shaped bald patches on the scalp are characteristic. The characteristic cob hairs, which are only half a centimeter long and not very pigmented, are found around the edges of these areas; occasionally they are split at the end. Predominantly the back of the head and the lateral region of the hairy head are affected, less frequently eyelashes, beard and the remaining body hair. Very rarely, there is a complete loss of body hair – this special case is called alopecia universalis. However, the bald patches are not painful and do not itch.

Hair loss during pregnancy

Metabolic diseases, medications as well as iron deficiency, hormonal disorders and extreme psychological stress can also negatively affect hair metabolism and lead to so-called diffuse hair loss. Likewise, in rare cases, malnutrition or malnutrition can cause hair loss. Finally, there is physiological hair loss. It is rare and occurs after pregnancy or during menopause, which is related to a sudden drop in the female hormone estrogen. If the estrogen level returns to normal, hair loss usually stops after some time.

Stop the hair loss

Before resorting to every conceivable means to boost hair growth, a dermatologist should be consulted. The reasons for hair loss are many and underlying organic disorders should be ruled out. The treatment of hair loss is often difficult. In the case of constitutional hair loss, there are now remedies that can be used to stop hair loss in certain cases. However, once hair follicles have shrunk or died, they cannot be “revived” – miracle cures that promise to make new hair sprout on a hairless bald head promise more than they can deliver.