Brutal or progressive, hair loss, medically called “alopecia”, is often a source of concern. What causes? What to do in case of alopecia? How to do the pull test? What to eat Update with Dr Jean-Luc Rigon, the dermatologist.
How does the hair grow?
All human beings lose their hair during their lifetime; this is a normal process. “Hair capital decreases throughout life. Thus, a 60-year-old woman has half the hair she had at the age of 15,” explains Dr Jean-Luc Rigon, dermatologist. A hair does not live the entire life of an individual, but it has a life cycle of 5 years; after which he dies and falls. Each hair follicle has up to 20 hair cycles. So you don’t have to worry too much about falling hair: it will most of the time be replaced. Over the course of life, 20 to 30 hair cycles follow one another. Each cycle consists of 3 phases:
First phase: the hair grows
During the anagen phase, the hair is growing. On average, they grow 1cm per month. But there are variations depending on gender (women’s hair grows a little faster than men’s) or season (hair grows faster in summer than in winter). The duration of the anagen phase also varies with gender: it lasts 4 to 6 years in women, compared to 2 to 4 years in men.
Second phase: the hair stops growing
During the catagen phase which lasts 3 weeks, the hair stops growing. Indeed, the hair follicle which surrounds and nourishes the hair root is no longer active.
Third phase: the hair falls
During the telogen phase, the hair in the growth stage will gradually grow towards the surface of the scalp, the hair whose growth is stopped. Thus, the dead hair is replaced by new hair. This phase of hair loss lasts 1 to 3 months.
The number of hairs that grow is always much greater than the number of hairs that fall: at any given time, approximately 80 to 85% of our hairs are in the anagen phase, 1 to 2% are in the catagen phase, and 15 to 20% are in the telogen phase.
What is alopecia?
Sometimes, hair loss accelerates and is no longer compensated by proportional regrowth: this is called alopecia because the hair becomes unusually thin. “It is estimated that a loss of over 100 hairs per day over a long period (several months) is abnormal loss.”
• Androgenetic alopecia or “baldness”
The pattern baldness or androgenetic alopecia is a scarcity of hair. It is localized to the forehead in men and more diffuse in women. Unlike seasonal falls which are sudden, these alopecia are progressive. The causes are both hereditary and hormonal. Thus, some hair being abnormally sensitive to male hormones, it is renewed more and more quickly and the phases of loss accelerate. We speak more often of male alopecia.
A simple test allows you to know if the hair loss is indeed abnormal: the pull test. “You have to run two hands through the hair, spreading your fingers apart like a large comb. If, in total, more than 20 hairs remain between the fingers, the level of loss is abnormal.”
• Losing your hair in autumn, spring
Fall and spring are good times for hair loss. “All furry animals, including humans, moult at the entrance and exit of winter. In September-October, many people come to consult because they are worried about hair loss. … However, it is quite normal at this time of the year, but the lack of morale, which sets in during the passage to the bad season, increases the concern “, reassures Dr Rigon.
A diet that is too strict can also be the cause of alopecia. “The tissues of the body that renew themselves the fastest are the most impacted by such a diet. However, hair renews itself very quickly.” These diets can cause deficiencies, themselves responsible for accelerated hair loss (zinc deficiency, magnesium deficiency, calcium deficiency and especially iron deficiency ).
• Stress, depression causing alopecia areata
Stress and depression are other possible causes of alopecia. They can cause alopecia areata, which is a special form of hair loss, or bleaching because gray hair falls out last. “This was the case with Marie-Antoinette, whose hair turned white the day before her execution.” Other causes of alopecia areata exist, especially in the event of dental problems.
Another factor in alopecia is having undergone general anesthesia. “Because the products are toxic to the root, the hair dies and then falls out. But generally, the hair grows back.”
• Pregnancy, childbirth, menopause
The follicles have receptors for certain hormones, such as estrogen or progesterone. If for one reason or another we are subjected to hormonal variations, it affects our hair.
- During pregnancy, female sex hormones (estrogen and progesterone) increase. The hair is protected and in good shape. But after childbirth, it’s the opposite, the hormone level drops. The growth phase is stopped, a large number of hairs pass into the catagen phase, then into the telogen phase. As a result, three months later, the women noticed that their hair was falling out. ” When there is an imbalance between female and male hormones, hair loss can be observed to accelerate” comments Dr Rigon.
- Dysfunctions of the ovaries or adrenal glands are also among the factors identified.
- Menopause accompanied by hormonal changes can lead to significant hair loss, as well as a change in the appearance of the hair (thinner, drier hair).
Hair loss and diet
Very strict diets can cause hair loss to accelerate. On the other hand, certain foods can slow down or prevent alopecia. “This is the case for all foods containing sulphur amino acids, “ says Dr Rigon. Among these foods: meats, fish, legumes, cereals, eggs. Trace elements also have an interest in preventing alopecia, as do certain dietary supplements based on sulphur amino acids. “But they are not harmless on the digestive level: they can in particular cause flatulence. In all cases, it is necessary to consult your doctor before taking these food supplements.”
The treatment of alopecia is above all that of its cause. If the origin is hormonal, an appropriate assessment and therapy will be offered. “You can also give a cocktail of vitamins for one to three months”, specifies the dermatologist. A sulphur-containing amino acid in tablet form (cysteine) is prescribed, as are minoxidil lotions.
• Anti-hair loss lotions and shampoos
It all depends on the severity of the fall. For low to medium hair loss, some lotions are effective. On the other hand, when baldness is really important, it is necessary to consult a dermatologist and to turn to drug treatment. Lotions containing 2% minoxidil® for women, and 5% for men are effective. “It should be noted that minoxidil is quite oily which can give an unsightly appearance to the hair. Moreover, the presence of propylene glycol in these products can induce allergies, in one in 20 cases” specifies Dr Rigon. If this is not sufficient, men can be treated with finasteride® medicines in tablet form.
• Hair transplant
When the person suffers too much from hair loss, they can be offered a hair transplant in the form of a micro-graft. This is a surgical procedure under local anesthesia that lasts 2 to 3 hours. Hair implanted at the back of the scalp is moved to graft it at the front. Indeed, the back hair is not subject to hormones and is therefore spared the phenomenon of baldness. In other words, the hair transplanted at the front of the skull will persist and renew itself normally throughout the life of the person operated on.
Some tips :
- Start by seeing a dermatologist before knocking on the door of a hair surgeon. Perhaps your alopecia does not require a hair transplant and can be treated with medication.
- If you have decided on the operation, don’t go to just any surgeon. Better to get advice from your dermatologist (he can refer you to one of his colleagues) or rely on word of mouth. Above all, avoid doctors who promise you the moon, who post their contact details on the web, who attract clients with advertisements such as “seen on TV”, or who boast of having operated on stars.
- Be very careful if the surgeon offers you an exorbitant price. Moreover, ask for a quote mentioning the details of the services. Also, make sure that the doctor is well covered in professional civil liability. And take your time to think and make your decision, beware of doctors who try to influence you.
On the other hand, there is a perfectly useless preventive treatment, which however had the hard life: the 100 brush strokes to make his hair more resistant. “It’s an urban legend. Far from strengthening the hair, it damages it!” To maintain your hair, it is better to exchange your brush for a wide-toothed comb and use it with gentle gestures.
Hair loss: who to consult?
The dermatologist is the specialist in hair loss, but the attending physician can be consulted on this point. If the cause is hormonal, follow-up will be with an endocrinologist or gynecologist.