Hair Loss Diagnosis

Gray hair at an early age can have different causes, such as vitiligo, vitamin B deficiency, thyroid imbalance, constant and extreme stress, anemia, bad diet, etc. but its greatest trigger is genetics, causing the premature death of pigment-producing cells in hair follicles. When it comes to treating gray hair caused by other health conditions then the focus must be on tackling the primary reason. In treating genetically determined, premature gray hair, any effective therapy should involve interference with our genes. However, at the moment, no such treatment exists that can effectively halt or reverse the dying of pigment-producing cells called melanocytes. There are some commercial products out there, though, containing vitamins, minerals and a Chinese herb Fo-Ti that promise to stop and reverse gray hair but the only evidence supporting the claims made by their marketers refers back to the old Chinese legend of an old villager, Mr. He, from one thousand years ago. Vitamins B, namely folic acid and PABA, have been observed to halt graying in individuals with diets poor in vitamins B but they cannot help reverse gray hair in people suffering from chronic vitamin B deficiency, let alone in cases of genetically-determined gray hair.

Therefore, the only available gray hair treatment option for premature and age-related gray hair is to cover it. There are two principal coloring options for covering gray hair, which include hair dyes and progressive hair colorants. Hair dyes can be temporary, semi-permanent, demi-permanent or permanent, depending on the durability of their coloring effects. The ability of the pigment molecules to penetrate into the hair shaft determines the stability of the hair color. Each hair consists of at least two layers, the cuticle, which is an outer protective layer, and the cortex, which is hidden under the cuticle. Permanent hair dye is, as its name says, the most stable of the hair coloring options, as its large molecules get trapped in the cortex of the hair and resist being washed out but it is also the most drastic method of dyeing hair. Hair dyes are popular, especially with female consumers. Men usually look for more subtle options of covering their gray hair as for a man dyeing hair is socially less acceptable. Progressive hair colorants, with their slow and gradual mode of action, seem to be the right product for men.

The marketing of progressive hair colorants is typically targeted at male customers but these products can be also successfully used by women. They color hair gradually and unnoticeably and only affect your gray hair. They can be applied selectively so that you can leave certain areas untreated to look more natural. Progressive hair colorants are easy to apply, no plastic gloves are needed to apply them (with very few exceptions), and you just have to spread them on your white areas. Their mechanism of action consists of the chemical reaction involving one or two substances from the colorant, which in the presence of atmospheric oxygen produce synthetic pigment on the surface as well as in the pores and for some of them also in the cortex of your hair. As the substance is drying in the air, the chemical reaction begins and lasts until the next shampoo wash. Hence, the longer the substance stays in your hair the better. The downside is that progressive hair colorants have to be reapplied quite frequently, which makes them more expensive compared with the majority of traditional hair dyes. Progressive hair colorants are either metallic based or use organic chemicals.

The occasional controversy surrounding these products results from a wrong understanding of their mode of action and the purpose they were designed for. They were not meant to cover all your gray hair with a single application. For people with more than 50% of their hair already white, it is almost impossible to achieve full white hair coverage with these products, no matter how often they apply them. They were designed for people who want to reduce the amount of their gray and would like to do it discretely and unnoticeably. Frequent shampooing reduces the effectiveness of these products as does exposure to direct sun.

A hair system is any type of supplemental hair in the form of a full wig, hairpiece, toupee, hair extension or a weave, which replaces your own missing hair. Hair systems are, for many hair loss sufferers, the only existing option to replace the lost hair and to regain the former appearance of a full head of hair. The quality and the price of hair systems depend on a variety of factors, such as the type of hair used, the production process used to weave the wig, the foundation of the hair system and how it is attached to the scalp.

The type of hair is among the first things most buyers will ask about. Both natural and artificial hair can be used. The natural hair can be of human or animal origin. Some hair systems blend human hair with animal hair to save on cost. The human hair can be of Asian origin (the least expensive option), Indian origin and European origin (the most expensive option). Asian and Indian hair must often be bleached, which makes it brittle and less durable. Considering the harvesting methods, virgin hair happens to be the most expensive and hair gained from combs and hairbrushes the least expensive option. Human hair requires more care than artificial hair but it looks more authentic, lasts longer and is more comfortable to wear. Its downside is its higher cost and the fact that it can lose its colour when exposed to direct sun for long hours or break, as normal human hair usually does.

As far as the wig’s manufacturing process is concerned, hair systems can be hand-tied or machine-tied. Hand-tied wigs can also be custom made, which happens to be the most expensive alternative. The foundation of a hair system can be either a polymer or a mesh. The polymer foundation is a more affordable but also a less comfortable option. A mesh structure breathes better than polymer structures and is thus more comfortable to wear but, besides being more expensive, it is also a less durable alternative and more difficult to maintain. Mesh is suitable for creating authentic-looking hairlines, therefore many wigs combine both technologies, mesh for the hairline and the polymer structure for the inside of the wig.

The technique of attaching a wig to your scalp and blending it with your existing hair is a critical factor. There are semi-permanently attached hair systems that are either glued to your scalp or woven into your existing hair and these can only be removed in a hair salon once every five or six weeks for cleaning. These systems cling tightly to your scalp but can be unhealthy and uncomfortable to wear after a couple of weeks of continued use. The temporarily-attached hair systems use double-sided sticky tape or clips to fix the hairpiece to your scalp and existing hair. They can be removed and cleaned any time you like but they can also be easily and unexpectedly removed, thus leading to embarrassing situations.

The final, determining factor when choosing a hair system is the price. Any hair system is temporary in nature, it will not last for ever like hair transplants do. Nevertheless, they can be pretty expensive. Hair transplants can cost as much as ten thousand dollars or more. Although you can get a wig for a few hundred dollars, the more authentic pieces cost a few thousand dollars and require regular maintenance costing a couple of hundred dollars a month. In addition, you need to buy at least two identical pieces, one to wear while the other is being maintained by your hair salon. Though not cheap, hair systems are often the only option to replace the lost hair for many alopecia areata patients, as well as a large number of female hair loss sufferers.

Baldness can be caused by a great variety of different factors but heredity seems to be the number one reason why men and women lose their mane. Hereditary baldness in men and women has the same main cause, which is dihydrotestosterone (DHT) attacking our hair follicles. DHT is a metabolite of the male hormone testosterone but it is also present in the female body. Hair loss sufferers lose their hair not because of increased levels of DHT in their bodies but due to the susceptibility of their hair follicles to harmful DHT attacks, although the exact mechanism and reasons why certain hairs, mostly those on the top of the head, are more vulnerable to such attacks are not yet know.

The most visible difference between the male and female form of hereditary baldness is in its shape. The male form has a characteristic horseshoe pattern whereas the female form is a diffuse thinning across the entire scalp and is for that reason less easily-recognised. The female form of hereditary hair loss is, in its form, practically indistinguishable from hair loss caused by various other factors. The second most common reason for a woman to lose her hair are hormonal imbalances during and after pregnancy or menopause. Such changes are typically of a temporary nature and so also is the hair loss, although post-menopausal hair loss is in most cases permanent.

When it comes to treating hair loss in women there are several specifics. First, most women are not very good candidates for hair transplantation due to their diffuse thinning pattern, which makes it impossible to identify the hair that will be resistant to future miniaturisation and will not die. Secondly, finasteride, which is one of the only two FDA-approved hair loss treatments available today, cannot be used on women and neither can dutasteride, which is its closest relative. Rogaine (generic name minoxidil) is the second FDA-approved hair loss treatment and its approved concentration for women is only 2% versus 5% for men. However, many doctors recommend their female patients use 5% minoxidil formulations such as Rogaine foam. Aminexil is a molecule similar to minoxidil and it is often recommended to women who are pregnant or breastfeeding as a safer alternative to minoxidil.

Although some anti-androgens such as finasteride (better known as Propecia) or dutasteride cannot be prescribed to women, there are other anti-androgen medications that can be effectively used to treat baldness in women. Spironolactone (trade name Aldactone) and cyproterone acetate (used in contraceptives such as Diane 35, Diane 50 and Ginette 35) are anti-androgens most commonly used to treat female pattern baldness.

Another treatment for females with seemingly good rates of success is topical estrogen solutions such as Crinohermal, which use a female hormone, estradiol, as their main active substance. Estradiol is capable of inhibiting the conversion of testosterone into follicle-harming DHT. Hormone replacement therapy is another hormonal treatment suitable for women at menopause, with estrogens and progesterone pills and creams being the most common forms of this treatment. Estrogen levels in the body decline with time. As women enter the menopause, estrogen levels decline and more of the male hormone testosterone is then bioavailable to be converted into follicle-harming DHT.

This list of female hair loss treatments is not exhaustive, though. There are a number of other remedies that are often claimed to help promote hair growth in women, such as alfatradiol, ketoconazole, fluridil, flutamide, as well as different substances of natural and mainly herbal origin. Despite the fact that there are female patients who will swear by some of these treatments, none of them has ever been sufficiently clinically studied, let alone approved by any major national health supervisory authority as a treatment for female hair loss and the claims of their guaranteed effectiveness should be taken with a grain of salt.