By Bong Li Shuen & Ngu Qui Min, AA Pharmacist

Pathophysiology

Hair follicles are responsible in the growing of hair. The root of the follicles is surrounded with blood vessels, creating more cells and providing essentials nutrients for hair growth. The hair is then pushed up to the skin with the help of oil glands and maintained growing for a few years before being shed off. This cycle continues for all the hair follicles (approximately 5 millions of follicles in the body). Each of us lose around 50-100 hair per day without noticing.

For an individual with balding, however, hair follicles are affected and gradually become smaller than normal, leading to thinner hair and quicker shedding. Eventually, hair follicles shrink to an extent which does not push any hair out to the skin surface.  

Types of hair loss

Hair loss is a more typical problem in men than women. The few common types of hair loss include:

  1. Male-pattern hair loss / Androgenetic alopecia (due to genetic and hormonal factors)
  2. Female-pattern hair loss
  3. Alopecia areata (due to autoimmune conditions)

Telogen effluvium (due to physically or psychologically stressful event)

Causes of hair loss

  • Stress
  • Weight loss
  • Cancer treatment
  • Iron deficiency
  • Pregnancy
  • Nutritional deficiency
  • Some diseases such as thyroid disorder, infection, etc
  • Certain medications including anabolic steroids and birth control pills

When to refer to a doctor

  • Sudden hair loss
  • Losing hair in clumps
  • Itchy and burning scalp
  • Developing other symptoms such as shortness of breath, dizziness, pale looking, etc
  • Hair loss in the other parts of the body

Treatment for hair loss:

  • Topical minoxidil (3% and 5%)
    Minoxidil is usually used for male pattern baldness and not effective for different reasons for balding. It increase blood flow to the scalp. By applying on the scalp two times daily, hair will regrow in 1-6 months time. Treatment must be continuously used to maintain hair growth. If the treatment is halted, hair loss will resume.
  • Finasteride (1mg and 5mg)
    While traditionally used to treat prostate enlargement, Finasteride has been approved for its use in male pattern hair loss. Taken once daily, Finasteride reduces levels of dihydrotestosterone (DHT), a type of male hormone responsible in shrinking hair follicles which leads to baldness. Effect of Finasteride will be noticed within 3 months time.

Supplements for hair growth:

Biotin

  • Keratin is a protein that is important in strengthening of the cells that form hair, skin and nails. Biotin plays a role in improving body’s keratin infrastructure.

Vitamin B complex

  • Improves blood flow to scalp
  • Protect hair and scalp from radical damage

Vitamin C

  • Improves blood flow to scalp and maintain blood capillaries of the follicles

Zinc

  • Improves immune system
  • Stimulates hair growth  

Essential Fatty acids (EPO or Salmon oil)

  • Improves hair texture
  • Prevents loss of dry brittle hairs

Reference:

  1. Ablon, G. (2015). A 3-Month, Randomized, Double-Blind, Placebo-Controlled Study Evaluating the Ability of an Extra-Strength Marine Protein Supplement to Promote Hair Growth and Decrease Shedding in Women with Self-Perceived Thinning Hair. Dermatology Research and Practice, [online] 2015, pp.1-8. Available at: https://www.hindawi.com/journals/drp/2015/841570/ [Accessed 18 Apr. 2018].
  2. Mayo Clinic. (2018). Hair loss – Symptoms and causes. [online] Available at: https://www.mayoclinic.org/diseases-conditions/hair-loss/symptoms-causes/syc-20372926 [Accessed 22 Apr. 2018].
  3. Monselise, A., Cohen, D., Wanser, R. and Shapiro, J. (2017). What Ages Hair?. International Journal of Women’s Dermatology, [online] 3(1), pp.S52-S57. Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5419032/ [Accessed 19 Apr. 2018].
  4. Nhsdirect.wales.nhs.uk. (2018). NHS Direct Wales – Encyclopaedia : Hair loss. [online] Available at: http://www.nhsdirect.wales.nhs.uk/encyclopaedia/h/article/hairloss/ [Accessed 18 Apr. 2018].
  5. Semalty, M., Semalty, A., Joshi, G. and Rawat, M. (2010). Hair growth and rejuvenation: An overview. Journal of Dermatological Treatment, 22(3), pp.123-132. 
  6. Tyagi, A. (2018). A review on hair loss and damage. Journal of Medicinal and organic chemistry, [online] 3(2), pp.48-53. Available at: http://www.rroij.com/open-access/a-review-on-hair-loss–damage-.pdf [Accessed 18 Apr. 2018]
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