- What is hair loss?
The medical term for hair loss is alopecia. One of the reasons that this can be a frustrating condition for many people is because there are a ton of causes. I tell my patients that hair is always falling out and new hair is growing back in. When you notice that you are not growing back as much hair or more hair is falling out than is normal for you you may have hair loss. Hair loss is much like having a plant that is growing but not flowering. A plant can be healthy and just not bloom and if you talk to a horticulturist they will tell you it could be because of light, age, temperature, nutrition etc. Hair is much the same, we need to look at what is happening in the entire body to determine what might be causing a patient's hair loss.
What causes hair loss?
Our hair cycles through 4 stages. Anagen( the growth phase), catagen(transition phase), telogen(resting phase), and exogen(shedding phase). For most of us, our hair quietly goes through this cycle over and over again in our lifetime with a new hair always waiting to replace the one that is shed. When something interrupts the regular rhythm of this cycle you might notice more hair begin to fall out or less hair growing back. In general, I tell my patients that in the hierarchy of important organs, hair comes in dead last. What that means is if you have a certain amount of nutrients that you need to distribute throughout the body, your body may favor a more critical organ like your heart, lungs or kidney instead of your hair if there is not enough of a nutrient around or maybe because you are using up more of something during times of stress. If you are losing hair and your body has just gone through an emotional or physical stressor the first place to start is supplementation. Giving your body all the nutrients it needs with a supplement like Inner Glow’s Advanced Hair, Skin and Nails formula will correct a lot of problems that are caused by stress and deficiencies. There are a lot of supplements on the market that only have 4 or 5 of the ingredients that are necessary for hair growth, these will not be as helpful as something like Inner Glow that contains all 21 ingredients necessary to grow hair. If you have a medical condition(see below) then you will likely need additional interventions beyond just supplements.
The main causes that I see for hair loss are:
- Stress-Physical or Emotional
- Extreme Diets
- Illness
- Hormones
- Auto-immune
- Inherited Conditions.
If you have one of the first 3 causes for hair loss then time, supplementation with a research proven vitamin like Inner Glow and good nutrition will likely begin to regrow your hair. If you have one of the last 3 you will likely need to see a dermatologist for some additional guidance and medication.
Can medical conditions/stress contribute to hair loss?
If so, please elaborate on common conditions that contribute to hair loss.
Stress can absolutely contribute to hair loss as mentioned above. In fact, one of the things that cortisol(our stress hormone) does is signal our body to stop growing hair. You can imagine that in evolutionary terms if you are in fight or flight mode growing hair should take a back seat. Nowadays when our stress is more chronic, hair loss can become a longer term issue.
The most common medical issues that contribute to hair loss are anemia, thyroid and hormone conditions and autoimmune disease. These are so common in fact that I will often check labs when new hair loss patients come into my office to make sure that they don’t need to be treated for a medical cause of their hair loss.
Over the counter herbals Ashwagandha(stress), Saw palmetto(hormonal) and Moringa extract(vegetarian source of iron) can be helpful for many of these conditions. Inner Glow contains all of these herbals in the correct concentrations, so if your labs are trending towards one of these conditions but you don’t require medication just yet often supplementation alone can help in the short term. I do caution patients against taking large doses of any herbal alone as it’s difficult to know how much is too much for some people, especially if you don’t know what your lab tests show or you haven’t spoken to your doctor.
How much hair are we supposed to lose per day?
Losing about 100 hairs a day is pretty normal. But when a hair falls out a new one should be already starting to grow in the follicle (where you can’t see it) to replace the old one. If your
How can readers differentiate daily shedding vs hair loss? What causes hair loss?
Hair loss is tough for people to diagnose themselves because when your body signals your hair to stop growing it doesn’t drop out right away. In fact, after a major event or stressor it can take several months to really see hair loss. For example post partum hair loss doesn’t occur until 3 months after you deliver your baby and the same goes for COVID related hair loss. I tell my patients that you have hair loss when the amount of hair that you are losing on a daily basis is greater than normal for you. If you are someone who loses about 75 hairs a day and you notice during shampooing what's coming out is more than average for a few weeks you likely are having hair loss. As a hair loss specialist, patients tell me all the time they’ve gone to doctors who will say you have a full head of hair- you don’t have hair loss. But I tell my patients you know when the loss is increasing or your ponytail or braid seems more thin. Go with your gut feeling because you have to lose over 40% of your hair before you have visible thinning sometimes! And the earlier we intervene the more likely I can bring your hair back. I know it can take months to get in to see one of us so I mention some great things you can do while you wait for your appointment below.
Are there any at-home remedies to combat hair loss?
I recommend a few things to all of my patients.
- Zinc pyrithione containing shampoo -because an increase in seborrhea can increase hair loss
- A high quality supplement that has all 21 nutritional building blocks you need, not just a handful like Biotin and Vitamin D. I recommend Inner Glow because it’s founded by a derm (myself) and a Plastic surgeon and is Non-GMO, Made in the USA and scientifically tested. It’s also critical to buy supplements that are 3rd party verified like Inner Glow as a recent study showed many vitamins fail their own label requirements.
- Gentle hair care-No tight or traction inducing hair styles especially when the hair is wet. And gentle combing.
- If you don’t struggle with seborrhea then hot oil treatments and deep conditioning masks can be helpful at smoothing the strands which makes them less prone to breakage.
- Stress control-this sounds obvious but getting enough sleep and doing the things which help you to relax will allow your body to focus on hair growth
- I also recommend a balanced diet (Mediterranean is best).
Rosemary and castor oil have gained popularity for aiding in hair growth. Can you use oils to help reverse hair loss?
Rosemary oil has carnosic acid in it which can be beneficial for hair loss. I recommend it to my patients but generally I recommend patients brew it themselves. I have them buy rosemary and boil it in water until the water turns a bit darker like a tea(usually 20+min) and then put it in a spray bottle and spray onto the scalp before styling. This allows patients to leave it on their scalp longer rather than just oiling for 20 min and washing it off.
I don’t generally recommend castor oil as it doesn’t have much research supporting it over any other oil.
There are some claims that fabrics like cotton contribute to hair loss, do you recommend switching to silk and satin? If so, why?
I do like silk and use a silk pillowcase myself however I don’t think it makes your hair grow. A smoother fabric can help prevent frizziness and friction which is especially helpful for curly hair though.
Is it possible to reverse hair loss? If so, how long does it typically take?
There are so many causes of hair loss but in general I will say that we have great success in reversing hair loss in the majority of our patients. The treatment I choose depends on the underlying cause of hair loss. The treatments can include multiple different types of topical and oral medications, lasers, PRP, microneedling, red light and injections. If you have tried all the basic things for several months it might be time to see a specialist. Generally with any intervention it will take at least 3 months to see hair growth.
Please provide any other tips and recommendations for combating/reversing hair loss.
- My number one recommendation is get evaluated early!! Unless you have hair loss because of a correctable condition, post partum, illness etc the longer you wait the less effective your treatment will be. Generally, I can’t bring back much more than 15-20% of a patient's hair if they have chronic hair loss. If you are in the early stages then correcting it this much will definitely make a huge impact. However if you are already visibly bald then you will be less impressed by what our treatments can do.
- I should also mention there are some new treatments available for Alopecia areata so if you’ve tried everything for this condition there are some great options that have recently been approved.
- Over the decades I have definitely seen an uptick in the number of people complaining of hair loss at an earlier age. And some young adults due to keto diets(too much meat), veganism(not enough meat), ozempic(calorie deficit) or other dietary choices are experiencing hair loss before they figure out how to get all of the required nutrients into their bodies in a balanced way. A change in dietary habits is one of the most common triggers for hair loss in younger people and if it happens, it shows up a few months after changing up your diet which is why people might not think to link the two things.
Noreen Galaria, MD FAAD is a board certified Dermatologist with a laser and cosmetic fellowship and has been practicing for over 20 years. After spending time as an academic dermatologist;training residents and doing research and publishing papers she moved into private practice 13 years ago and opened 3 offices outside of the DC area. She is also the CEO and Founder of Inner Glow vitamins. A dermatologist and plastic surgeon developed brand of skin nutraceuticals.
