Hereditary hair loss is a condition that affects 6.5 million men in the UK at any one time. For some, a receding hairline is something to be taken in stride: after a certain point, they’ll say goodbye to the shampoo and conditioner and reach for the clippers instead. But for others, hair loss is a major cause for concern. Perhaps they don’t think being bald suits them, or worry about being made fun of, or simply just love their hair - but the reality is that hair loss is a daunting prospect for millions of people in the UK. And it’s not just men that experience hair loss: more than 50% of women experience female-pattern baldness after the age of 65 as well.
A simple search online reveals countless clinics and online shops promising miracle cures for baldness. But how do you know who’s telling the truth? Can hair loss be slowed, or even stopped? Can it even be reversed? We’ll answer all these questions and more in our ultimate guide to hair regrowth.
What causes hair loss?
Hair loss can be caused by a multitude of different conditions and lifestyle factors. The most common cause of baldness though is hereditary hair loss, which is extremely common and becomes more likely to affect you as you age. Hereditary hair loss is caused by a combination of factors. Genetically, hereditary-pattern baldness is primarily passed down from the affected person’s mother - though research suggests you are more likely to go bald if your father is as well. Hormones also play a significant role in hereditary hair loss: dihydrotestosterone (DHT) is an androgen that causes the hair to thin and a reduction in hair growth, and people who produce more DHT are more likely to lose their hair. Finally, ageing is a hugely significant factor in hair loss - the vast majority of people will lose their hair to some extent as they get older.
That said, hair loss is not simply caused by hereditary factors. Alopecia - otherwise known as spot baldness - is a condition that causes hair loss in some or all areas of the body. Alopecia is believed to be an autoimmune disease caused by a breach in the immune privilege of the hair follicles. The condition varies hugely in severity between cases: some people only have small bald spots, while others suffer total loss of body hair. Some people will go into full remission over time, while others won’t respond to treatment at all. Alopecia affects one in every 500 people in the UK, making it far rarer than pattern baldness.
There are a multitude of other factors that can lead to hair loss at points in a person’s life. Cancer patients, for example, will lose their hair while undergoing chemotherapy. Illness, emotional trauma and malnutrition can all weaken hair growth. Medical conditions such as thyroid disease and iron deficiency anemia can also cause you to lose your hair. The causes of hair loss are so diverse that before you think about taking steps towards hair regrowth, it’s worth seeing your GP to rule out serious illness.
How much hair loss is normal?
Everyone sheds hair. Most healthy people have between 80,000 and 120,000 hairs on their head, and on average shed 50-100 hairs a day. Shedding happens as part of the body’s natural renewal cycle, so don’t be concerned if you’re seeing a few hairs in the shower or caught on your hairbrush. Naturally, those who style their hair may lose more of it - so if you’re concerned about shedding, it might be useful to lay off the wax and hairspray.
Can stress cause hair loss?
Yes. In addition to products and hairstyles that put stress on the hair follicles, excessive shedding can also occur as a result of stressful events or acute illnesses. Alongside alopecia, which can be brought on by stress, there are two other types of stress-related hair loss: telogen effluvium and trichotillomania. Telogen effluvium occurs when significant stress pushes large numbers of hair follicles into a resting phase, causing affected hairs to fall out suddenly when combing or washing your hair. Trichotillomania, on the other hand, is an irresistible urge to pull hair from your scalp or other areas on your body. In addition to stress, trichotillomania can be brought on by boredom, loneliness or frustration.
How can I stop hair loss?
In order to prevent further hair loss, you must determine why your hair is falling out in the first place. For stress-related hair loss, it’s best to start by addressing the cause of your stress. What can you do to remove excess stress from your life? Is there anything you can do to offset your stress, such as exercise or meditation? Are your stress levels something worth seeing your GP about? These are all questions worth asking before embarking on a hair regrowth regimen if your hair loss is stress-related. Similarly, any hair loss caused by an underlying medical condition should be treated by focusing on the illness first.
Hereditary hair loss, on the other hand, takes place regardless of stress or illness (though those things can certainly make it worse). A receding hairline can cause dread in those who really love their hair, but don’t panic - there are treatments that can slow the progress of pattern baldness and even stop it in its tracks. A combination of prescription medication, regrowth products and the right shampoo can prevent further hair loss and leave you feeling confident.
What treatments can help stop hair loss?
The most effective way to treat hair loss requires the use of a combination of different treatments. The first (and most widely-used) is minoxidil, a topical treatment applied twice daily to a dry scalp in the area your hair is thinning. The second is finasteride, a prescription medication taken daily that works by suppressing the hormone responsible for hair loss. The third treatment is shampoo designed to encourage hair growth. The shampoos are typically caffeine-based.
What causes hair loss in women?
Hair loss in women can be caused by many of the same issues that cause it in men. However, female-pattern baldness is different to the male version in that it is typically caused by an underlying disorder, specifically an endocrine condition or hormone-secreting tumour. In premenopausal women, an excess of the hormone androgen can induce hair loss alongside a host of other symptoms, including acne, weight gain, excessive chest and facial hair and irregular menstruation.
If you’re experiencing a combination of these symptoms, we recommend seeing your GP to investigate.
Do minoxidil, finasteride and hair loss shampoos work for women?
Unfortunately, finasteride is a medication designed specifically to treat male-pattern baldness. Although women do carry the hormone testosterone, finasteride has been shown to have adverse effects on women who take it. It is not suitable for women and should not be taken by women suffering from hair loss.
Thankfully, minoxidil and hair loss shampoos are both suitable treatments for women suffering from hair loss. There are even minoxidil products specifically formulated for women, and any shampoo designed to prevent hair loss will be suitable for women as well.
How does minoxidil work?
Minoxidil is an antihypertensive vasodilator used to treat male-pattern baldness. By encouraging blood flow to the hair follicles of the scalp, the treatment increases follicle size and hair shaft diameter. This helps hair regrow thicker in areas of the scalp where it was previously thinning. Minoxidil is clinically proven to be effective in promoting hair growth, stabilising hair loss in nine out of 10 men. In addition, 40% of men experience hair regrowth in areas of the scalp where it had stopped growing three to six months after beginning the treatment.
A topical treatment, minoxidil is typically available as a foam or solution. The treatment should be applied twice a day, to a completely dry scalp, approximately 12 hours apart. When you start using minoxidil, you may notice more hair falling out than had been previously. But don’t panic - extra shedding when beginning with minoxidil is completely normal, and happens as dormant hair follicles are replaced by newer ones.
Although minoxidil is generally very well-tolerated by most people who use it, there are some side effects. Some users may notice burning or irritation of the eye after use, while others can experience redness and irritation in the treated area. Others may experience unwanted hair growth in order areas of the body, and in rare cases hair loss can be exacerbated by the product.
How does finasteride work?
Dihydrotestosterone (DHT) is a hormone that causes the hair to thin and hair growth to decrease. DHT is converted from testosterone by the enzyme 5-alpha reductase, producing symptoms of pattern baldness. Finasteride works by inhibiting that enzyme, preventing testosterone being converted into DHT and lowering the levels of DHT in the scalp. Finasteride has been shown in long term trials to be highly effective; one clinical study found that nine in 10 men either regrew hair or had no further hair loss.
Finasteride is taken orally once a day and always comes in a dose of 1mg. While finasteride is highly effective at combating hair loss, it must be taken continuously to be effective. If you stop taking finasteride at some point, any hair prevented from falling out or grown thanks to the treatment will fall out, and pattern baldness will resume.
A single pill a day is a convenient way to combat hair loss, but it’s important to make clear that finasteride does have some side effects. Men taking finasteride often experience a reduced sex drive and in some cases erectile dysfunction. These side effects, however, can subside if you’ve been taking the drug for some time.
What are the best shampoos for hair loss?
Some shampoos are specifically designed to help prevent hair loss. These products tend to contain active ingredients - typically caffeine - that help stimulate and strengthen weakened hair roots. In order to be effective, caffeinated shampoos should be applied daily and left in the hair for a minimum of two minutes. If left for more than two minutes, more caffeine will be absorbed into the scalp - so, the longer, the better.
There are currently no clinical studies assessing the effectiveness of caffeinated shampoos, so empirical evidence is unavailable. However, online reviews of caffeinated shampoos are typically very positive, and some experts believe they could be a useful supporting treatment when taken alongside minoxidil.
Side effects when using caffeinated shampoos are very rare, but can include redness and burning of the scalp in some cases.