Hair Loss

Hair is one of those things that seems to stress people quite a lot, with concerns of too much or not enough hair, or hair in the wrong places. Dr Joe Kosterich talks about hair loss, including differences between men and women, hair loss with age, the effect of testosterone on hair, other causes of hair loss, and what we can do about hair loss.
It’s a little known fact that men and women actually have the same number of hair follicles per square centimetre of skin. Hair is one of those things that seems to stress people quite a lot. There seems to be a whole group of people concerned that they have too much hair, or hair in the wrong place, and there is a whole second group of people concerned that they haven’t got enough hair or again, they haven’t got quite enough where they would like it to be.
On the plus side, in the vast majority of instances, there is no medical problem underlining this. We will talk about a couple of issues through the video but generally speaking, it is more about appearance than about anything that’s actually “wrong” with you.
In this video we are going to be focusing more on hair loss. Now, this is where it is a little different for males and females. Most males will lose some hair as they grow older. What’s described as Male Pattern Baldness is exactly that; the hair starts to recede from generally the front. For some people it starts as young as their 20s, some people in their 50s or 60s, and obviously you do see the occasional 90-year-old who still has a reasonably full head of hair.
There is a genetic pattern to this and there is not a huge amount you can do about your genes. The main reason behind male pattern baldness is thought to be levels of DHT, or dihydrotestosterone, within the blood stream. Testosterone, a male hormone, does seem to affect the follicles that produce hair. The body will produce a certain amount of testosterone and there’s not a lot you can actually do about that. It is the testosterone that does affect the hair follicles and impacts on their growth.
There are other causes of hair loss and it can include problems with the thyroid gland or anaemia. These are rarer causes, but certainly – and particularly with women – it’s worth having tests for that if you’re starting to lose hair and you think it’s a little bit odd.
Stress in some people can also cause hair loss. Some people who are anorexic can have hair loss and, of course, there are medications that can lead to hair loss: chemotherapy being the most famous. In those instances, people are pretty familiar with what’s going on and what to expect.
So what can we actually do about hair loss? There are a number of options these days and not all of them are guaranteed to work. There are some medications and these are often used by males. They are available from your doctor on prescription and the way they work is by blocking testosterone receptors. Again, sometimes the side effects can be a bit problematic; one of the biggest side effects is a potential drop in libido and sometimes problems with getting and maintaining an erection, so that can be a trade off. People sort of think, “great my hair is growing better but I’m not quite as happy with the side effects as I might be.” Not everybody gets the side effects so you don’t have to assume that that will be a problem, but obviously for some it’s going to be a show stopper.
There are some topical applications that can be used – these are like a lotion that can be put on the head – and again, it doesn’t work for everybody but there is a reasonable response in about 50% of people. With both the tablets and the lotion – and the lotion can be used by women as well, the tablets can’t be – they do only work for the time you take them. There may be a carry-over effect but you do need to use it consistently.
Hair transplants are commonly done these days and they can be done generally under local aesthetic. It is literally about taking hair from one part of the scalp – usually the area towards the back of the head and over the ears will retain hair longer than the front of the scalp. You can literally take a little bit of hair – much like transplanting a plant in the garden: you take it out roots and all – and move it somewhere else. They can be quite successful and people can have a series of those.
There are, as mentioned, lots of treatments available for hair regrowth. Some of them can be expensive, that’s not the say you shouldn’t go down that path, but it is to say that you should ask plenty of questions before you sign up or agree to anything.
As I mentioned, there are really only a few basic forms of treatments; there are variations on those themes but the rationales are the same. So be aware that prices can vary and whilst getting the cheapest deal doesn’t make it the best deal, just be aware that it is worth making enquiries in a few places. Make sure you ask lots of questions about what you can expect, both from the point of view of success, but also potential side effects.
Again, if there are problems with your thyroid gland or if you’re anaemic then correcting those underlying problems is obviously step one. In that instance, the hair may well regrow by itself. If people are under stress and that’s affecting their hair, then again, dealing with the stress is the key. So where there is an underlying issue, the key is dealing with the underlying issue.
So to sum up, hair loss – certainly for males – is very common, not a given, but not far from it. That doesn’t mean you have to accept it; there are some treatment options. Nothing is entirely side effect free and you have to balance those things off. Not everybody gets the side effects and they will be quite okay. Make some enquiries, find out what your options are and then decide what’s the best thing for you to do.