It was his four-year-old son who first noticed John Brandt’s hair loss. “He said I had a hole in the back of my head,” says the 30-year-old, Toronto-based consultant who prefers to use a pseudonym. “It was a bit of a surprise, given how early it started — most of my family gets male pattern baldness [thinning hair at the hairline and on the top of the head] but at a much later stage in life.”
Brandt was initially wistful about losing his hair. “I got comments from hairdressers on its thickness, so it was somewhat disappointing that I was going bald.” But he says he has dealt with it, opting to try a shampoo that promises to slow hair loss rather than taking medications. He believes it has slowed down the hair loss.
“I do occasionally wonder what I will do when I have lost more, as it will require some styling changes,” says Brandt. “Would I go with a comb-over? Shave my head?”
Causes of hair loss
Hair loss is very common. “Genetic hair loss, sometimes called androgenetic alopecia, affects about 50% of men and 30% of women by age 50,” says Dr. Jeff Donovan, a Toronto dermatologist and hair transplant specialist. “Other hair loss conditions such as shedding issues affect 20% to 40% of women.”
The causes of hair loss are myriad, according to the Capilia Group, a network of hair loss professionals. They include:
- Aging and diminishing levels of estrogen in menopausal women and testosterone in middle-aged men
- Autoimmune conditions, such as alopecia areata (when patches of hair fall out), alopecia totalis (loss of the whole head of hair) and alopecia universalis (loss of all body hair), lupus and scleroderma
- Nutritional deficiencies
- Thyroid issues
- Over-styling or over-dyeing hair, or continually pulling it back too tightly (called traction alopecia)
- Certain medications, such as steroids and chemotherapy drugs
- Hormonal fluctuations brought on by birth control, pregnancy and childbirth
- Infections and scarring
Whatever the reason, the emotional fallout from hair loss for both men and women can be serious. It can lead to avoiding social situations, issues at work, loss of confidence and depression. “There is a normal grieving process that accompanies hair loss,” says Donovan.
Treating hair loss
Treatments are available that can slow hair loss or even restore hair growth, Donovan adds. “With the exception of some hair-shedding problems, there are no cures for most of the types of hair loss, but there are good treatments for many of those that aren’t curable.” He says a treatment plan begins with an assessment of the patient’s type of hair loss to determine whether it is genetic or caused by an underlying issue.
Some approaches include:
- For hair loss due to low iron levels or low thyroid hormone levels (which can lead to shedding) iron supplements or thyroid pills can be curative, says Donovan.
- Genetic hair loss can be more difficult to treat, but topical, oral and surgical methods may be options. These can include finasteride pills for men, which are 90% successful in halting hair loss, minoxidil for men and women (30% to 40% success rate) or hair transplantation.
- For autoimmune conditions such as alopecia areata, a range of topical medicines, steroid injections into the scalp or pills can be used, says Donovan.
- For hair loss due to scarring, treatments include steroid lotions, creams, injections and immunosuppressive pills.
Before starting any hair loss product or treatment, Donovan recommends a visit to a dermatologist. Blood tests or scalp biopsies may be needed for an accurate diagnosis.
And read the fine print on any hair loss medications. Early in 2012, Health Canada issued a warning about a slightly increased risk of aggressive prostate cancer in men taking hair-loss products containing finasteride and dutasteride over longer periods of time. Discuss any concerns you have with your doctor.
Worried about losing your hair? Keep these tips in mind:
- Keep an eye on your hairbrush. It’s normal to lose between 50 and 100 hairs per day. More than 100 may signal a shedding issue.
- Avoid low-calorie diets. If you’re eating less than 1,300 calories a day, hair loss may be a side effect.
- Many women lose some hair after the birth of a baby. Don’t panic; it usually grows back in a few months.