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Hair Loss

Hair loss, or alopecia, is a common condition that affects millions of men and women globally. While it is often seen as a cosmetic issue, hair loss can significantly impact self-esteem, mental health, and overall quality of life. The causes of hair loss are multifactorial, including genetics, hormonal imbalances, medical conditions, nutritional deficiencies, and environmental factors.

There are many forms of hair loss, ranging from temporary shedding to permanent baldness. Effective management depends on identifying the underlying cause and implementing the appropriate treatment strategy. Recent advancements in regenerative medicine, such as platelet-rich plasma (PRP), stem cell therapy, and low-level laser therapy, are expanding treatment options beyond conventional approaches.

Types of Hair Loss

Androgenetic Alopecia (Male and Female Pattern Baldness):

  • Most common form of hair loss
  • Caused by genetic and hormonal factors
  • Typically involves receding hairline and thinning crown in men; diffuse thinning over the scalp in women

Alopecia Areata:

  • Autoimmune condition where the immune system attacks hair follicles
  • Presents as round patches of hair loss on the scalp or body

Telogen Effluvium:

  • Temporary hair shedding due to physical or emotional stress, surgery, childbirth, or illness
  • Hair falls out after entering the resting (telogen) phase prematurely

Anagen Effluvium:

  • Sudden hair loss during the growth phase due to chemotherapy or radiation

Traction Alopecia:

  • Hair loss due to repetitive pulling or tension (e.g., tight hairstyles)

Cicatricial (Scarring) Alopecia:

  • Inflammatory disorders that destroy hair follicles and replace them with scar tissue

Causes and Risk Factors

  • Genetics: Family history of hair loss is a strong predictor
  • Hormonal imbalances: Conditions like polycystic ovary syndrome (PCOS), thyroid disorders, and menopause
  • Nutritional deficiencies: Iron, vitamin D, zinc, and biotin
  • Medications: Chemotherapy, anticoagulants, beta-blockers, retinoids
  • Stress and illness: Major life events, infections, or autoimmune diseases
  • Scalp infections: Fungal infections like ringworm

Hair Growth Cycle

Hair grows in cycles consisting of three main phases:

  • Anagen (Growth Phase): Lasts 2–7 years; determines hair length
  • Catagen (Transition Phase): Lasts 2–3 weeks; hair stops growing
  • Telogen (Resting Phase): Lasts 2–3 months; hair falls out and new hair begins to grow

Disruption in this cycle can result in excessive hair shedding or thinning.

Diagnosis

Evaluation of hair loss involves:

  • Medical history and physical examination
  • Hair pull test: To assess active shedding
  • Scalp biopsy: For suspected scarring alopecia or autoimmune conditions
  • Blood tests:
    • Thyroid function
    • Iron levels and ferritin
    • Hormonal profile (testosterone, DHEA, prolactin)
    • Vitamin D and B12 levels
  •  Dermatoscopy: Examination of scalp and hair under magnification

Conventional Treatments

Topical treatments:

  • Minoxidil (2% or 5%): FDA-approved for male and female pattern hair loss
  • Applied directly to the scalp to stimulate hair growth and prolong the anagen phase

Oral medication:

  • Finasteride: Inhibits 5-alpha-reductase, reducing DHT levels (approved for men only)
  • Spironolactone: Anti-androgen used in women with hormonal hair loss
  • Oral minoxidil: Off-label use for hair growth in low doses

Corticosteroid injections:

  • Used in alopecia areata to suppress immune activity and reduce inflammation

Anti-inflammatory and immunosuppressive drugs:

  • Methotrexate, cyclosporine in severe autoimmune alopecia

Hair Restoration Procedures

Hair transplant surgery:

  • Follicular unit transplantation (FUT)
  • Follicular unit extraction (FUE)

Scalp micropigmentation: Cosmetic tattooing to simulate hair density

Regenerative Therapies

Platelet-Rich Plasma (PRP) Therapy:

  • Involves injecting concentrated platelets from the patient’s own blood into the scalp
  • Platelets release growth factors that stimulate hair follicle activity and new growth
  • Typically performed in 3–6 sessions over several months

Stem Cell Therapy:

Overview: Use of autologous stem cells (e.g., from adipose tissue or bone marrow) to regenerate damaged hair follicles

Mechanism:

  • Promotes angiogenesis (new blood vessel formation)
  • Stimulates follicular regeneration and reduces inflammation

Evidence:

  • Research shows improvement in hair density and thickness
  • Still under research; not yet FDA-approved

Exosome Therapy:

  • Exosomes are extracellular vesicles derived from stem cells
  • Contain proteins, RNA, and growth factors that support follicle repair and regeneration

Low-Level Laser Therapy (LLLT):

  • Non-invasive treatment that uses red or near-infrared light to stimulate hair follicles
  • Improves cellular metabolism and blood flow in the scalp

Supportive and Holistic Management

Diet and nutrition:

  • Adequate intake of protein, iron, zinc, and biotin
  • Omega-3 fatty acids for scalp health

Stress reduction:

  • Yoga, meditation, and counseling to manage chronic stress and anxiety

Proper hair care:

  • Avoid harsh treatments and excessive heat styling
  • Gentle shampoos and conditioners suitable for sensitive scalps

Scalp massages:

  • Stimulate blood flow and support follicle activity

Monitoring and Follow-up

  • Regular photography to track progress
  • Re-evaluation of hormonal and nutritional status
  • Adjustments in treatment based on response

Psychological Support

  • Hair loss can cause emotional distress, social withdrawal, and depression
  • Support groups, therapy, or counseling may help in coping with appearance-related anxiety

Conclusion

Hair loss is a multifaceted condition that requires individualized assessment and treatment. Whether due to genetics, hormones, stress, or medical issues, many forms of hair loss are manageable or reversible with the right care. Advances in regenerative medicine—particularly PRP, stem cell therapy, and laser treatment—offer new hope for restoring hair growth and scalp health. A combination of medical therapy, lifestyle changes, and innovative treatments can help individuals regain confidence and achieve .

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