What are the ways to prevent hair loss?

Preventing Hair Loss: Evidence-Based Strategies

To effectively prevent hair loss, start with topical 5% minoxidil once daily, check and correct deficiencies in vitamin D, zinc, iron (ferritin), and thyroid function, and consider oral finasteride (1mg daily) for men with androgenetic alopecia. 1

Understanding the Causes of Hair Loss

Hair loss can result from multiple factors:

• Androgenetic alopecia: Most common form affecting up to 50% of men by age 50 2
• Nutritional deficiencies: Major cause in women before age 50, affecting 30% 2
• Medical conditions: Thyroid disorders, autoimmune diseases
• Medications: Chemotherapy, certain drugs
• Physical trauma: Tight hairstyles, hair pulling

Evidence-Based Prevention Strategies

1. Micronutrient Optimization

• Vitamin D: Essential for normal hair follicle function; deficiency is associated with alopecia areata 3

  • Check serum 25(OH)D levels and supplement if deficient
  • Vitamin D functions as a steroid hormone and plays a role in hair follicle keratinocytes 3

• Zinc and Iron: Critical for hair growth

  • Check ferritin levels even without anemia 1
  • Morning zinc levels should be measured 1
  • Correction of these imbalances can stop excessive hair loss 2

• Thyroid Function:

  • Thyroid function tests (TSH and free T4) should be initial laboratory evaluation 1
  • Consider checking thyroid antibodies (TPO) if abnormalities found 1

2. Pharmacological Interventions

• Topical Minoxidil:

  • First-line treatment for androgenetic alopecia 1, 4
  • Use 5% solution/foam once daily 1, 5
  • Continue for at least 6 months to evaluate response 1
  • Apply using dropper applicator, 1mL per application 5
  • Results may take 2-4 months to become visible 5

• Oral Finasteride (for men only):

  • 1mg daily inhibits 5-alpha-reductase enzyme 1
  • Regrows noticeable amount of hair in about 40% of balding men 2
  • Not for use by women, especially pregnant women 1, 5
  • Side effects may include sexual dysfunction 1

3. Advanced Therapies

• Low-level laser therapy:

  • Use 3 times weekly as a non-pharmaceutical option 1
  • Minimal side effects reported 1

• Platelet-rich plasma (PRP) therapy:

  • Alternative or adjunctive option 1
  • Initial treatment phase: 3 sessions at 4-6 week intervals 1
  • Maintenance sessions every 6 months 1

• Scalp cooling:

  • Recommended to prevent chemotherapy-induced alopecia 3
  • Contraindicated in hematological malignancies and certain conditions 3

Monitoring and Follow-up

• Evaluate treatment response at 3 months (early signs of improvement) 1
• Critical evaluation at 6 months (significant improvements should be noticeable) 1
• Comprehensive evaluation at 12 months 1
• Continue effective treatments indefinitely to maintain results 1

Cautions and Considerations

• Avoid using minoxidil if scalp is red, inflamed, infected, or painful 5
• Stop minoxidil if chest pain, rapid heartbeat, dizziness, or unwanted facial hair growth occurs 5
• Finasteride should not be handled by pregnant women due to potential risks to male fetus 1
• Biotin and orthosilicic acid can be considered but are not generally recommended 3
• For chemotherapy-induced hair loss, scalp cooling is recommended 3

Hair loss can significantly impact psychological well-being and quality of life 4, 6. Early intervention with evidence-based strategies can help prevent progression and potentially reverse hair loss in many cases.