From the Guidelines
Hair loss is primarily caused by a combination of genetic, hormonal, and environmental factors, with androgenetic alopecia being the most common cause, and can be effectively managed with treatments such as topical minoxidil, oral finasteride, and addressing underlying nutritional deficiencies, as supported by recent studies 1.
Causes of Hair Loss
The causes of hair loss are multifaceted and can include:
- Genetics: Androgenetic alopecia (male or female pattern baldness) is hereditary and involves the hormone dihydrotestosterone (DHT) shrinking hair follicles.
- Hormonal changes: Thyroid disorders, hormonal imbalances, and menopause can lead to hair loss.
- Medical conditions: Autoimmune conditions like alopecia areata, stress-related telogen effluvium, and skin conditions such as psoriasis and eczema can cause hair loss.
- Medications: Certain medications, including chemotherapy drugs, blood thinners, and some antidepressants, can lead to hair loss.
- Lifestyle factors: Poor nutrition, physical trauma to the hair, and excessive styling can contribute to hair loss.
Nutritional Deficiencies and Hair Loss
Recent studies have highlighted the importance of micronutrients in hair growth, with deficiencies in vitamins D, zinc, and folate being associated with alopecia areata 1. While the current evidence is largely based on small case-control studies and case reports, it suggests that maintaining adequate levels of these micronutrients may be beneficial for hair growth.
Treatment Options
Treatment for hair loss depends on the underlying cause and may include:
- Topical minoxidil (Rogaine) for promoting hair growth and slowing down hair loss.
- Oral finasteride (Propecia) for men with androgenetic alopecia.
- Anti-inflammatory medications for autoimmune conditions like alopecia areata.
- Hormone therapy for hormonal imbalances.
- Addressing underlying nutritional deficiencies, such as supplementing with vitamins D, zinc, and folate, as supported by recent research 1. Intralesional corticosteroids, such as triamcinolone acetonide, can also be effective in stimulating hair regrowth, particularly in cases of alopecia areata, as shown in a study published in the British Journal of Dermatology 1.
From the Research
Causes of Hair Loss
- Androgenetic alopecia (AGA) is the most common cause of hair loss, often challenging to treat 2, 3, 4, 5
- Other causes of hair loss include:
- Telogen effluvium: a nonscarring, noninflammatory alopecia of relatively sudden onset caused by physiologic or emotional stress 4
- Trichotillomania: an impulse-control disorder; treatment is aimed at controlling the underlying psychiatric condition 4
- Trichorrhexis nodosa: occurs when hairs break secondary to trauma and is often a result of hair styling or overuse of hair products 4
- Anagen effluvium: the abnormal diffuse loss of hair during the growth phase caused by an event that impairs the mitotic activity of the hair follicle, most commonly chemotherapy 4
- Genetic factors or predisposition 5, 6
- Vitamin and mineral deficiencies 6
- Skin problems, hair growth disorders, poor diet, hormonal problems, certain internal diseases, drug use, stress and depression, cosmetic factors, childbirth, and the chemotherapy process 6
Factors Contributing to Hair Loss
- Genetic factors: individual diversity of causal agents, as well as of the sequence of events, or combined factors, must be kept in mind 5
- Androgens: play a crucial role in the development of androgenetic alopecia 2, 5
- Prostaglandins and epigenetic factors: also contribute to the development of pattern hair loss 5
- Nutrition: the Mediterranean diet, rich in antioxidant, anti-inflammatory components, may play a role in hair loss treatment 6
- Microbiomata, oxidative stress, and microinflammation: additional pathogenic factors that are suspected to contribute to pattern hair loss 5