This article is a translation of the original French article “Les causes les plus fréquentes de la perte de cheveux” and is intended for the French market. Treatments, availability and prices may differ at our London clinic.
Baldness and androgenetic alopecia
Androgenetic alopecia, often referred to as baldness, is the most common cause of hair loss in both men and women. It affects over 70% of men and 57% of women over the age of 80. However, this condition can begin much earlier, sometimes as early as your thirties.
In men, this form of baldness usually shows up as a receding hairline at the temples or thinning on the crown. Picture an "M" gradually taking shape on the forehead. Over time, this can progress to complete baldness on top of the head, while the hair on the sides and back is retained.
For women, it is a little different. Hair loss often starts on the crown and is characterised by diffuse thinning. The hair becomes finer, but the frontal hairline generally remains intact. There is no "M" in women, but rather an overall reduction in hair density.
So why does this happen? The answer lies in our genes and our hormones. Dihydrotestosterone (DHT), a derivative of testosterone, plays a key role. In predisposed individuals, DHT binds to the hair follicles, making them smaller and weaker. The result: hair becomes finer and shorter, and eventually stops growing back.
Treatments do exist, but they often require patience and perseverance. Minoxidil, for example, can help slow hair loss and stimulate growth. However, results are only visible in around 30 to 40% of users and can take several months to appear. Finasteride, for its part, blocks the action of DHT on the hair follicles. Effective for many men, it can nonetheless cause side effects such as reduced libido.
For those looking for more permanent solutions, a hair transplant is an option. This technique involves harvesting hair follicles from a dense area and implanting them into a thinning area. The results can be impressive, offering a lasting solution, but it is important to consider the cost and the recovery time.
However, baldness is not the only cause of hair loss. Another factor, often overlooked but just as crucial, is hormonal imbalance.
Hair loss due to hormonal imbalance
Our hair depends closely on our hormones. A hormonal imbalance can be a major cause of hair loss, in men and women alike. Let's look at how this works in detail.
In women, an excess of male hormones, known as androgens, can cause alopecia. This type of hair loss is often accompanied by other symptoms such as excessive hair growth on the face or body, a deeper voice, or irregular menstrual cycles. This phenomenon is often seen in conditions such as polycystic ovary syndrome (PCOS), in which the body produces more androgens than normal.
Men are not spared either. A hormonal imbalance, in particular a sharp rise in testosterone, can weaken the hair follicles. Testosterone is converted into dihydrotestosterone (DHT), a hormone that binds to the hair follicles and makes them smaller and weaker. The result: hair becomes finer and eventually falls out.
But that is not all. Hormonal changes linked to pregnancy, childbirth, the menopause or even stopping the contraceptive pill can also trigger hair loss. For example, after childbirth, oestrogen levels drop sharply, which can lead to temporary but sometimes dramatic hair loss.
So what should you do if you think your hormones are to blame? The first step is to consult a doctor or a dermatologist. They can carry out tests to check your hormone levels and identify any imbalances. Once the problem has been identified, several treatments may be considered:
- Medication: medicines such as anti-androgens can help reduce levels of male hormones in women.
- Hormone therapies: for menopausal women, hormone replacement therapy may be an option.
- Lifestyle changes: sometimes, adjustments to diet or stress management can help rebalance hormones.
However, hormones are not the only culprits. Medication and medical treatments can also play a significant role in hair loss.
Hair loss caused by medication and medical treatments
Certain medicines and medical treatments can have unexpected side effects, including hair loss. This problem may be temporary or permanent, depending on the treatment and the patient's response.
Take chemotherapy drugs, for example. These treatments, essential in fighting cancer, attack not only cancer cells but also healthy, fast-growing cells, such as those in the hair follicles. The result: hair loss that is often rapid and significant. Fortunately, this loss is generally reversible once treatment stops.
Anabolic steroids, often used to build muscle mass, can also cause hair loss. They increase testosterone levels, and testosterone is converted into dihydrotestosterone (DHT), a hormone that weakens the hair follicles. This mechanism is similar to that of androgenetic alopecia.
However, medication is not the only potential culprit behind hair loss. Eating habits and nutritional deficiencies also play a crucial role in hair health.
Eating disorders and nutritional deficiencies
Eating disorders and nutritional deficiencies can seriously affect the health of your hair. You may not know it, but a lack of certain essential nutrients can lead to alopecia. For example, iron and zinc deficiencies are often responsible for hair loss. Iron is crucial for blood formation, and without it, your hair follicles do not receive the oxygen they need to function properly. Zinc, for its part, helps synthesise keratin and collagen, two essential components of strong, resilient hair.
But that is not all. An excess of vitamin A can also cause hair loss. Yes, even vitamins can work against you if they are not balanced. Other nutrients such as B vitamins, copper, silicon and vitamin D are also important. A vitamin D deficiency, for example, can leave your hair dull and brittle.
So how can you tell if you are deficient? Symptoms may include fatigue, muscle cramps, vision problems and, of course, hair loss. To avoid these deficiencies, it is essential to maintain a varied, balanced diet. Make sure to include protein, fruit, vegetables and fatty acids such as those found in oily fish, avocados and almonds. If necessary, food supplements can also be a solution, but always under the supervision of a healthcare professional.
The impact of physical and psychological stress on hair loss
Stress, whether physical or psychological, can play a major role in hair loss. Imagine a stressful event, such as an emotional shock or a period of intense fatigue. Two to three months later, you might notice heavier hair shedding than usual. This is known as telogen effluvium, a reactive form of hair loss.
Stress affects the hair follicles by disrupting their growth cycle. Normally, your hair goes through phases of growth, rest and shedding. Stress can push hairs into the resting phase prematurely, leading to sudden shedding. Stress hormones such as cortisol can also slow keratin production, making hair more fragile.
But that is not all. Stress can also cause scalp inflammation, poor blood circulation and excess sebum, all factors that contribute to hair loss. To curb this shedding, it is crucial to tackle stress at its source. Here are a few strategies:
- Stress management: practise meditation, controlled breathing or visualisation-based relaxation. These techniques can help calm your mind and reduce stress.
- Balanced diet: make sure you consume enough protein, vitamins (such as B and D vitamins), iron, zinc and omega-3s. These nutrients are essential for healthy hair.
- Physical activity: regular exercise can not only reduce stress but also improve blood circulation in the scalp.
- Food supplements: anti-stress supplements such as magnesium can help maintain nervous balance and support hair growth.
Remember, hair loss due to stress is generally temporary. Once the source of stress has been removed or managed, your hair tends to regenerate. However, if the shedding persists, it is always wise to consult a healthcare professional for a more in-depth diagnosis.
Diagnosis and tests for hair loss
To find out why your hair is falling out, an accurate diagnosis is essential.
A trichogram is a microscopic examination of the hair roots. It measures the proportion of hairs in the growth and resting phases, which can provide clues as to the cause of the hair loss. Trichoscopy, meanwhile, is a non-invasive method that uses a dermatoscope to examine the scalp and hair. It measures several parameters, such as hair density and the presence of abnormal hairs.
Treatments for hair loss
Several options exist for treating hair loss, each with its own advantages and drawbacks. Here is an overview of the most common treatments.
Minoxidil, often the first treatment recommended, is available as a topical solution in two strengths: 5% for men and 2% for women. It helps slow hair loss and stimulate growth. However, patience is required: results can take several months to appear and stop as soon as treatment is discontinued.
Finasteride, prescribed under the name Propecia and its generics, is another option for men. This medicine blocks the action of DHT, a hormone responsible for the miniaturisation of hair follicles. Although effective for some, it can cause serious side effects, such as reduced libido. It is therefore crucial to discuss its risks with a doctor.
For those looking for more natural solutions for minimal shedding, food supplements can be helpful. B vitamins (especially B6 and B8) and certain amino acids such as cystine and methionine are essential for healthy hair. These nutrients can strengthen fragile hair and support its growth.
A hair transplant is a more permanent option. This technique involves harvesting hair follicles from a dense area (often the nape of the neck) and implanting them into a thinning area. The results can be impressive, but it is important to consider the cost and the recovery time.
