Why Your Hair Is Falling Out and How To Fix It

Today, we're talking about a pretty sensitive subject: hair loss. 

I know how detrimental losing your hair can be, for both men and women, but especially for women.

As a licensed cosmetologist I often get people asking me what to do about their hair thinning or falling out. And the very first thing to understand, just as I tell all my clients who ask about this: hair loss is a complicated subject, without a single solution.

I don't want to get your hopes up, nor do I want you to feel hopeless. The truth is that there are many things that you can try that have proven to be effective. And it's usually through a combination of actions that you can (in many cases) reverse your hair loss.

Remember, knowledge is power. So you do have to start with learning things so that you'll know which steps are right for you.

So that's what we're going to go through together, right now in this post. 

Let's lay some basic understanding of hair loss and of course, I am going to list out actionable steps for you to try out (I sure do love me a good list. Who's with me on that? lol)

As always, I want to keep this post as simple as possible to understand. So while I am going to be providing a lot of detail here, I'm going to avoid going into too much medical lingo and diving in too deep. Even if you are a total fact-finder, this post will be a good jumping off point for your own research on potential treatment options.

Please note: I am not a doctor. The information on this blog is for educational & informational purposes only, and does not constitute medical advise. You should consult your healthcare provider if you are seeking medical advise, diagnosis, or treatment. I will not be held liable for any direct, indirect, consequential, special, exemplary, or other damages arising therefrom.
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What the Heck Is Hair Anyway?

Before we can get into why you might be losing your hair and how to help resolve it, it's essential to understand a little bit about your hair.

When you understand what your hair is made of and how it functions, you'll have an easier time getting to the root of the why & how for your hair loss.

​So first of all, hair is probably way more complex than you'd imagine. But I only want to focus on mainly two parts: the hair bulb & the hair shaft.

The hair bulb contains living cells which divide and grow, in order to build the hair follicle (which holds the hair in place) and the hair shaft (which is what you see). Your blood vessels nourish the cells in the hair bulb, and deliver the hormones that your hair needs to grow.

The hair shaft is mostly made up of a protein called Keratin. It also contains some amino acids. There's a bit more to the structure of the hair, but for our purposes today, that's the important bit. 

The second thing to understand is that your hair follicles go through a cycle of growing, shedding, resting, and then repeating. Typically, 80-90% are in a growth phase, while 10-20% is in the rest phase. 

This is why it is totally normal to loose about 50-150 hairs a day — they have moved to the shedding and resting phase together (BFFs-for-life status. lol).

When you have more hair than that shedding at the same time, that's when you'll notice your hair feeling and maybe even looking thinner (particularly on your scalp).

Ok, so hopefully you've started to piece together some pretty important things for healthy hair & growth, and in simplest terms they are: nutrition, blood flow, and hormones.
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Why Am I Experiencing Hair Loss?

Now that you've got a very general overview of what your hair needs to be healthy, you can move onto the next step: determining the root cause of your hair loss.

Not all hair loss happens because of the same reason, and thusly, the treatment is going to vary. Further, there can be multiple reasons for hair loss.

Sometimes you may be able to figure out the root cause on your own, but if you are having extensive hair loss please get help from your doctor.

If we keep in mind the three things your hair needs, we can start to look at what things impact those. So let's look at two categories: external factors & internal factors.

External Factors

Yes, technically hair loss usually happens because of the "inner workings" of our bodies. But sometimes it might be happening due to something outside of yourself that you could get a handle on.

So let's look at a few common reasons:

• Stress - Stress can cause what's called telogen effluvium. This is essentially a, usually temporary, shedding of hair caused by stress. The stress causes your hair to move into that resting stage earlier than normal (aka the telogen stage). 
• Diet - Remember how we talked about protein, amino acids, and hormones? Well, your diet can make or break the health of your hair. If you aren't getting the right vitamins, eating healthy whole-foods, and getting enough protein you may experience hair loss.
• Medications - Many medications can cause hair loss as they have the tendency to impact your hormones. Sometimes you can be on something for years, and for whatever reason, your body is no longer ok with it. So talk with your doctor about what you've been experiencing, and see if there's potential alternatives.
• Shampoo & Conditioner - Ok, this one usually does not cause hair loss (although certain chemicals can very well do that, like DMD hydantoin), but it can cause the appearance of hair loss if you are using a poor quality product because it causes breakage. Thus, making your hair look thinner.
• Heat - Much like the bullet point above, heat does not cause hair loss (unless you burned yourself really badly), but it can dry out your hair and cause breakage.
• Physical Trauma - If you bumped your head, pull out your hair, or anything like that, it's possible that the hair follicle or bulb got damaged. Usually, it will only be a bald spot vs. your hair overall getting thin. In this case, it's really a 50/50 chance. If there's damage to the bulb, the hair most likely will not grow back. Additionally, really tight hairstyling (like braids or tight ponytails) can also cause that physical trauma for the hair follicle.

Now, I want you to be the detective for your life. What things from this list do you do?Has anything changed lately, within the last 6 months or so? Have you been particularly stressed out? What about self-care? You working out & eating healthy? Do you use professional-grade shampoo & conditioner? Take stock of the things going on and see if there's any red flags for you.
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Internal Factors

These get a bit tricker. Sometimes there's things that you can do, and sometimes there's not. In a very general sense, most of these internal factors have to do with hormones — and that's why it gets complicated.

Let's dive into the most common internal factors that can cause hair loss:

• Conditions - If you have something like a thyroid disorder, lupus, diabetes, anemia, PCOS or even a STI you could be experiencing hair loss because of it.
• Hair/Scalp Conditions - There are many different conditions that specifically affect your hair. These conditions would be things like: androgenetic alopecia (aka male pattern baldness or female pattern baldness), alopecia areata, alopecia totalis, alopecia universalis, scalp psoriasis, etc.
• Age - Unfortunately, as we age we loose collagen, often have poor circulation, and in combination with lifestyle, our body stops doing what it needs to to keep our hair the way it once was.
• Genetics - This is another one that you can't really control. It simply is what it is. You may be able to utilize some of the options I'm going to cover in a little bit and it may help, or at the very least slow down the hair loss. But your genes would contribute to things like male or female pattern baldness. Scientists think there's a gene that may affect how sensitive your hair follicles are to a hormone called DHT (dihydrotestosterone), which makes the hair follicles shrink.
• Pregnancy - Obviously, there is a lot of new hormones being introduced when you're pregnant. Some women may experience hair loss or even hair growth while pregnant, then after having the baby excessive shedding.

In addition to all of these things there's of course things like surgery, illness, cancer treatments, etc. that put the body's "internal workings" into shock or out-of-balance, and it goes without saying that that can affect your hair.

How To Improve Hair Loss

So far we've covered the 'what', and the 'why', which means we are ready to dive into the 'how'.

​I'm sure it goes without saying that there is no fool-proof method to cure hair loss. What works for one individual may not work for another. And I know that might be disheartening, but there are still things that you may be able to try depending on your situation.

So the first element to helping your hair loss is to try to uncover the source(s), and correct it.

Once you've narrowed down some potential reasons as to WHY you might be experiencing hair loss you may be able to correct things based on your specifics — like changing your medication with your doctor. Or learning that your thyroid is out of wack so you take the appropriate steps to bring back the hormonal balance. Maybe you've been incredibly stressed lately and so you can start to implement breathing & system regulation techniques.

Point being: sometimes you can attack the hair loss source head on.

So go back to the external and internal causes, and be the detective for your hair loss source.

In addition to trying to mitigate the hair loss source, you can also focus on the things we know help with hair health & growth — this is the second element.

Hair growth comes from, again in the simplest form, good nutrition, blood flow, and hormones.

I'm sure it goes without saying that none of those are solo-standing, but rather, all three need to work together. You can't usually just do one thing and then your hair loss is fixed. You need multiple things working together to combat hair loss & hair growth.

The sooner that you can implement these things the better! If the bulb dies, there's no bringing it back.

So let's dive into each of these in a bit more detail for hair growth (or the very least preventing further hair loss) .

Nutrition

Since we know that the hair needs specific nutrients, it stands to reason that there may be a deficiency by either you not consuming the proper amount of nutrients your hair needs, or you could have something getting in your body's way of properly using that nutrient (that's where you're going to need to talk with your doctor).

However, let's look at the list of things, in general, that you can give your body for healthy hair:

• Whole foods - Believe it or not, heavily processed foods can affect your hormones. Seems kind of crazy I know, but if you can start to eat foods that haven't been processed your hair will definitely thank you for it. It's going to take time before you start to see results (like 6 months).
• Protein - If you aren't getting enough of the one thing your hair is mostly made of, there's obviously problems to be expected. Your body is constantly making new hair and it can only grow from the nutrients available in your body. Protein rich foods, like fish, also have other essential ingredients for hair health like omega-3s fatty acids, or even L-lysine in meat. 
• Biotin - Although biotin deficiencies are rare among non-pregnant people, and there's not a lot of scientific evidence for biotin promoting hair growth, there is a lot of anecdotal evidence that biotin works. I've found it to be effective in my own personal experience; although it does not work for everyone. (Do note that biotin can cause some people to break out.) It essentially helps the body metabolize fats, carbohydrates, and protein. And it may also assist some people glycemic control when diabetes is involved — this would be important due to vascular impairment with type 2 diabetes.
• Iron, Zinc, Niacin, Vitamin A, Vitamin D, Vitamin C, Collagen, & L-lysine - All of these vitamins & minerals are important for various reasons but we know they've been shown to help with hair health and growth.

​In addition to these more well-known items (and in some cases better studied), that I just went through, there's also some other potential things to look into and try.

What I'm about to list doesn't have a lot of evidence backing them, but they seemed worth mentioning from my research. I'll let you be the judge for your own situation if these are something that you'd want to introduce into your diet and/or supplements:

• Selenium - A mineral that may help with hair growth, but you've got to be careful because too much of it can end up causing brittle hair.
• Ashwagandha - There is some promising research that the ashwagandha supplement may also help with stress-induced hair loss for WOMEN (without an auto immune disease or being pregnant). But, just FYI, all the available research seems to be done by the companies that sell this supplement.
• Saw Palmetto - This is for MEN, and there has been some limited studies showing that it may help with hair growth when combined with other topical treatments (like minoxidil). One study did show somewhat of an increase in hair growth when taken alone.

There are of course many other "holistic" supplements/treatments that people are touting as effective treatments for hair loss, but until I see more research and evidence backing them, I don't want to list them here as possible contenders. There's nothing worse, IMO, than searching for answers to something serious only to find endless lists of nonsense. (Am I right? or am I right?!)
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photo credit: Vegamour.com

Blood Flow

As I already mentioned, having good blood flow, delivering all those healthy nutrients and hormones to the hair bulb, can help hair grow.

Of course, all of these categories are a bit intertwined, as blood flow is not something that can operate purely on it's own, but here are the things that tap into this concept:

• Scalp massage - Although research is limited, the results seem promising. A good scalp massage is thought to stretch the cells of hair follicles — stimulating the follicles to produce thicker strands. It may also help dilate blood vessels beneath the skin, thereby encouraging hair growth.
• Minoxidil Topical Treatment - A very effective treatment for many people, backed by research, and it works by improving the blood flow around the hair follicle. Thusly, moving the hair from the resting phase to the growth phase. 
  It's incredibly important to know that there are strict guidelines for men & women. ***Men need the 5% and women cannot use anything more than the 2%. Unless advised by their doctor.***
• Dermarolling (Dermapen or Microneedling) - A study on men found significant improvement for men who derma rolled & used the topical minoxidil. I do also think that this would be effective for women as well since dermarolling results are not gender specific. 
• PRP Therapy - This can be combined with dermarolling, or may simply be injected into the scalp by a medical professional. PRP therapy began by dermatologists after researchers found that high concentrations of platelets in plasma cells help prolong the growing phase of the hair cycle. It's been shown to be effective for both men & women. 

It's important to understand that all of the things mentioned above cannot make hair that is non-existent grow. In other words, if the hair follicle/bulb is dead or never was there to begin with, you will not have more hair. These treatments mostly stop hair loss, while promoting "healthier conditions", so that the hair that is there can thrive.

Which puts even more emphasis on WHY you need to take action sooner rather than later.

Hormones

Hormones can either help or hurt your hair. It may be a good idea to visit an endocrinologist to check to see how all your hormones are doing. Together, with your doctor, you'll be able to come up with a plan for your specific needs.

While medications and conditions are major factors for your hormone levels, obviously diet and stress can impact that too.

As far as mitigating the "bad" hormones (it's not that they are bad per se, but they just are not in balance). We'll have to look at this separately for men and women, since men and women have different hormonal needs.

Women & Hair Hormones

Sometimes it might feel like we've gotten the short end of the stick, because there's not really any promising (& safe) pills that we can take for our hair loss.

Perhaps, women's bodies are more complex. Because even though a group of women may be experiencing female pattern baldness, the reasons for each person will be different (which is not the case for men).

Usually, we have to do our due diligence of bringing our hormones back into balance vs. blocking hormones. Most of the time we'll find things like conditions (aka Lupus, Thyroid, or PCOS) causing issues for us.

In which case, we need to manage those conditions more effectively.

Other times, it's our medications like birth control causing the hair loss. Which we sometimes can change or stop all together for other alternatives.

So if you're experiencing enough hair loss that you're truly concerned about, please go see a doctor who specializes in female hair loss. Of course, you can sometimes figure out what's going on with your endocrinologist or doctor, I just find specialists to be more knowledgeable when it comes to things like hair loss.

Having said all of that, there are a few things to try (under doctor recommendation & supervision):

• Estrogen & Progesterone - Again, if your hormones are not in the proper balance, simply taking them to help your body may do the trick.
• Finasteride - Your doctor will know better if it's worth the risk, but IMO it seems particularly risky for women to take. But I get it. Losing your hair as a woman is not fun, and I'd also want to explore any and all potential treatments.
• Androgen Receptor Inhibitors - We have to remember it's risky business messing with our ENTIRE BODY's system, but there are some drugs that are said to help with hair loss through different mechanisms such as spironolactone, cimetidine, and cyproterone acetate.
• Low Androgen Birth Control Pills - These may help regulate the production of ovarian androgens in some people. There is another contraceptive that is cyproterone acetate with ethinyloestradiol, mostly used in Europe to treat female hair loss. However, once you stop the medication the hair loss will return.
• Ketoconazole Shampoo - The brand name is Nizoral, and while it's not great for your hair shaft, it can help your hair follicle. Ketoconazole curbs the production of testosterone and other androgens (if that's why you're losing hair that is).

I think it's worth mentioning that drugs/pills many times simply put a bandaid on a bigger issue. Which means, that we need to put as much emphasis as we can on bringing our bodies to balance. Whether that be with our mental health, or our nutrition & self-care.

Men & Hair Hormones

The major contributing factor for hair loss in men is DHT. It's thought to cause hair follicles to miniaturize — thus, contributing to male pattern hair loss. 

Just as I mentioned to the women reading this, taking medication that affects your ENTIRE SYSTEM is risky business. So please do not go to the black market to get medications (yea, I know how guys are). Instead, partner with a knowledgable doctor who understands hair loss and can help you.

Having said that, there are medications that have proven to be effective for men:

• Finasteride - Works by decreasing the amount of DHT. This is more about stopping hair loss, not necessarily growing more hair (although it can happen). While perhaps less "risky" for men, it does come with quite the laundry list of side-effects (like low libidio, ED, and in severe cases, gynecomastia). But it has been proven to be effective for many men and is FDA approved.
• Dutasteride (Brand Name: Avodart)- Works just like finasteride, BUT it seems to do a better job. It blocks DHT at a much higher percentage. When it comes to side-effects, doctors are saying the two are about the same, but there seems to be debate about "worse" side-effects among those who use Dutasteride vs. Finasteride - many stating Finasteride is worse.
• Topical Spironolactone - Is an androgen receptor inhibitor, and although typically prescribed orally for women, it can be used TOPICALLY for men.

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Solution for Permanent Hair Loss

There's really only one option here, and that's hair transplant surgery. Once hair bulbs/follicles die there is no bringing them back. 

Thus, the only option would be surgery.

Hair transplant surgery works by taking hair from other parts of your body and transplanting them to grow out of your scalp. Not every one is a candidate for this, so yes, you will have to consult with a doctor. 

I'm mentioning this option, not because you didn't know about it (hey, maybe you didn't), but because this surgery has come a long way. People are getting much better looking results. The era of "hair plugs" is no more.

And if you're really depressed about hair loss, and can afford it, surgery may be the best option for you. So don't shy away from potentially good options just because of a social stigma.
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Alternative Treatments for Hair Loss

You might be wondering why this list isn't mentioning some things you may find when you really start digging into alternative hair loss treatments, like rosemary oil.

The things is:  Yes, there's a lot more things claiming to be effective for hair loss but I just can't find enough evidence to really support any of it.

And again, I'd rather not waste your time by listing too many things. That's not to say that a one-off thing won't work for you personally, it's just that I've pretty much covered everything that I believe to be the most effective treatments for hair loss.

You'll already have your work cut out for you just based on everything that we've gone over so far.

HOWEVER, having said that, if you're the person who wants a few more things to try, here you go: 

• Rosemary Oil Topical - There was one study done with low percentage of minoxidil (2%)  being compared with a specifically formulated rosemary oil (not the essential oil which could cause contact dermatitis), and this study showed that the oil was producing similar results to the minoxidil. 
• Pumpkin Seed Oil Oral - Similar to rosemary, a study was done to see if the oil would improve androgenic alopecia, and the conclusion was that it seemed to garner some results but that more studies were needed to prove replication.
• Low-Level Light/Laser Therapy - There are a variety of lights, red light therapy being one, but the efficacy of these still remain to be determined as more studies are needed. There are some FDA cleared hair growth devices (usually meaning that it's safe to use).
• Saw Palmetto Shampoo - For some people a DHT "blocking" shampoo may be helpful. There's again, not a lot of research for this or any real evidence that says its actually effective, but there is anecdotal evidence of people having success. 

To Sum It All Up

Hair loss is a complicated issue. It takes patience to systematically figure out what is going to work for you, and understanding that all treatments take time to work.

There is no one-size-fits all solution. But we know that we can  1.) Attempt to figure out the source of our hair loss & take specific actions to correct it (whether that be any of the external factors and/or internal factors). And 2.) Use treatments that will improve nutrition, blood flow, and/or hormones.

Also, you will most likely need to do multiple things in order to improve your hair loss. There is no one-and-done.

To make things easier for you, I've rounded up some products that I mentioned above that are a good starting place for most people.

*Disclaimer: some, or all, of the products in this are affiliate links, which means I may earn a small commission. Again, I am not a doctor and you should always consult your doctor when looking for treatment, diagnosis, or medical advise.

Kick-starter Product List For Improving Hair Loss

• Minoxidil (2% for Women & 5% for Men)
• Biotin Supplement 
• Collagen Supplement
• L-lysine
• DHT Blocking Shampoo or Ketaconezole Shampoo
• Dermaroller or Dermapen
• Multi-Vitamin for Women

I know that hair loss can be scary and anxiety invoking, which is why I can't let you go without once again mentioning how important mental health is. Please take care of yourself, and don't let yourself stress out over your hair loss. 

Now, I'd love to hear from you! Do you have any questions? Or have you personally found something to work really well that I didn't mention but other people should definitely know about? Tell me in the comments below!

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