They get matted on the brush, fall into the sink and hang on the sweater. Almost everyone suffers from hair loss at some point in their life. Our columnist and pharmacist knows what to do.
Wasn’t my braid much thicker? Is it normal to have SO many hairs in the brush, in the sink, in the sink? And, shriek, is what I think I can clearly see my scalp? My experience is that very few people remain relaxed when these questions come up. The vast majority are alarmed, some in panic, when they come to the pharmacy.
Behind the sales counter you then have to ask two questions: Do you notice individual bald spots, or is the hair falling out over a larger area? And: Has this been going on for longer than about three months? In the first case, a doctor needs to take a look at it, ideally as soon as possible. In the second one you can wait a bit. Because everyone loses more hair at times, for example this is typical in autumn. And for some the fluctuations are large. There are simply phases in life when you see more hair on the ceramic. But this regulates itself after a few weeks or months. And up to 100 hairs a day is considered completely normal anyway, that’s quite a few.
However, if the problem has been going on for a long time, I would advise the customer to find a dermatologist who is familiar with the topic of hair. There are special hair consultations both at dedicated dermatologists and at university hospitals. Make an appointment. Hair loss can have many causes that are treated very differently. And as soon as your problem goes beyond seasonal hair loss, the sooner you start, the more you can achieve.
Iron, zinc, vitamin D and biotin can be useful
Until your appointment with the dermatologist you are in good hands at the pharmacy. I’m not a big fan of supplements, but I think they’re a good idea. For example, iron, zinc, vitamin D and biotin can be useful – the body needs all of them to produce healthy hair. However, nutritional supplements are particularly beneficial if there is also a nutrient deficiency. Biotin in particular almost never exists, even though it is contained in many hair and nail products. Vitamin D deficiency, on the other hand, is nothing unusual.
Zinc deficiency can also occur. And iron deficiency – which is not uncommon among vegetarians because meat contains a lot of iron – is one of the common causes of poor hair growth and hair loss. Ultimately, it leads to anemia or less oxygen in the blood. And that immediately causes the body to downregulate processes that use a lot of energy. Like hair growth, for which cells have to divide quickly.
But discuss this topic in the hair consultation. I don’t want to recommend anyone to take dietary supplements on their own, it’s easy to take too much zinc in particular. And a deficiency can only be detected with a blood test.
Good sleep makes hair grow
What you should also do: Stop working all night long. The hormone melatonin, which is mainly produced in the dark, apparently plays a role in hair growth. Maybe this is a relic from cave times: in winter, when it’s dark for a long time, you need more fur. Not only daylight, but also artificial light inhibits melatonin production. Getting enough sleep is a factor for beautiful hair that hardly anyone considers. But there are also hair serums with melatonin that aim to improve growth and structure. And I wouldn’t be surprised if someone who likes the new sleep sprays etc. with melatonin feels like their hair is fuller.
Of the medications, I only want to discuss minoxidil here because it is available without a prescription for external use for hair loss. The active ingredient really helps many people if you take it early enough. Minoxidil was first used as a tablet to lower blood pressure until it was noticed at some point that users’ hair grew better. The active ingredient also expands the blood vessels in the scalp so that the hair roots are better supplied with nutrients again, which is at least part of the suspected principle of action.
The aim of using minoxidil is to stimulate the hair to grow again, which is actually already in the four-month resting phase, at the end of which it naturally falls out. It can also increase the cell division rate locally, the hair root enlarges and produces thicker hair again.
Solutions or foams are used to treat hair loss. But be careful, you really need to wash your hands well after applying the product to dry hair, and it’s best not to use minoxidil right before bed. Because if you spread the active ingredient on the pillow and therefore all over your face, hair can sprout there too. Other possible side effects include skin rash or itching, and some users have an allergic reaction, especially to a certain component of the solution, propylene glycol.
From antihypertensive to hair growth agent
Important to know: Minoxidil only works as long as you are being treated. And: If more hair suddenly falls out after about five weeks of treatment, that is not a bad sign, but on the contrary an indication that you are responding well to the treatment. The reason for the so-called shedding effect: Normally, every hair grows according to its own rhythm, but with minoxidil, a lot of new hair suddenly pushes out a lot of old, loose hair from the scalp at the same time. This is exactly what can make diagnosis more difficult if you have been taking minoxidil for a long time.
So everything speaks for an appointment for the hair consultation as early as possible. The problem is systematically addressed there: Were there serious illnesses or treatments? Does the hair only fall out on the crown? What does the scalp look like, what does the hair look like under the microscope? You can determine how high the proportion of hair is in the resting phase and thus precisely predict what will happen in the next few months. Blood is often taken, not only because of the vitamins (see above), but also, for example, to detect thyroid levels that are too high or too low and increased testosterone levels.
By now it is usually clear what you are dealing with. The immune system is to blame for circular hair loss, alopecia areata. Diffuse hair loss can have many reasons, from iron deficiency to medications such as the antibiotics nitrofurantoin and erythromycin, but also very common cardiovascular drugs such as statins and ACE inhibitors. The list is long and is on the highly recommended side www.haarmedizin.de.
The most common form of diffuse hair loss in both sexes is hereditary hair loss (androgenetic alopecia, AGA). The name itself suggests that predisposition and hormones (androgens, specifically testosterone and its breakdown product DHT) play a role.
Stress causes hair to shrink
Incidentally, a termination, a separation, a bereavement or any other type of stress can also cause your hair to grow worse, become thinner or fall out; as well as a strict diet or an infection with a high fever. This usually becomes noticeable about four months after the event, when all the hair that was already in the resting phase has fallen out and it becomes clear how the head has fared since then. And: Over the years, hair becomes thinner and more brittle, just like bones. However, unlike bone density measurement, there is no standard here. And the point at which someone begins to notice the changes and suffer from them varies from person to person.
But I don’t want to leave here without offering an immediate solution for crisis situations. Do you know stray hair? This is available in well-stocked drugstores and perfumeries, in many colors. You can simply sprinkle it on the areas where the scalp starts to show through. This can immediately reduce suffering.
Note: The column cannot provide individual advice Pharmacy replace the package insert or the medical diagnosis and treatment.