Hair loss, but why?

There are apparently people who value their hairstyle more than their outfit. Hair does indeed have a major impact on our well-being. Hair loss affects everyone, has a wide range of different causes and, for many people, is an uncomfortable topic – especially if the hair loss occurs early on in life or is very sudden. This is despite the fact that hair loss is a completely natural process.

Before saying any more about hair loss, its reasons and causes, let's start with the solution to the hair loss problem, which is a painful and stressful issue for many people. Actor Telly Savalas, a.k.a Detective Kojak in the TV show “Kojak”, states the solution with a smirk: “A bald head is the best protection against hair loss.” Although, strictly speaking, many bald heads are not actually hairless. There are hair follicles that produce hair under the apparently bald area. They just aren’t the thick, visible hairs, but rather, fluffy vellus hairs, which people don't notice.

OK, of course, this is not a serious approach and to be honest, the topic isn't really funny either. And it’s certainly not new. Our ancestors from distant eras also had to deal with balding and thinning hair. Even so, to this day, the mystery of hair loss has not been fully investigated. New findings are constantly emerging and helping to uncover the causes, effects and solutions.

We humans have plenty of hairs, several million of them. And apart from our hands, lips, the soles of our feet, fingernails and toenails, they are all over our bodies. More specifically, hair, both long and tiny, can grow on up to 96% of our skin surface.

Natural hair loss

Our relationship with our hair is one of continual coming and going. Although you lose around 70 to 100 hairs a day as a result of completely natural hair loss, around 85-90% of all the existing hair on a person is in its growth phase. This level of hair loss has no impact on your appearance because it simply isn't noticeable. The hair shaft, the visible part of the hair, keeps us looking good.

Apart from this natural type of hair loss, there are other types, which have varying degrees of severity. The causes of hair falling out we need to mention here are genetic, related to illness or self-inflicted. In any case, we recommend that you consult a dermatologist if you believe you are losing more hair than normal.

Do you have the feeling that you are losing more hair than normal? Find yourself fishing out individual hairs from the bathroom sink in the morning or constantly having to remove hair from your brush, for example? If this is the case, this is what dermatologists refer to as "effluvium" – a medical term for hair loss. Virtually no one counts the number of hairs they lose in any given day, but a figure of 100 or more counts as "effluvium".

The German Association for Skin and Allergy Support lists some other causes:

Stress
Diet
Prolonged malnutrition
Side effects of a disease (e.g. infections, psoriasis)
Medication (e.g. antibiotics)
Chronic diseases (e.g. diabetes, thyroid disease)
Anemia
Metabolic disorders
Cancer
Poisoning
Hormonal changes

In many cases, hair loss more or less stops by itself. If, for example, medication, stress or malnutrition are responsible for the temporary hair loss, you will get your luscious hair back again as soon as the triggers that were responsible in the first place have been changed or removed.

Not all hair loss is the same. If you find yourself obliged to deal more closely with this subject, you will come across many technical terms. To shed some light on these, we’d like to take a quick look at a few selected hair loss types here in our little Hair Care Universe.

Anagen effluvium

Hair loss occurring a few days to weeks after the trigger event. One example is taking medication, or also especially radiation therapy and chemotherapy. The hair follicles become damaged, leading the hair to fall out. Often, the affected person may lose their hair completely. However, the growth process can be "restored" and the hair can grow again, Due to the length of the growth phase, though, it can take a while for your former luscious hair to be visible again.

Telogen effluvium

This is where the hair that is in its resting phase falls out. This usually lasts three months, during which time combing and brushing causes the hair to fall out. This is a completely natural process. Specific triggers, such as stress or a fever, can lead to an increased level of hair loss. However, it is delayed and not immediate.

Androgenetic alopecia

With this type of hair loss, the hair follicles have a hypersensitive reaction to the hormone DHT (dihydrotestosterone, a metabolite of testosterone). This leads to follicle shrinkage and degeneration, with only vellus hair forming in its wake (if at all).

Androgenetic alopecia (hormonal and hereditary) in women

During menopause, women have to contend with numerous health issues. Hair loss may be one of them. Major hormonal changes cause estrogen levels to decrease and the levels of male hormones to increase, resulting in thinner hair and hair loss. This leads to additional mental strain for women experiencing menopause. As mentioned in the introduction, hair is extremely important for every person. This hair cannot be expected to "grow back”.

During pregnancy too, the condition of your hair or its growth will change. Due to the increase in your estrogen level, more hairs than usual will enter the growth phase, resulting in hair that is thicker than normal. However, this is reversed after birth and the temporarily thicker hair thins out again. In most cases, the hair loss is really only temporary. A similar phenomenon occurs after women stop taking the pill. In this situation too, the hair count changes.

Androgenic hair loss in men (androgenetic alopecia)

Hey men, how often do you compare your old pictures with what you currently see in the mirror, gently run your hand over your temples and sigh at the sight of your ever dwindling hair? We are talking about a receding hairline here, which hurts, there is no doubt. After all, who wants to put up with seeing more scalp than hair, especially on the sides? Unfortunately, this form of hair loss is one of the forms where you can’t hope for spontaneous recovery. No hair will grow again here in the future unless you decide to have a hair transplant. It is not uncommon for the end result to be a bald head.

No, we don't see this as the ultimate protection against hair loss. This form is not caused by illness; it is hereditary. The age at which this happens is unpredictable. It affects some men in their 30s, others in their 50s, or even only in old age. Men with this hormonal type of hair loss can virtually experience the opposite effect if, for example, they undergo hormonal treatment for prostate cancer. In this case, the hair loss is stopped or does not occur at all. This is another example of the influence that hormones can have.

Alopecia areata – circular hair loss

This hair loss disorder results in circular bare patches entirely free of hair on the scalp after an initial period of burning and itching. This affects both men and women, and can appear suddenly, even in young adults. In Germany, it affects more than 1 million people. It cannot be cured, or rather there is no proven cure. However, a spontaneous recovery can occur. The problem usually persists for an extended period of time. Even after it goes away, there is still always a chance of new, further phases of this circular hair loss. Nothing much is known about the exact causes of alopecia areata, however, researchers suspect it might be related to autoimmune diseases. Some affected people also suffer from other autoimmune diseases (neurodermitis, vitiligo/white spot disease).

Alopecia areata universalis

Loss of all head and body hair

Alopecia totalis

Hair falls out over the entire head area, including eyelashes and eyebrows.

Diffuse hair loss – diffuse alopecia – alopecia diffusa

In contrast to the almost structured retreat of hair with androgenetic alopecia, hair loss is fairly uniform in the diffuse variant. Diffuse hair loss can occur due to several reasons. These include medication, hormones, fever, and thyroid diseases.

Scarring alopecia

The hair breaks down in certain areas and the hair follicles are damaged or destroyed, creating small scars. The damage appears to be the result of inflammation, which can be caused by various factors, such as bacteria, fungus, or environmental influences.

Traction alopecia is also in this category of alopecia and is one of the self-inflicted causes of hair loss. Hairstyles can trigger this, among other things. If ponytails, buns, braids, extensions, and so on, are tied too tight or are too heavy for the hair roots to support, damage can occur over time to these specific hair roots. Constantly wearing caps, hats, and dreadlocks also poses risks. The cause is therefore purely mechanical in nature, and cannot be attributed to any medical condition.

Trichotillomania

Hair falls out due to deliberate pulling or plucking. Psychological factors, such as stress, anxiety, depression are the cause here, and need to be addressed with a specialist.

Trichophagia – Rapunzel syndrome

This psychological illness is a type of obsessive-compulsive disorder. Young women are especially susceptible to this disorder, which consists of swallowing and eating one's own hair. If this occurs over a longer period, this can lead to significant health issues. In the most severe cases, it can result in death. Hair is unable to be digested by the human body and accumulates in the stomach. An operation to remove it may therefore prove necessary. In any case, it is advisable to seek medical and psychological help with this disorder.

Please note: This information in no way constitutes medical or cosmetic advice. Consult your GP, dermatologist, or pharmacist for further information and advice before obtaining any remedies or preparations from the Internet for self-treatment.