Hair loss is more common than you might think. About 40% of my patients have at least some hair loss. Knowing the hair growth cycle is important when trying new solutions for hair loss. Hair growth follows a three stage cycle with an average strand growth of about half an inch per month. This measurement is an average because hair only grows during the anagen phase. At any given moment, about 85% of hair follicles are in this growth phase. The rest of the follicles are in either of the other two phases: catagen (transitioning) phase or telogen (resting) phase. For some individuals, the growing phase lasts as long as seven years. For others, however, it is a little as two years. At the end of the anagen phase, hair strands fall out, and their follicles remain dormant and hairless for about three months. After that, a sprig of hair sprouts, and the growth process starts again. The body considers hair an accessory and in times of stress or illness the body will devote its resources to other vital functions.
Chronic stress can lead to the production of certain chemicals that can shift hair follicles to from the growth to resting phase. Hair loss is also commonly related to estrogen changes that occur in women’s 40s and 50s. Other reasons for hair loss are related to nutritional or caloric deficiencies, such as anemia and thyroid problems.
One of the best ways to assess your degree of hair loss is by performing a pull test. One hundred strands is the average hair shed per day. This shedding includes the natural bulb at the end of the strand, but strands can also shed from split ends and will not contain the bulb. A pull test can be tedious to track, but placing a towel down while combing your hair and remembering pick up any hair that falls out while showering can give you a more accurate assessment. If you count more than 100 strands after performing this test, it is time to see your doctor.
When I see my patients for hair loss, I often start by checking for anemia. It is important that doctors check not only hematocrit iron levels but ferritin level. Ferritin is the storage form of iron. Iron is essential component for red blood cell function, so the body will derive iron necessary for hair growth from storage. Several factors can contribute to iron deficiency.
As we get older, our stomachs slow the production of hydrochloric acid which is necessary for iron absorption. Eating calcium rich foods can also reduce iron absorption because both of these minerals compete for the same gut transporters. Iron absorption from nonheme, plant sources, however, is promoted by vitamin C. I recommend that women who menstruate take an iron supplement to prevent anemia from blood loss.
Beyond nutrition, hormonal changes seen in pregnancy, PCOS, early perimenopause can contribute to hair loss. Talk to your OBGYN about different prescriptions that be used to combat hormone-related hair loss such as oral contraceptives or spironolactone. There is also some research supporting the use of biotin for hair growth.
The best biotin supplements are those you can get through doctor’s offices. Biotin can also be found naturally in eggs, avocados, and salmon. Once nutrition and hormones are taken care of, PRP or platelet-rich-plasma treatment is an amazing strategy to promote hair growth. This procedure involves harvesting stem cell growth factors from your own blood. These factors promote stem cell activity which will then grow more hair follicles. There are several promising studies that support the use of PRP for tissue healing and hair growth. This treatment involves injecting PRP solution into the area with hair loss with one session per month for about four to six months.
The average patients sees about 25-30% new hair follicle growth following the treatment! After our teens and twenties, once hair leaves, it is most likely not going to grow back. Take care of your hair today, beauties!